Case Study: Back Pain

Overview

wrist pain

A young office worker was reaching and twisting under her desk for a wastebasket and had immediate onset of lower back pain with radiation into the left buttock and left leg. Pain was most significant in the left sacroiliac (SI) joint. We saw her for a first appointment five days after the initial injury. Because of her symptoms, there was an initial concern of lumbar disc injury with nerve impingement. Her gait was altered and uncomfortable. In addition, she could not sit comfortably for any length of time. Hip and leg measurement showed a rotational pelvic obliquity.

Solution

We taught her a pelvic self-mobilization routine and she was able to correct the obliquity on the first try. We went over proper stretching technique and started her on a routine to address tightness in muscle groups about the lower back and

hips. She showed significant tightness and unusual range-of-motion restriction in the hip flexor and quadriceps muscles.

Results

We saw her again in one week. Her pelvic alignment was still good, her gait was improved, and she could sit more comfortably. But there was still pain in the SI joint and new pain in the anterior hip and deep buttock. We modified her hip flexor stretch and added a stretch for a lateral hip rotator muscle, which seemed to be an improvement immediately. We also evaluated her workstation for ergonomic factors and recommended a lift under her monitor as well as adjustments for her chair.

Conclusion

We saw her for a final time two weeks later. Her back pain was gone with only tightness remaining and she was having no trouble sitting at all. She was doing the stretches as needed when her back started to feel tight. Stretches were reviewed a final time and we discussed body mechanics alternatives for reaching her wastebasket that did not involve reaching and twisting. The initial concern about disc injury turned out to unfounded. She was well on her way to a full recovery and no further appointments were necessary.