Low Back, Core and Pelvic Girdle

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Clinical anatomy, kinesiology, and the jing-jin ("sinew meridians" or myofascial tracts)

  • Bones, muscles, discs and facet joints, and neurology
  • Posture and motion dysfunctions
  • The arthritic progression: strain/sprain, derangement, degeneration

History-taking: key diagnostic questions

  • "Red flag" symptoms of urgent/serious medical conditions potentially warranting referral to physician care: stenosis, tumors, infection, fractures, organ-referred pain and radiculopathies
  • Differentiating symptoms of muscles, joint, disc, and spinal cord, and nerve root injuries
  • Neural hypersensitization and psycho-social factors
  • Functional capacity questionnaires for reporting to managed care insurance

Physical exam of the low back, core and pelvic girdle: how findings can guide treatment with acupuncture modalities

  • Observation, inspection and palpation
  • Joint exam: active range-of-motion and passive stress testing of the lumbar spine, sacroiliac joint and pubic symphysis
  • Neurologic exam: upper motor neuron; leg reflex, sensory, and motor function; sciatic neuropathy
  • Manual strength testing and referred pain pattern charts for 10 key muscles of the low back, core and pelvic girdle
  • Special orthopedic tests for the lumbo-sacral spine
  • Documentation of physical exam findings
  • Measuring and reporting functional capacity baselines and treatment outcomes
  • Clinical flow charts to facilitate efficiency and accuracy in examination

Diagnosis and Pattern Identification

  • Lumbo-sacral sprains/strains, postural and motion dysfunctions, and myofascial pain of the iliopsoas, quadratus lumborum, paraspinals, abdominals and gluteals
  • True sciatica vs. radiculitis vs. piriformis myofascial pain
  • Radiculopathies and stenosis
  • Post-partum pain, insufficiency of the iliolumbar and sacrotuberous ligaments, and dysfunctions of the sacroiliac and pubic symphysis joints
  • Chronic lumbo-sacral pain, spondylosis, arthritis, degenerative disc disease, scoliosis
  • Spondylolisthesis and compression fractures
  • Failed low back surgery syndromes

Treatment

Build on your skills with the Review/Practicum Lab