OMM for severe back spasm

[strongyloides]

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Had a pretty debilitating back spasm last night. Couldn't move or twist my back at all. I looked at our OMM textbook, couldn't really find anything that would apply. I tried some myofascial on myself with enough relief to walk a few steps.

So I'm in post-spasm day 1, my ROM upon waking was about 10% of normal, now a few hours later at about 50% of normal. Wondering if anyone (especially some of the OMM fellows lurking around) can suggest techniques they would try now, and out of curiosity what they would have tried last night when the attack came on.

If this ever happens to one of my patients I don't want to be caught empty handed again, I felt pathetic enough not knowing what to do with myself in moment of crisis.

 

[(nicedream)]

Had a pretty debilitating back spasm last night. Couldn't move or twist my back at all. I looked at our OMM textbook, couldn't really find anything that would apply. I tried some myofascial on myself with enough relief to walk a few steps.

So I'm in post-spasm day 1, my ROM upon waking was about 10% of normal, now a few hours later at about 50% of normal. Wondering if anyone (especially some of the OMM fellows lurking around) can suggest techniques they would try now, and out of curiosity what they would have tried last night when the attack came on.

If this ever happens to one of my patients I don't want to be caught empty handed again, I felt pathetic enough not knowing what to do with myself in moment of crisis.

What about good old-fashioned kneading and heat?

 

[gagolden]

I have used OMT on acute spasm numberous times and gotten very good results. Im talking mostly on roations on docs wives and nurses. Just a little side note, almost all of the instances were preceded by some kind of trauma, fell on ice or sports accidents.

I used soft tissue for a good long time on the area, followed up with some good ol agressive HVLA. After the HVLA, I did some more soft tissue (mostly on thier wives...just to brown my nose up a little)

 

[strongyloides]

What about good old-fashioned kneading and heat?

Got someone coming over later to do just that.

Just a little side note, almost all of the instances were preceded by some kind of trauma, fell on ice or sports accidents.

I used soft tissue for a good long time on the area, followed up with some good ol agressive HVLA. After the HVLA, I did some more soft tissue (mostly on thier wives...just to brown my nose up a little)

Heh. Yes, there was some brief sport activity involved, but at least 6 hours prior.

How long did you perform the soft tissue, ~20 minutes? Problem with HVLA is that when I run my fingers down my back, I feel the thoracic spinous process flexed considerably, but I can't quite feel whether its SB/rotated left or right. So I tried counterstrain on both sides last night, with some relief during the technique, but pain returned upon its cessation.

 

[(nicedream)]

Heh. Yes, there was some brief sport activity involved, but at least 6 hours prior.

What kind of "sport activity"? And how "brief"?

 

[gagolden]

Got someone coming over later to do just that.



Heh. Yes, there was some brief sport activity involved, but at least 6 hours prior.

How long did you perform the soft tissue, ~20 minutes? Problem with HVLA is that when I run my fingers down my back, I feel the thoracic spinous process flexed considerably, but I can't quite feel whether its SB/rotated left or right. So I tried counterstrain on both sides last night, with some relief during the technique, but pain returned upon its cessation.

I probably would do 15 min on wives, but five to 10 is more than adequate. You shouldn't be able to determine if your SB/RT on your own, when you move your shoulder to internal rotation you distort your own back. You need a friend. Have em do some good ol Kriksville Crunch. You could always do a Texas twist or a Chicago roll if its low enough. M.Energy is aways a option. The key really is the prep the tissues before and after with plenty of soft tissue.

 

[ShyRem]

Most techniques are better done by someone else on you, not you on yourself.

 

[DragonWell]

So I tried counterstrain on both sides last night, with some relief during the technique, but pain returned upon its cessation.

Just curious how you self-adminster counterstrain. I've thought about trying it on my own back, but doesn't the muscle have to be passively moved back to neutral? I wonder if the efferents required to move yourself out of the position are what kicked your pain back in?

 

[FutureNavyDOc]

Most techniques are better done by someone else on you, not you on yourself.

Yeah, that's called osteobation and it can make you go blind as well as make your palms hairy. 😀

 

[jrf331]

Navy doc didn't you tell me that the Soft tissue for Peyronies was your favorite technique. You were able to self administer that weren't you?

 

[Taus]

Navy doc didn't you tell me that the Soft tissue for Peyronies was your favorite technique. You were able to self administer that weren't you?

I thought all that soft tissue w/ the dominant hand was the major cause of that disorder....

 

[jrf331]

I thought all that soft tissue w/ the dominant hand was the major cause of that disorder....

ST with the dominant hand is the major cause, so if side bent right one should use the left hand to correct the problem. I think that is evidenced based too.

 

[FutureNavyDOc]

Navy doc didn't you tell me that the Soft tissue for Peyronies was your favorite technique. You were able to self administer that weren't you?

It wasn't ST, it was a MFR technique. You take the tissue where it wants to go and hold and wait for a release.😉

 

[danclear]

Just curious how you self-adminster counterstrain. I've thought about trying it on my own back, but doesn't the muscle have to be passively moved back to neutral? I wonder if the efferents required to move yourself out of the position are what kicked your pain back in?

Treating yourself is difficult, but it can be done...although not usually that effectively. Doing JSCS on yourself can be done, but you have to really move yourself back to neutral slowly, or use a limb to bring your relaxed head back to neutral (if you were treating your head, neck, or upper back).

I am able to HVLA my thoracics by arching against a countertop (make sure it can support you). Just be sure to cross your arms against your chest and put the vertex of your lesion against the edge of the counter. I am a frequent osteobater when it comes to this technique. In fact, I do it in public...who cares what the society norms think of it! 🙂

To treat the back spasm I would also have someone apply some deep paraspinal inhibition. There is likely a structural lesion in the thoracics to address once the spasm has been resolved.