Dave Burke

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Five years ago, Dave fell at work, landing on concrete while holding a heavy object. The injury caused constant low back pain, neck pain and shoulder pain. Dave’s job required lifting and he couldn’t lift over 20 pounds. He felt humiliated by the perception that he faked pain to avoid work. He couldn’t support his family. Bills piled up and savings were exhausted; he was devastated.

Previous Treatment

Dave went through two lumbar decompression surgeries, multiple epidural and lumbar facet joint injections, several courses of physical therapy and a work hardening program. Daily medications included Percocet (an opioid), Flexeril (a muscle relaxer) and Lyrica (an anticonvulsant used off-label for pain relief). Dave was also due for a trial spinal cord electrical stimulator implant.


Dave’s nurse referred him to Mike Caruso. Right away, we knew we had to attack this from a different physical and psychological place. Based on a functional movement pattern assessment that revealed previously undetected deficits in hip and trunk mobility, Dr. Caruso approached his therapy in strategic steps. Dave learned to move his hips and upper back in ways that spared his lower back. He committed to a home exercise program that included photographs and instructions.


Dave performed his exercises and made significant progress. His upper trunk and hip mobility improved and he walked and sat with less pain. He asked his doctor to reduce his meds. Over a few weeks, Dave refined his postural alignment while lifting, retrained core muscle endurance, and worked on building his spine’s capacity to carry a load.


When we re-tested Dave’s lifting ability, it was amazing. He comfortably lifted 60 pounds from the floor. This was a 300% functional improvement in four months compared to the five years of previous treatments. Dave progressed to a medium-heavy work level and focused on stopping opioids and returning to work full-time. He achieved both goals and continued with his home exercise program.


Still, Dave’s pain doctor was unconvinced – though progress reports and Dave’s own statements proved otherwise – and recommended the trial  spinal cord stimulator implant. The trial did provide additional relief, but Dave chose to forgo a permanent implant and concentrated on his self-care skills.  He also reduced his daily opioid use.


Dave successfully improved his physical capability and returned to work full time, leaving behind five years of daily opioids, constant pain and poor functioning. Dave learned to tap his own internal resources to overcome disability and restore his autonomy and self-efficacy – an achievement he will value forever.