Friday, November 6, 2009

Anterior derangements

The anterior derangement which is classified as symmetrical or asymmetrical pain usually across L4/5 with or without buttock and/or thigh pain has a deformity of an accentuated lumbar lordosis. This is a rather rare condition that we see but of course since I started this blog, just about every type of derangement has surfaced.

We had a patient with a long standing recurrent history of back pain (8 years) which was originally described to us by his wife and it took several recurrent episodes before she dragged him in to see us. The most enlightening piece of information was the dramatic lordosis (swayback) and the fact that he could not bend forward nor could he reverse the curve. He was then put through the appropriate testing which in these types of derangements usually reverses rather rapidly allowing for full forward flexion to occur.

This again emphasizes the importance of a good mechanical exam and also the importance of patient generated referrals. Even though this patient had medical care in the past, it was his wife that researched the McKenzie method and made the appropriate referral.