So far our blog has consisted of success stories of those with reducible derangements. The question that is raised “what do we do when a person is irreducible?” Irreducible simply means that at the current time there is no “directional preference”. This means that with all movements, symptoms increase or travel further into the leg. This past month, I have had two such cases, both involving the lumbar spine and pain throughout the leg with weakness. Both had lateral shift deformities and were unable to bear full weight on the involved extremity.
“Time, time, time is on my side, yes it is.” These are lyrics from the Rolling Stones 1964 hit. This holds true with the treatment of irreducible derangements. In both cases, we instructed the patients on the importance on not aggravating the condition and were instructed in very gentle mid range lumbar spine movements that would never increase leg pain. This eventually resulted in enough of a reduction of their constant pain and both became mechanical responders. In both cases, all the extremity pain has centralized to the lumbar spine and they are now undergoing a recovery of a reducible derangement.
The main difference between reducibles and irreducibles are that the reducibles rapidly respond and the irreducible may respond but will require a longer period of time.
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