Woman holding hands on spot back in pain isolated on white
by Adam Field, P.T.

Kim called me four months after her back injury. “You’ve helped my co-workers so much. I hope you can help me.” Kim had been an ER nurse for 15 years, frequently transferring patients, reaching to take vitals, and peering down at her laptop to document notes. She frequently found herself with the familiar ache associated with a sore back.

“This time, I was so dumb,” she said, recounting the incident that brought her to my office.

“We had a very sick patient come in, and I went to grab a wheelchair. There was equipment in the way. Instead of moving it, I tried to reach over a chair to grab it and felt this stab in my lower back that radiated down my left leg. I’ve never felt pain like that before.”

Kim had an MRI, which showed torn fibers at the posterior between the fourth and fifth lumbar discs. Fortunately, she did not sustain a complete tear. “The thing is I’d been having backaches for weeks before this incident. I think my posture and bad habits were giving me a warning, but this was the final straw.”

After spending three weeks on the couch applying ice, taking anti-inflammatories, and using a steroid pack, Kim returned to her chiropractor who tried to get her sore and stiff spine moving. “It took a few months but I started getting better, but now I have this nagging backache almost all the time. I also feel crooked and off balance,” said Kim.

Upon examining Kim’s hip position and leg length, it was clear that several months of inactivity had left her with a severely crooked pelvis. Her left piriformis, a muscle that stabilizes the pelvis during walking, was spasmodic. Her hamstrings, which she hadn’t stretched for so long, were excessively tight.

I applied moist heat to Kim’s lower back while performing deep tissue massage to the glutes and where her sacrum connects with her pelvis (sacroiliac joint). Utilizing myofascial release, I worked on the tissue binding her tight low back muscles to the top of her pelvis (fascia). Positioning her on her side, I applied heat to her mid back and a sustained fascial stretch to the tough tissue on the outside of her left thigh (iliotibial band), and deep tissue fascial techniques to the muscle that begins at the lumbar spine and comes forward to stabilize the core in her abdominal region (psoas).

I began to see substantial improvement in the symmetry of Kim’s pelvis, and when she stood up she was amazed at the improvement in her pain and balance. I provided Kim with instructions in postural correction techniques and stretches for her to perform at home in order to maintain the improvement she experienced in my office. It was great to hear her say, “People were telling me to come see you. I’m glad I finally listened.”

About the Author:

Adam Field is a physical therapist with expertise in craniosacral therapy, myofascial release, and chronic pain. His office is in the JCC Benderson Building, 2640 North Forest Road, Getzville, NY 14068. Call 716-982-8200 or visit www.adamfieldphysicaltherapy.com.