Recently, I treated a 43-year-old woman with chronic lower back pain. Several years earlier, she had been diagnosed with a herniated disc between the fourth and fifth lumbar vertebrae (L4\u2013L5), for which she underwent surgery at the age of 31.<\/p>\n
Despite the surgery, her symptoms continued to recur: pain in the right buttock radiating down into the lower leg and foot. Many people are quick to attribute new symptoms to a previous disc herniation. This is understandable, but it does not always provide the full explanation.<\/p>\n
The question I therefore ask myself is:\u00a0Why did the disc herniation develop in the first place, and which factors might still be contributing to her symptoms today?<\/p>\n
During my initial assessment, I identified increased resting tension in the right crus of the diaphragm, a structure that attaches to the lumbar vertebrae. The diaphragm also plays an important role in circulation, including lymphatic flow. In my clinical experience, restricted mobility of the diaphragm may have a significant influence on the function of the lower back.<\/p>\n
I believe that a disc herniation rarely develops as a result of a single factor. Particularly when it occurs at a relatively young age, I consider which underlying factors may have contributed to its development.<\/p>\n
In addition to the increased tension in the diaphragm, I also identified an intraosseous restriction in mobility within the sacrum. My experience is that chronic lower back pain rarely involves just one isolated restriction. More often, several structures appear to influence one another.<\/p>\n
I also try to identify the event or physical stress that may have caused the body to begin compensating. In this case, we were able to trace this back quite clearly.<\/p>\n
For me, combining the patient’s history, the physical examination and the restrictions in mobility identified during the assessment is essential to understanding the\u00a0primary dysfunction<\/em>.<\/p>\n Following the first treatment, she experienced a temporary increase in symptoms, a response I regularly encounter in clinical practice. This was followed by a noticeable improvement, and after four treatments spread over three months, both her lower back pain and radiating symptoms had resolved.<\/p>\n Of course, this is just one clinical case, and every patient is different.<\/p>\n Does this mean I treat the diaphragm and sacrum in every patient with chronic lower back pain?<\/p>\n Certainly not.<\/p>\n And that is precisely what makes working as an osteopath so interesting. I do not follow a standard treatment protocol. For me, every treatment begins with identifying the\u00a0primary dysfunction<\/em>: the structure that, at that particular moment, demonstrates the greatest restriction in mobility.<\/p>\n When this primary restriction decreases, I often observe that the body appears better able to initiate its own recovery processes.<\/p>\n This is why, when assessing chronic lower back pain, I do not focus solely on the area where the pain is experienced. Instead, I investigate which structures may be restricting the body’s ability to function optimally.<\/p>\n For me, that is the essence of osteopathy.<\/strong><\/p>\n[\/vc_column_text][\/vc_column][\/vc_row]\n","protected":false},"excerpt":{"rendered":" [vc_row type=”in_container” full_screen_row_position=”middle” column_margin=”default” column_direction=”default” column_direction_tablet=”default” column_direction_phone=”default” scene_position=”center” text_color=”dark” text_align=”left” row_border_radius=”none” row_border_radius_applies=”bg” row_position_desktop=”default” row_position_tablet=”inherit” row_position_phone=”inherit” overflow=”visible” overlay_strength=”0.3″ gradient_direction=”left_to_right” shape_divider_position=”bottom” bg_image_animation=”none”][vc_column column_padding=”no-extra-padding” column_padding_tablet=”inherit” column_padding_phone=”inherit” column_padding_position=”all” flex_gap_desktop=”10px” column_element_direction_desktop=”default” column_element_spacing=”default” desktop_text_alignment=”default” tablet_text_alignment=”default” phone_text_alignment=”default”…<\/p>\n","protected":false},"author":2,"featured_media":3917,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[18],"tags":[],"class_list":["post-3914","post","type-post","status-publish","format-standard","has-post-thumbnail","category-publicaties-en"],"_links":{"self":[{"href":"https:\/\/andromeda-osteopathie.nl\/en\/wp-json\/wp\/v2\/posts\/3914","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/andromeda-osteopathie.nl\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/andromeda-osteopathie.nl\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/andromeda-osteopathie.nl\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/andromeda-osteopathie.nl\/en\/wp-json\/wp\/v2\/comments?post=3914"}],"version-history":[{"count":1,"href":"https:\/\/andromeda-osteopathie.nl\/en\/wp-json\/wp\/v2\/posts\/3914\/revisions"}],"predecessor-version":[{"id":3915,"href":"https:\/\/andromeda-osteopathie.nl\/en\/wp-json\/wp\/v2\/posts\/3914\/revisions\/3915"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/andromeda-osteopathie.nl\/en\/wp-json\/wp\/v2\/media\/3917"}],"wp:attachment":[{"href":"https:\/\/andromeda-osteopathie.nl\/en\/wp-json\/wp\/v2\/media?parent=3914"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/andromeda-osteopathie.nl\/en\/wp-json\/wp\/v2\/categories?post=3914"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/andromeda-osteopathie.nl\/en\/wp-json\/wp\/v2\/tags?post=3914"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}