 Miguel S attended the clinic complaining of pain in the left sacroiliac joint radiating into the left buttock and left lower lumbar area (he said the pain felt as though the left kidney was involved) after lifting a 25kilo bag of animal feed. He said the pain has gradually become worse over the last two weeks.
He visited his doctor who said it was a muscular strain and prescribed some anti-inflammatories to help with the pain and inflammation.
His pain decreased whilst taking anti-inflammatories but returned as soon as he missed a tablet.
Sacroiliac joint ligaments
Lumbar Muscles
Buttock Muscles
On Examination: he displayed a positive “twitch” test over the ligaments of the left sacroiliac joint, pain on pressure, muscle spasm in the left buttock radiating into the lower left lumbar area. He had difficulty raising his left leg and found it difficult to stand for any period of time.
Prolotherapy was performed to the ligaments of the left sacroiliac joint and its attachment to the left L5/L4 transverse processes under ultrasound guidance. The patient experienced the “three minute miracle” after which he was able to walk and lift his leg with no pain. He received an osteopathic treatment the following week. He now says he is free from pain and to be more careful next time he’s lifting and twisting.
Miguel caused ligamentous injury to the left sacroiliac joint. The muscles crossing the joint which included the buttock muscle and the lumbar muscles tried to stabilise the joint by contracting and going into spasm. This is a protective mechanism to help the body stabilise the joint. However, along with muscle spasm and contracture, there is pain and inflammation. The body repairs itself by a process called inflammation and to take anti-inflammatory tablets is counter-productive to the healing. Once the unstable ligaments are treated the body no longer maintains the muscle spasm and the pain disappears. It is important to understand that short-term anti-inflammatory treatment may be appropriate but long-term treatment will stop the body from healing.
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