| Mr. R.M.H. is a 44-year-old senior professional tennis tournament player who first came to this office on 9/30/96, complaining of right buttock pain of 2 years' duration. The patient had been unable to compete in professional tennis tournaments for 1.5 years prior to presentation because of right buttock and right hamstring pain. He was able to continue as a tennis instructor. The low back pain worsened 4 months prior to presentation, and he was having pain and difficulty working as an instructor. He consulted a chiropractor, and was treated 3 times, but there was no improvement. He was never treated by a physiatrist or physical therapist. The patient had sharp low back pain radiating to the right buttock and posterior thigh without any other neurologic symptoms. There was aggravated especially when running and changing direction rapidly. Stretching and massage therapy temporarily alleviate the pain but not for more than a few hours.
The physical examination was significant for lumbar flexion with an imbalance and a rapidly rotating right hemipelvis and lumbar extension with low back pain on right hip extension. The right straight-leg raise caused low back pain at 80ø, the left did not. There was trigger point tenderness in the lumbar muscles, especially on the right, at the hip flexors. There was a mild decrease in movement in the right hip and hemipelvis, and there was weakness of the right hip flexors with no other findings on a neurologic examination. He was diagnosed with chronic low back pain and a right lumbar myofascial dysfunction.
He was treated with a series of once-weekly trigger point treatments with acupuncture needles for 3 weeks and instruction in specific yoga-like stretching of the muscle, following the dry needling. Within 2 weeks the pain was almost completely resolved and he was able to resume teaching without pain. He was contacted 1 year after the treatment, and he reported being able to play in national seniors singles and doubles tournament during the year. The patient continues to do the specific exercise instructed and has had no further treatment by any other health professionals.
If you have this problem or any other musculoskeletal problem, please feel free to contact the office. |