The AAO Journal, 2023/06, 33(2):12. doi: 10.53702/2375-5717-33.2.10, type of study: ,cr,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

Free full text   (https://meridian.allenpress.com/aaoj/article/33/2/10/493538/LBORC-NUFA-Poster-Abstracts-2023-Residents)

Keywords:

case report [736]
female [654]
low back pain [523]
OMT [3924]
osteopathic manipulative treatment [3945]
women [607]

Abstract:

Introduction/Background: The sacrum has 5 separate segments at birth that begin to fuse around age 18 with complete fusion around 30 years of age. Although much attention is given to sacral dysfunctions, osteopathic literature and teaching focuses on treatment of the articulations or motion of the whole sacrum, rather than intersegmental sacral dysfunctions. Case: GG is a 19 year old cis female who presented to our outpatient clinic with 8 months of constant, severe, low back pain. Onset was insidious, although she is a college basketball athlete with a significant history of left leg genu valgus and leg length discrepancy status post multiple corrective surgeries at age 12. Previous treatments were chiropractic, physical therapy, and athletic training care which included cupping, dry needling, and use of a TENS unit. Medical management included NSAIDs, muscle relaxers, and topical creams and patches. None of these provided relief and she was forced to limit her activity. Examination revealed a complex intersegmental sacral somatic dysfunction. Osteopathic treatment was performed applying balanced ligamentous principles to each sacral segment. Results: The patient had significant reduction in pain after one treatment and complete resolution of pain after her second. She was able to return to her full training and competition schedule. Discussion: We theorize that the patient had intersegmental sacral dysfunctions that were not painful until sacral fusion began. This case highlights the importance of identifying and treating these types of sacral dysfunctions, especially in the pediatric and young adult populations. Anatomy literature addresses sacral segments and fusion but there is an opportunity for osteopathic thought in this area as current teaching and literature does not address intersegmental sacral somatic dysfunction.