Low Back Pain

Presentation

A 69-year-old male patient presented with a history of chronic low back pain. As a professional writer, his job required him to sit most of day. Over time he had developed a slumped posture resulting in reduced abdominal strength and tight hip flexors. He had also gained weight in his abdomen, which added to his symptoms.

Evaluation, clinical reasoning & treatment strategizing

X-rays revealed no major disc abnormalities or any otherwise more serious pathologies. All muscles that cross the hip and lower back region were examined for trigger points and functional length, especially hip-flexors, TFL, gluteals, erector spinae, quadriceps, quadratus lumborum and both the lumbar and sacral multifidi.

Treatment

Manual NMT treatment commenced on the above muscles at weekly intervals for eight weeks. Active-Isolated Stretching was recommended with gentle lumbar extension movements. Changes to desk ergonomics were recommended and the patient used the “Brűgger relief exercise” to correct seated posture. Weight loss further reduced the strain on his low back.

Outcomes and Follow-up

After one month, symptoms were reduced to simply one hour of stiffness in the morning. The patient stopped taking NSAIDs (non-steroidal anti-inflammatory drugs) by the end of the second month of treatment. We referred him to a strength and conditioning specialist for advanced flexibility and lumbo-pelvic stability. Over a six month period, pain was significantly reduced and gains were maintained.

360 NMT can assist with many different lower back pain situations, including cases with disc pathology. In most low back pain cases, there is some soft-tissue driven pain, which we can manage and reduce.