A 43-year-old woman visits me with severe lower back pain, radiating to the right buttock and leg. In recent years, she has experienced lower back complaints more frequently, usually without radiation. The current symptoms developed following a long bus journey two weeks ago.
Examination indicates limited mobility in several lumbar vertebrae, the right SI joint (the joint between the pelvis and the sacrum), and a tense gluteal muscle. There are no clear neurological symptoms that might suggest a hernia.
No muscle will develop such high tension on its own, so there must be more to the story. Examination reveals a loss of mobility in the area of the small intestine, specifically where it transitions into the large intestine in the lower right abdomen. Upon further inquiry, it appears there was a severe intestinal infection six years ago, for which she was hospitalized. She recovered well afterwards, although she still experienced occasional abdominal pain during that first year. This previous intestinal infection could very well be the cause of the current loss of mobility in the intestine, which reflexively leads to tension in the gluteal muscle. This tension in the gluteal muscle, in turn, causes irritation of the nerve that travels from the lower back through this muscle to the leg.
This makes the patient’s history and the findings logically explainable, which provides a good prognosis for treatment.
After several treatments of the abdomen, most joints of the lower back and the right SI joint had normalized in their movement. Notably, the patient experienced significant intestinal complaints during the initial treatments, which later subsided and disappeared.
After a follow-up three weeks later, the final lumbar vertebra was also moving well again, and the patient was symptom-free.
This case is a fine example of the profound interconnectedness within the body between very different tissues; in this instance, the intestine causing lower back complaints.
