Osteopathic Treatment Technique : Case Study - Persistant low back pain

Summary

This video discusses a 35-year-old male with persistent low back pain that lasted for six months. Despite local treatments, his pain persisted until the practitioner investigated a previous shoulder injury. The issue was traced back to a contracted latissimus dorsi muscle, which had affected the sacrum’s function and contributed to the pain. By releasing tension in the lat muscle and addressing related areas like the pecs and sacrum, the patient’s pain resolved. The case emphasizes the importance of a holistic approach in treating musculoskeletal pain, considering the interconnectedness of the body’s structures to achieve long-lasting relief.

Takeaways

• 😀 The patient's persistent low back pain was initially unclear in origin, and previous treatments did not yield lasting improvement.
• 😀 A key detail in the patient's history was a stumble on the stairs that caused a yank on the arm, leading to shoulder pain that had since resolved.
• 😀 The latissimus dorsi muscle plays a crucial role in influencing the sacrum and low back, which was initially overlooked in the treatment approach.
• 😀 The contraction of the latissimus dorsi muscle, resulting from the arm yank during the stumble, caused dysfunction in the sacrum and lower back.
• 😀 Focusing on the latissimus dorsi muscle and its impact on the sacrum helped to break the cycle of recurring low back pain.
• 😀 Manual techniques targeting the latissimus dorsi muscle, including working on the muscle's attachment points, helped restore normal function in the low back.
• 😀 When treating low back pain, it's essential to consider the entire body and not just focus on the affected area.
• 😀 The connection between the shoulder, latissimus dorsi, and low back (sacrum) was critical to resolving the patient's issue.
• 😀 A holistic approach was necessary for the successful treatment of the patient's low back pain, looking beyond the local pain site for underlying causes.
• 😀 After treatment, the patient was advised to be cautious not to over-exert themselves and risk reverting to their previous state of dysfunction.

Q & A

What was the primary complaint of the patient in the video?

The primary complaint of the patient was persistent low back pain, which had started about six months ago.

What made the case challenging for the treating practitioner?

The case was challenging because despite three treatments, the patient's low back pain wasn't improving, and the root cause was unclear at first.

What key detail about the patient's history was uncovered during further investigation?

The key detail uncovered was that the patient had a stumble on the stairs a couple of weeks before the onset of the pain. Although they had shoulder pain at the time, it had resolved and wasn't initially linked to the low back pain.

Why was the shoulder injury important in the context of low back pain?

The shoulder injury was important because it led to tension in the latissimus dorsi (lat) muscle, which is connected to the sacrum. This muscle contraction contributed to the dysfunction in the low back, preventing the sacrum from functioning properly.

How does the lat muscle influence the sacrum and low back?

The lat muscle, when contracted due to an injury like the shoulder yank, pulls on the sacrum, causing dysfunction in its relationship with the innominate bone and the L5 vertebra, which can lead to low back pain.

What treatment approach did the practitioner use to address the issue?

The practitioner focused on releasing tension in the lat muscle by addressing its attachment at the shoulder, as well as the related shoulder muscles. This helped restore function in the sacrum and alleviate the low back pain.

Why is it important to address both the shoulder and the low back in this case?

It's important because the issue with the low back was not isolated. The shoulder injury was the root cause, and addressing only the low back wouldn't have resolved the underlying problem. A holistic approach was needed.

What specific techniques were recommended to release tension in the lat muscle?

The practitioner recommended hands-on techniques, including working on the lat muscle insertion and using functional movement to release the muscle tension. This involved extending the arm and working at the muscle attachment to the humerus.

What was the post-treatment advice for the patient?

The patient was advised to avoid overexerting themselves for a couple of weeks, gradually returning to activity. The goal was to maintain the improved function without causing re-injury by doing heavy physical activities too soon.

What broader lesson can be learned from this case for practitioners?

The broader lesson is that musculoskeletal pain, like low back pain, may not be caused solely by the area of pain itself. A holistic, whole-body approach is necessary, and a thorough history and examination can help uncover underlying issues in other parts of the body, such as the shoulder.