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Tackling Structure and Function with an Osteopathic Approach: A Patient with a Herniated Lumbar Disc and a Small Hemipelvis

Journal: The AAO Journal Date: 2023/06, 33(2):Pages: 21-22. doi: Subito , type of study: case report

Full text    (https://meridian.allenpress.com/aaoj/article/33/2/20/493544/LBORC-NUFA-Poster-Abstracts-2023-Students)

Keywords:

case report [514]
hemipelvis [1]
hip [316]
low back pain [413]
male [479]
OMT [2951]
osteopathic manipulative treatment [2973]

Abstract:

Introduction/Background: A systemic review and meta-analysis in 2005 concluded that Osteopathic Manipulative Treatment (OMT) could significantly reduce low back pain. This case examines how an osteopathic approach is implemented when OMT initially fails to result in long-term improvement. This case also discusses the use of non-invasive Spinal Decompression Therapy (SDT) combined with OMT. Case: A 54-year-old male presented to the clinic with complaints of lower back pain that started over 5-years ago. He described the pain as chronic and aching. Physical exam identified a right, small hemi-pelvis, as well as several other somatic dysfunctions. The pain had been mostly located in his lower back until it suddenly changed and started radiating into his right hip. OMT, which previously had been successful in relieving the pain, no longer provided relief. Due to the alteration in the pain pattern and the lack of response to OMT, imaging was attained. The imaging results included a paracentral fourth lumbar disc extrusion that had migrated caudally and was approximating the right fifth lumbar nerve root. A combination of OMT, non-invasive SDT, and the exercise prescription were utilized to treat the patient. Results: The patient’s hip pain resolved in the second week of treatment and his back pain resolved in the fourth week. This outcome was attained by addressing biomechanical pathologic findings treatable by applying an osteopathic approach. Discussion: This case demonstrates the treatment of lumbar radiculopathy from a lumbar disc herniation using a combination of OMT and non-invasive SDT. This study is limited by being a single case. Future research using a similar osteopathic approach that is placebo-controlled with an appropriate sample size would be beneficial.


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