Constant Back Pain?
There are a group of people in society that live with constant low back and pelvic pain that cannot be diagnosed via conventional orthopedic, neurological, or Chiropractic examinations. This pain can be an annoying ache all day long or a severe debilitating pain that affects all activities of daily living. So they live with constant discomfort after seeking relief from professionals they thought would surely reduce their pain.
Examples
Three women I treated last year even visited the emergency room (ER) because their pain was so intense, but they too left the hospital with undiagnosed pelvic pain. Muscle relaxers and pain medications prescribed by the ER doctors were unable to reduce these ladies discomfort. Another female patient consulted me wondering if I could decrease her back pain that she had suffered for 33 years. Thirty three years of back pain undiagnosed by professionals. One neurologist she consulted even prescribed antidepressants because he thought she was seeking attention. But this problem is not isolated to the female population. I have seen both sexes young and old with this disorder.
What Causes This
These patients present with a variety of symptoms. They might have a dull-severe pain in their low back that is not reduced or eliminated by Chiropractic adjustment. They may have pain in their pelvic region that is not curtailed with any medications including the previously mentioned muscle relaxers, pain medications, or antibiotics in case of an infection. I have treated patients with lateral hip pain that refers to their knees, or they can have nauseating groin pain. The symptoms may vary but the cause is always the same. Tightened illiopsoas (psoas) and iliacus muscles commonly referred to as the Core muscles by exercise enthusiasts. These two muscles are the cause of the mysterious pain afflicts these people.
Diagnosis Details
The psoas is a muscle that is not easily palpated, which explains why most physicians have difficulty diagnosing this problem. The psoas and iliacus are located in the anterior hip region beneath the rectus abdominus, and oblique muscles as well as the small intestine and colon. The psoas originate at the antrolateral aspect of thoracic vertebrae 12 and all five of the lumbar vertebrae inserting with the iliacus at the lesser trochanter of the femur. See Figure 1.
These muscles are hard to locate and palpate, let alone treat. As mentioned previously these muscles are referred to as the Core muscles and they provide very important functions for the human body. The psoas and iliacus both initiate flexion at the hip. The psoas also provides flexion of the upper body in the same way as the rectus abdominus. Essentially, the psoas provides a fulcrum or bridge between the upper and lower bodies. Because they provide such important functions it is easy to understand how they can cause severe pain and discomfort when they are pathologic or in contracture.
How it Happens
Contracture occurs when a muscle shortens during contraction for extended periods of time, but does not return to a normally relaxed flexible state. This can occur in people who sit for extended periods such as those who key data into a computer all day long. The myofilaments (the contractile bands that move upon each other during a contraction) of these muscles can become fixed via adhesions between the bands making contraction and relaxation of these muscles impossible.
Contracture can also occur from an injury. If a muscle is strained or a contusion occurs this can also result in contracture and the formation of trigger points. Trigger points form after a muscle is injured from over work, muscle strains, and the aforementioned contusion. Trigger points are tight hypersensitive knots or bands within the area of injured tissue consisting of fibrin (scar tissue) from the inflammatory process and contracture, making the muscle ischemic (lacking in oxyegenated blood flow).
Post partum mothers can experience contracture of the psoas and iliacus because during pregnancy the developing fetus lies on these muscles causing them to contract in a guarding fashion. That is why mothers can experience ongoing back pain long after the baby is born. An example of contracture of the psoas can be seen in those people who walk with an anterior body posture typically seen but not limited to the elderly.
Man's Best Friend
Another group of sufferers from this problem are dogs. Yes, dogs. I had one patient several years ago that called to cancel his appointment because he needed to take his dog to the vet to be euthanized. He was very upset, so I asked him what kind of symptoms his dog was exhibiting. He said his dog (a female Rottweiler named Six) had difficulty walking and was in obvious pain, so he concluded it would be best to put his ten year old dog to sleep. I suspected it might be something I could help my patient correct, so I asked him to bring Six to my clinic.
After a little palpating of the psoas, I found them to be extremely tight, and Six didn’t want me touching them either. So, I instructed my patient in the proper technique to massage his dogs psoas, which were in contracture for about a half hour.
She wasn’t back to normal, but she managed to limp back to the car after my patient finished massaging her muscles. My patient was very happy, and after a couple more sessions, Six was walking daily on Cottonwood Beach in Washougal, WA. Six lived another three years.
After a little palpating of the psoas, I found them to be extremely tight, and Six didn’t want me touching them either. So, I instructed my patient in the proper technique to massage his dogs psoas, which were in contracture for about a half hour.
She wasn’t back to normal, but she managed to limp back to the car after my patient finished massaging her muscles. My patient was very happy, and after a couple more sessions, Six was walking daily on Cottonwood Beach in Washougal, WA. Six lived another three years.
Treatment of this condition is an involved process that includes hot packs, cross fiber, deep tissue, and effleurage massage techniques. Chiropractic manipulation; and stretching exercises . These procedures can return the muscle to its pre-injury status. The amount of time needed varies between patients. Usually, if patient has had this condition for a prolonged period of time, it may take longer for him or her to recover. The ladies mentioned earlier that visited the ER recovered in three to four treatments, and the lady that had this problem for 33 years was feeling no pain after seven treatments. But, patients do vary in the recovery process.
On my web page: deeptissuechiropractic.com you can read some testimonials from patients who have received relief from this disorder and continue to stay well, as long as they continue doing their exercises.
If you have these symptoms or questions concerning your malady, please feel free to call
Deep Tissue Chiropractic at (360) 513-7818.
