60 y.o. female with onset of R lower back pain and sciatica with 8/10 pain to the level of the foot approximately 10 months earlier without apparent injury or trauma. Treatment to date has been PT, massage, physician, imaging, and 2 chiropractors without any change in her symptoms. She underwent a lumbar MRI that revealed disc herniation at L5-S1. Subsequently, she tried a third chiropractor who did lumbar decompression traction for several sessions, which made her chronic low- back and sciatic pain much worse. At that point, she was referred to our clinic by a co-worker who had been treated with an excellent outcome.
An evaluation revealed lumbar segmental dysfunction at multiple levels, a R on L sacral torsion, R psoas spasm, R kidney ptosis, ascending colon and cecum restriction, and a R ilial inferior shear (down slip).
Treatment entailed treating the dysfunction listed above. I started with the R ilia inferior shear, the kidney, and the psoas, as the psoas are related to kidney mobility.
Outcome: the patient was 75% improved a few days after the initial treatment. She was treated approximately 8 times to work out all of the abdominal visceral dysfunction, the lumbar spine, and the sacrum. The final outcome was a complete resolution of her symptoms.
Takeaways: the R ilial inferior shear was very important in this patient, as they usually are. In her case, the lumbar traction performed by the chiropractor further irritated this by taking the ilia further inferior on a strain level due to the pelvic harness that was used. Inferior shears of the ilia are VERY REAL and do exist…..gravity does not correct them as some people think. I see about 10 of these per year, and they wreak havoc on the body. The correction of inferior shears is easy and non-traumatic for the patient.
When the ilia shears inferiorly on the sacrum, it places tension on the SI and sacrotuberus ligaments as well as the lumbar and sacral nerve roots = sciatic symptoms. The R kidney, ascending colon, and cecum restrictions are often involved with ilial lesions, so these have to be treated out as well. The ptosis of the R kidney, in this case, was a severe lesion as it is a “shear” vs. a rotation or side bending dysfunction = more problems for the body to deal with. Psoas spasm creates a buttress effect on the SI joint as it crosses anterior to it.
So…….hope you got something out of this case study. It very well illustrates the interdependent function of the abdominal visceral system and the musculoskeletal system. You must treat both for an effective treatment outcome in many of our patients. Have fun !!
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