The treatment of pain is a response to the systems at work in the body. To accomplish homeostasis, the body’s intelligence compensates in many ways to keep us moving and surviving. These compensations happen at every level, with symptomatic expressions at every turn. For this reason, as much as treatment can be considered an “art” (with every practitioner having their own approach) treatment should also be understood from a clinical systems perspective. Today we will demonstrate this concept through a recent Case Study in our office.
PATIENT ZERO
Our client was experiencing sciatica-type pain in their left hip as well as circulatory challenges in their left leg and foot. They have had multiple traumatic injuries over the years, including a major fall, car accidents, and two abdominal surgeries (one on the left side). The patient reported increasing sharp pain at the TL (thoracolumbar) junction of the spine and in their lower back for multiple weeks with a recent worsening after attempting a light 2K jog-walk workout. Their left ankle was swollen, causing discomfort – although weight-bearing was possible.
A stretching and movement protocol was followed after a massage and multiple joint mobilization sessions. Heat therapy was administered to the low-back and hips, ice therapy to the ankle and foot. In the end, the runner’s stretch (in a deep lunge) seemed to have the most impact in lessening the pain and tightness. So, although the pain was experienced in the lower back, it is actually stretches and pressure administered to the front of the hip and abdomen that relieved this client’s pain. However, it did not correct the issue permanently.
THE CULPRIT
Throughout this investigation, Patient Zero and our therapists deduced that the presenting issues were resulting from the Psoas Major, a main stabilizing bundle of fibers that is part of the hip flexors. At its uppermost point, the psoas attaches at the TL (thoracolumbar) junction in the spine and, at its lowest point, attaches to the lesser trochanter (at the top of the femur). Systemically, problems with this important stabilizing and interconnected bundle of tissues come from several different influences. Internal and external stresses to muscle, bone, visceral and connecting tissues as well as emotional trauma can all have a negative impact on the function and flexibility of this area.
Although this client’s concerns continue, treatment is ongoing. We encourage all clients to consider the effect of their body’s systems as we work with them to address the presenting issues. Due to the layers of contributing factors, systemic issues need to be addressed with systemic treatments over time – they can not be solved immediately.
If you are experiencing pain and discomfort from an old injury or repetitive strain, you may need systemic treatment from our Osteopath, Registered Massage Therapists, Reflexologist, or Movement Therapist. Send us an email with inquiries to admin@riverofliferehab.com or book an appointment through our online system here: https://bit.ly/4azHTta
