scholarly journals Pelvic pain in Maigne’s syndrome—a multi-segmental approach

2022 ◽  
Vol 27 (1) ◽  
Author(s):  
Tejinder Singh ◽  
Parijat Kumar
Keyword(s):  
Pelvic Pain ◽  
Manual Therapy ◽  
Sacroiliac Joint ◽  
Thoracolumbar Spine ◽  
Thoracolumbar Junction ◽  
Low Back ◽  
Lower Abdomen ◽  
Positive Skin ◽  
Therapeutic Exercises ◽  
Spine Mobility

Abstract Background Maigne’s syndrome is a poorly understood condition that affects the thoracolumbar junction. The symptoms can range from pain in the low back, pelvis, hip, lower abdomen, and groin. These symptoms can have bio-mechanical and neurophysiological attributions due to the complexity of spinal mechanics. Thoraco-lumbar junction (T12-L1) is a transitional zone with a higher degree of mean angular motion and a mean translation motion than T10-T11 and T11-T12. This higher degree of translational and rotation mobility predisposes these segments to a higher degree of stress, making them more prone to biomechanical faults such as dysfunctions and positional faults. These altered static and dynamic mechanics can create a cascade of problems along the biomechanical chain. The co-existence of thoracolumbar junction problems with pelvic pain and dysfunctions strengthens the idea of regional interdependence. Case presentation The patient is a 44-year-old Caucasian male who reported pain in the low back with symptoms radiating to the right hip, iliac region, lower abdomen, and gluteal region. The patient tested positive for Sacroiliac joint dysfunction with both Laslett’s cluster testing and palpatory sacroiliac examination. In addition, the segmental examination showed restriction in thoracolumbar junction with positive skin rolling test and hypomobility in manual segmental testing. Thus, the manual therapy treatment targeted the thoracolumbar junction and sacroiliac joint to address the underlying biomechanical dysfunctions. Conclusions The manual therapy targeting both sacroiliac and thoracolumbar spine can improve pelvic and thoracic spine mobility. In addition, therapeutic exercises can focus on enhancing anterior and posterior chain force generation capacity. This combined approach helped improve functional outcomes with a significant decrease in the Modified Oswestry Disability index and significant improvement on Visual analog scale.

scholarly journals Additional treatments for acute nonspecific lumbodynia

2019 ◽  
Vol 11 (2S) ◽  
pp. 98-102
Author(s):  
O. A. Solokha ◽  
N. V. Vashchenko
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Medical Care ◽  
Manual Therapy ◽  
Clinical Guidelines ◽  
Clinical Findings ◽  
Common Reason ◽  
Low Back ◽  
Therapeutic Exercises ◽  
Inflammatory Drugs

Low back pain (lumbodynia) is a most common reason for seeking medical care and a most common of disability. The review presents current clinical guidelines for the management of patients with acute nonspecific lumbodynia. The diagnosis of acute nonspecific lumbodynia is based on clinical findings and, in most cases, requires no instrumental studies. Nonsteroidal anti-inflammatory drugs are most effective in reducing pain. Additional therapies, such as therapeutic exercises, manual therapy, massage, acupuncture, etc., are discussed. There are data on the use of B vitamins, Milgamma® in particular, in acute non-specific lumbalgia.

scholarly journals Effect of Muscle Energy Technique in Patients with Non-traumatic Lumbo-pelvic Pain in the Age Group of 30-40 Years

2021 ◽  
pp. 1-9
Author(s):  
A M R Suresh ◽  
◽  
Dimple Kashyap ◽  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Pelvic Pain ◽  
Manual Therapy ◽  
Post Treatment ◽  
Pelvic Girdle ◽  
Low Back ◽  
Muscle Energy Technique ◽  
Muscle Energy ◽  
High Level

Purpose: Pelvic girdle and low back pain have fallen under the diagnostic umbrella of non-specific low back pain (NSLBP). It is true that low back pain can have it’s etiology in pelvic girdle mal-alignment, and similarly low back pain with neural irritation can lead to in co-ordination of muscles causing pelvic malalignment, it is important to understand that motor in co-ordination in the pelvic girdle can be the result of peripheral and/or central mechanisms. Peripheral mechanisms include reflexogenic muscle spasms whilst central mechanisms include cortical inhibition of muscles and/or delayed central transmission due to noxious input affecting intra-cortical synergistic control between various regions of the central nervous system (CNS). Muscle energy technique (MET) is a common conservative treatment for pathology around the spine, particularly lumbopelvic pain (LPP). MET is a gentle manual therapy for restricted motion of the spine and extremities and is an active technique where the patient, not the clinician, controls the corrective force. MET of the low back has decreased pain, increased range of motion, decreased muscle tension and spasm, and increased strength when used with supervised neuromuscular re-education and resistance exercise training. At present, the treatment effect and the outcome of one or two MET session is undefined. This study is designed to determine the effectiveness of brief MET sessions on posterior innominate/ Pelvic pain when used on subjects with non-traumatic pelvic pain. Materials and method: 20 male patients of convenient random sampling based on the inclusion criteria were included in the study and were given muscle energy technique- anterior rotation of Innominate bone for single session once a day for two days and the pre and post treatment outcome were recorded using VAS score and Pelvic inclinometer (PALM) measure. Results: The pre and post treatment effects using paired t-test and the correlation on VAS, shows a decrease of mean and SD from baseline (4.7 ± 1.03) to (1.95 ± 1.14) with (t=14.457, p =.001) indicating a very high level of significance. The pre and post treatment effects using paired t-test and the correlation on PALM, shows a decrease of mean and SD from baseline (10.5 ± 1.50) to (7.1 ± 1.07) with (t=12.803, p =.004) indicating a high level of significance. Conclusion: The results showed that Muscle Energy Technique is as effective as any other manual therapy techniques in the treatment of lumbo-pelvic pain or posterior innominate considered in this study, suggests that MET was highly effective in managing pain and neutralising the pelvic rotation angles with LPP. The treatment is evidenced, and provided as much benefit as any other manual therapy techniques for LPP. Some objective outcomes showed a trend which suggested that there might have been a great interaction if the sample size was larger. Thus the conclusion from this research is that there was a high statistical significance between the pre and post treatment with brief MET sessions in acute LPP.

