This is a case report details how treatment for low back pain that effectively combines the correct physical therapy intervention with the appropriate massage can dramatically improve results. This patient came to me after having low back pain for months due to posing practice for a figure competition.
She was unable to bend forward to perform tasks as simple as putting on her shoes. She also had a lot of pain with getting in or out of her car and sneezing. We combined physical therapy with her regular massages and had complete resolution of symptoms and return to all activities after just two visits.
Her pain was located mostly on one side of her low back and travelled into the sacroiliac joint (between the hip bone and tail bone). There was muscular spasm on the involved side of the back accompanied by a rotation of the pelvis and decreased mobility of the lumbar spine.
Treatment 1: Trigger point manual therapy to the low back followed by a pelvic correction, and then exercises to maintain the correction and decrease the spasm.
One week later…
Her motion had improved from 50% to 70% (100% being what would be normal for someone of her age and ability). She was able to put on her shoes without as much pain but still felt very stiff and restricted. Her pelvis had maintained its’ corrected position which allowed for us to focus treatment to the spine.
Treatment 2: She had gone to her massage therapist the day before treatment 2 and they focused a lot on the spasms in the low back. This allowed us to focus exclusively on restoring joint mobility and following this up with exercises to re-establish the coordination.
One week later…
With regular repetition of the exercises to maintain the changes made, she was back to fully functioning in her regular lifting and cardiovascular exercise routine.
Discussion: A pelvic rotation is often accompanied by low back pain, muscle spasm, and unilateral hip weakness due to the changes in muscle alignment. When correcting a misaligned pelvis it is essential to have the correct exercise prescription to hold the alignment.
Focusing treatment for low back pain on just the back or pelvis, or just the muscles or joints is a surefire way to get temporary and meaningless results. By simply addressing the muscular spasm or joint restrictions in the low back, temporary relief may be achieved but no lasting results, and the same goes for simply addressing the pelvis.
After any joint mobilization or corrective massage, the correct exercises must be utilized to maintain those changes made. This is where combining therapies can be the most effective treatment for low back pain. While any one practitioner may only have enough time to administer their own treatment (massage, chiropractic, acupuncture) by combining any one of these treatments with corrective exercises you can be sure to have superior, lasting results in a shorter time frame.
This case was completed in two visits with The Doctors of Physical Therapy located in north Scottsdale, AZ.