CLINICAL CASE 1 WITH TREATMENT PLAN USING DIRECT AND INDIRECT TECHNIQUES
CLINICAL CASE 1 WITH TREATMENT PLAN USING DIRECT AND INDIRECT TECHNIQUES
Osteopathic manipulative treatment (OMT) is used to treat a patient’s problem associated with somatic dysfunction: impaired or altered function of related components of the somatic (body framework) system—skeletal, arthrodial, and myofascial structures, and related vascular, lymphatic, and neural elements.
HISTORY: A 25-year-old female has had lower back pain for 1 week since playing indoor football. She has muscle spasm in the right lumbar erector spinae muscles and tenderness on the right L2–5 transverse processes, which are resistant to anterior pressure compared to the left side.
ASSESSMENT: (1) Lumbar strain and sprain; (2) lumbar somatic dysfunction.
PLAN: OMT to lumbar region using counterstrain and indirect myofascial release resulting in reduced tenderness and tension and improved motion.
Since this is a case of acute strain and sprain, the indirect techniques of counterstrain and myofascial release were applied. In the case of incomplete resolution of the restriction with these treatments, direct techniques such as muscle energy or thrust could be applied but with a risk for symptom exacerbation or worsening of an acute sprain. No evidence of inflammation (swelling, redness, and heat) or neurological involvement and patient tolerance of the restrictive barrier would favor applying direct techniques on the first visit.
Traitement Général Ostéopathique (TGO)
Octobre 2021
Osteopathic manipulative treatment (OMT) is used to treat a patient’s problem associated with somatic dysfunction: impaired or altered function of related components of the somatic (body framework) system—skeletal, arthrodial, and myofascial structures, and related vascular, lymphatic, and neural elements.
HISTORY: A 25-year-old female has had lower back pain for 1 week since playing indoor football. She has muscle spasm in the right lumbar erector spinae muscles and tenderness on the right L2–5 transverse processes, which are resistant to anterior pressure compared to the left side.
ASSESSMENT: (1) Lumbar strain and sprain; (2) lumbar somatic dysfunction.
PLAN: OMT to lumbar region using counterstrain and indirect myofascial release resulting in reduced tenderness and tension and improved motion.
Since this is a case of acute strain and sprain, the indirect techniques of counterstrain and myofascial release were applied. In the case of incomplete resolution of the restriction with these treatments, direct techniques such as muscle energy or thrust could be applied but with a risk for symptom exacerbation or worsening of an acute sprain. No evidence of inflammation (swelling, redness, and heat) or neurological involvement and patient tolerance of the restrictive barrier would favor applying direct techniques on the first visit.