I have a 61 y/o pt. who ice skates, golfs, rides horses and plays the violin at least 30 min a day. She came in with LBP but I found her Left T-L paraspinals in spasm and noticed her Left SC joint ant to the Right. I have been treating her with arm raise and twist. She is getting better the pain is decreasing but she still has pain when we re-check her right side (bad side which causes left thorcic pain)especially when I have her "chunk" right side because a "regular" check doesn't have any effect anymore. And her left SC is still more anterior compared to the right. Any suggestions????
Shirley- this may seem stupid, but what is a SC joint? When you check side to side there is no need to hold them or chunk them per se, unless what you are trying to get at is that the difference between R and L is so small that the patient can not tell a change? If this is so then I would move on to the other FAB 5 positions. Also I would not have her really actively use her bad side as you are reassessing because you are "reinjuring" the bad side (promoting the bad side to be bad) and this may explain why it cause her left thoracic pain, as you are using the bad side to chunk with? Are you using the form and ranking the positions and treating according to the rank. If she can not treat all the positions because of pain, them maybe find an alternate position that you can assess and treat in. Not sure if this helps.
Good comments by ktoncapecod. I also want to point out that you said her SC is still more anterior compared to right. Perhaps you can also use the advanced form and get into a position that takes her R SC even more ant and see what happens. it sounds like this is the position it wants to go into. Again remember to stick to the FAB 5 until the patient gets it and then venture out. Ktoncapecod I agree with her process entirely.
