Spine Health. PROCEDURE 16 — CORRECTION OF LATERAL SHIFT

This procedure has two parts: first the deformity in scoliosis is corrected; then, if present, the deformity in kyphosis is reduced and full extension is restored. The patient, standing with the feet about thirty centimeters apart, is asked to clearly define the areas where pain is being felt at present. The therapist stands on the side to which the patient is deviating and places the patient’s near elbow at a right angle by his side. The elbow will be used to increase the lateral pressure against the patient’s rib cage.

The therapist’s arms encircle the patient’s trunk, clasping the hands about the rim of the pelvis. Now the therapist presses his shoulder against the patient’s elbow, pushing the patient’s rib cage, thoracic and upper lumbar spine away while at the same time drawing the patient’s pelvis towards himself. In this manner the deformity in scoliosis is reduced and, if possible slightly overcorrected.

READ:   Spine Health. PROCEDURE 1 — LYING PRONE

Initially, there will be significant resistance to the procedure, which may actually cause an increase in pain. It is quite safe to continue with correction as long as centralisation of pain takes place, and therefore the patient must be questioned continually about the behaviour of his pain. Relaxation of the patient during the procedure is very important and we should always try to get the patient to ‘let it all go’. The first pressure in the series should be a gentle gradual squeeze which is held momentarily and then released. After this an accurate assessment of the patient’s reactions must be made. Experience has taught me that too much pressure or too fast a correction in the initial stages may result in fainting and collapse of the patient. If well tolerated the pressure is applied a little further each time. As correction progresses over ten to fifteen rhythmically applied pressures, the patient usually describes that the pain moves from a unilateral to a central position, and by the time over correction is achieved there will be a significant reduction in intensity of the pain or the pain may have moved slightly to the opposite side. If after a few rhythmical pressures no progress is made in the correction, it may be necessary to apply a longer and more sustained pressure.

READ:   Spine Health. PROCEDURE 7 — EXTENSION MOBILISATION

Sometimes reduction may be felt clearly by the therapist and the patient’s trunk is felt to move slowly but surely from its previously held position. In lightly-built or tall and slender patients shift correction may occur quite easily, and only a few minutes of ten to fifteen pressures are required to reduce the derangement. On the other hand, some acute lateral shifts are extremely difficult to reduce and one may have to perform five or six series of corrective pressures.

Assuming that correction of the deformity in scoliosis has been achieved, we must now proceed with restoring the lumbar lordosis. This is preferably commenced in the standing position. The patient no longer exhibits a lumbar scoliosis but may still have a kyphosis. The therapist, holding the patient as for correction of the scoliosis, must maintain slight over correction while moving the low back of the patient into the beginning of extension. A few movements will indicate the ease with which the lordosis will be restored. If the extension range improves rapidly it is usually belter to recover as much extension as possible in the standing position. If extension does not increase rapidly, then it is better to change to extension in lying. This procedure should produce a steady and continuing reduction of central pain, and it should automatically follow for all patients with a postero-lateral derangement once the scoliosis has been corrected and the symptoms have centralised.

READ:   Back Pain History

Fig. Correction of lateral shift.

Effects:

These will be discussed following the next procedure.

Deformities of the spine: Lordosis, Kyphosis, and Scoliosis ICD-9: 737.20 LORDOSIS ICD-9: 737.10 KYPHOSIS ICD-9: 737.30 SCOLIOSIS Video: How to Correct a Scoliosis With Exercise and Stretching Description ⚡ Lordosis ⚡ is an abnormal inward curvature of the lumbar or lower spine. This condition is commonly called “swayback.” Kyphosis is an abnormal outward curvature of the upper thoracic vertebrae. Commonly, this curvature is known as “humpback” or “round back.” Scoliosis is an abnormal sideward curvature of the spine to either the left or right. Some rotation of a portion of the vertebral column also may occur. Scoliosis often occurs in combination with kyphosis and lordosis. These three spinal deformities may affect children as well as adults. FIGURE. Spinal curvatures Etiology Lordosis, kyphosis, and scoliosis may be caused by a variety of problems, including congenital spinal defects, poor posture, a discrepancy in leg lengths (especially in scoliosis), and growth retardation or a vascular disturbance in the epiphysis of th...
TYPICAL TREATMENT PROGRESSION — THE DYSFUNCTION SYNDROME Day one Assessment and conclusion/diagnosis. Explanation of the cause of dysfunction and the treatment approach. Postural correction and instructions, especially regarding sitting; demonstrate the use of a lumbar support. Commence with exercises to recover function — that is, extension in lying, flexion in lying, or side gliding in standing, whatever procedure is indicated. Emphasise the need to experience some discomfort during the exercises, and the importance of frequent exercising during the day. If flexion in lying is recommended, we must warn to stop exercising if the symptoms quickly worsen. We may have overlooked derangement, or commenced the procedure too early following recent derangement. Always follow flexion exercises with some extension. Day two Confirm diagnosis. Check postural correction. Completely repeat'postural correction and instructions. Check exercises. If improving nothing should be changed. If not improving, ensure tha...
The Dysfunction Syndrome The word ‘dysfunction’ chosen by Mennell to describe the loss of movement commonly known as ‘joint play’ or ‘accessory movement’ seems infinitely preferable to the terms ‘osteopathic lesion’ and ‘chiropractic subluxation’, neither of which means anything and both of which mean everything. ‘Dysfunction’ or ‘not functioning correctly’ at least acknowledges that something is wrong without going through the sham procedure of pretending that only those who belong to the club really understand the terminology. For years osteopaths and chiropractors have claimed that only the people, properly trained in their particular calling, have the necessary knowledge to understand their terminology. There may be some truth in that. Although I believe that the term ‘dysfunction’ as used by Mennel does not strictly cover the loss of movement caused by adaptive shortening, I have chosen to use this term instead of repeatedly referring to ‘adaptive shortening’. Essentially, the mechanism of pain prod...
Hyperlordosis: Treatment, Prevention, and More What’s hyperlordosis? Human spines are naturally curved, but too much curve can cause problems. Hyperlordosis is when the inward curve of the spine in your lower back is exaggerated. This condition is also called swayback or saddleback. Hyperlordosis can occur in all ages, but it’s rare in children. It’s a reversible condition. Keep reading to learn about the symptoms and causes of hyperlordosis and how it’s treated. What are the symptoms of hyperlordosis? If you have hyperlordosis, the exaggerated curve of your spine will cause your stomach to thrust forward and your bottom to push out. From the side, the inward curve of your spine will look arched, like the letter C. You can see the arched C if you look at your profile in a full-length mirror. You may have lower back pain or neck pain, or restricted movement. There’s limited evidence connecting hyperlordosis to lower back pain, however. Most hyperlordosis is mild, and your back remains flexible. If the arch in your bac...
Intervertebral discs Figure. The adult vertebral column and typical vertebrae in each region, lateral views. There are at least 24 intervertebral discs interposed between the vertebral bodies: six in the cervical, twelve in the thoracic and five in the lumbar region, with one between the sacrum and coccyx. (Additional discs may be present between fused sacral segments.) The discs account for approximately one-quarter of the total length of the vertebral column, and are primarily responsible for the presence of the various curvatures. On descending the vertebral column, the discs increase in thickness, being thinnest in the upper cervical region and thickest in the lower lumbar. In the upper thoracic region, however, the discs appear to narrow slightly. In the cervical region the disc is about two-fifths the height of the vertebrae, being approx-imately 5 mm thick. In the thoracic region the discs average 7 mm in thickness, so that they are one-quarter of the height of the vertebral bodies. The discs in ...