scholarly journals Evaluation of Diagnostic Accuracy of Sacroiliac Joint Block under Sonographic Guidance in Low Back and Pelvic Pain

2014 ◽  
Vol 2 (2) ◽  
pp. 31-40
Author(s):  
Masoud Hashemi ◽  
Vahid Akhyani ◽  
Peyman Dadkhah ◽  
Parviz Jalili ◽  
Majid Poorfarokh ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Pelvic Pain ◽  
Sacroiliac Joint ◽  
Low Back ◽  
Sonographic Guidance

scholarly journals Therapeutic exercise for pregnancy low back and pelvic pain: a systematic review

2017 ◽  
Vol 30 (2) ◽  
pp. 399-411 ◽  
Author(s):  
Cássia Colla ◽  
Luciana Laureano Paiva ◽  
Rafaela Prusch Thomaz
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Physical Therapy ◽  
Pelvic Pain ◽  
Methodological Quality ◽  
Descriptive Analysis ◽  
Low Back ◽  
Therapeutic Exercise ◽  
Therapeutic Exercises

Abstract Introduction: During pregnancy, a woman’s body goes through many changes, and lower back and pelvic pain are common and may persist after pregnancy. Although the literature point physical therapy as an effective therapeutic tool, there are few studies on the effects of physical therapy intervention through exercises for this purpose. Objective: To perform a systematic review on the use of Physiotherapy, through therapeutic exercises, for the prevention and treatment of pregnancy low back and pelvic pain. Methods: A systematic search for randomized trials (RCTs) was conducted on the databases PubMed, PEDro, Cochrane, EMBASE, LILACS and Periódicos Capes. There was no date or language restriction. The terms included in the search were: “pregnancy”, “low back pain”, “pelvic pain”, “exercise therapy” and their descriptors in Portuguese. Methodological quality was assessed using the PEDro scale and a descriptive analysis of the studies was performed. Results: Eight studies, including 1781 pregnant women, were selected. Among them, one study addressed the issue of low back pain, two focused on pelvic pain and five on low back and/or pelvic pain. Seven studies presented high methodological quality, and only one study had low methodological quality. Limited evidence on low back pain was found, and conflicting evidence on pelvic pain, and low and/or pelvic pain. Conclusion: RCTs on the subject are scarce and heterogeneous, making it impossible to reach a consensus or any conclusions about which protocol of therapeutic exercise is more effective in the use of physiotherapy for pregnancy low back and pelvic pain.

scholarly journals Chronic nonspecific (musculoskeletal) low back pain. Guidelines of the Russian Society for the Study of Pain (RSSP)

2019 ◽  
Vol 11 (2S) ◽  
pp. 7-16 ◽  
Author(s):  
V. A. Parfenov ◽  
N. N. Yakhno ◽  
O. S. Davydov ◽  
M. L. Kukushkin ◽  
M. V. Churyukanov ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Sacroiliac Joint ◽  
Educational Program ◽  
Russian Society ◽  
Low Back ◽  
Facet Joints ◽  
Level Of Evidence ◽  
Therapeutic Exercises ◽  
Radiofrequency Denervation

Examination of a patient with chronic low back pain (LBP) is aimed at eliminating its specific cause and assessing the social and psychological factors of chronic pain. The diagnosis of chronic nonspecific (musculoskeletal) LBP is based on the exclusion of a specific cause of pain, discogenic radiculopathy, and lumbar stenosis. It is advisable to identify possible pain sources: pathology of intervertebral disc pathology, facet joints, and sacroiliac joint and myofascial syndrome.An integrated multidisciplinary approach (a high level of evidence), including therapeutic exercises, physical activity optimization, psychological treatments (cognitive behavioral therapy), an educational program (back pain school for patients), and manual therapy, is effective in treating chronic musculoskeletal LBP. For pain relief, one may use nonsteroidal anti-inflammatory drugs in minimally effective doses and in a short cycle, muscle relaxants, and a capsaicin patch, and, if there is depressive disorder, antidepressants (a medium level of evidence). Radiofrequency denervation or therapeutic blockages with anesthetics and glucocorticoids (damage to the facet joints, sacroiliac joint), back massage, and acupuncture (a low level of evidence) may be used in some patients.Therapeutic exercises and an educational program (the prevention of excessive loads and prolonged static and uncomfortable postures and the use of correct methods for lifting weights, etc.) are recommended for preventive purposes. 

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