low back pain

[physiodungun]

dear friends,

i had a problem in 56 y.o man that c/o lower back pain.After 6 session of treatment,pt. claimed that the pain over his lower back disappear but he c/o numbness over her left peroneous muscle.I change my treatment from SWD to ILT ( lumbar traction ),but pt. still c/o of same symptom.i hope that if someone can help me and give me some idea's about this problem.thank you......

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[sanagupta]

Hello
Ur problem seem to me similar to the problem which we discussed under the heading..increased pain due to lumbar traction.my patient also had similar complaints..
This phenomena is called pheripherilistion..which is not considered a good sign in recovery.Try treating his back with unilateral lumbar traction and Unilateral PA ,also rule out any local problem to the muscle...u can even try Ift to the lower back ,i have got good results in some patients with refeered pain
Regards
Sana

[ehsanch]

Hi.
Your patient was suffering from acute protective spasm of low back muscles which causes stifness and pain, and once the spasm is reduced nerve root irritation may occur due to increased mobility of spine by a protuded disk or an osteophyte.In this case traction will further aggrivate the problem.

[jerryhesch]

In addition to the previous posts I suggest also looking peripehrally. In 25 years I encountered 1 superior glide fixation of the fibula and restoring inferior glide reduced the peroneal numbness. Sometimes there is concomitant trauma that is not consciously recorded such as pushing very hard on the brake pedal at the point of impact with MVA, etc.
I always interpret dermatomes and sensory nerves very cautiously, there is so much overlap, for example the calf can beupper lumbar (saphenous) and upper sacral also.
Regards
jerry Hesch, MHS, PT