Question
i am a male that has back pain for 3 years now.

i have spina bifida occulta and may also have assemtrical facet at that same l4.

3 prolapsed lumbar discs mildy touching of the lumbar from a mri

functional scolosis i guess that it is functional at 9 degrees

also right side SI joint dysfucntion for many years

my pain was mostly on right side back around the QL muscle

but with much TrP work on the right psoas getting at it thru

the abdomine back pain has reduced quite a bit.

also have done tons of ab, hip and back strengthening

and posture correctiion and TrP release for many muscles.

now daily i have been working on this right side psoas TrP

it is very painful to work on but if i keep at it i think

i can stop it from completely tightning up again.

but just yesterday it has started to spasm no matter is standing,

sitting, or lieing down.

it is not painful but unusual as this has never happened to me

before. it spasms for about 3 seconds in the ab region.

i am not 100 percent that it is the psoas that is spasming but am

quite sure.

just what to make of this? are muscle spasm neccesarily a bad

indicator? i almost think sometimes they are a good think as i do

get some of them in the upper back muscles now and then.


the second question is in my right side scapula upper back and

neck area i have also had problems.

now this 1st rib i can sometimes in various positions get it to

move. perhaps that is caused from the functional scolosis?

but now i have for about 1 month almost permanent pain in this

area. i do work on all the TrP of the neck and above the sternum

and trap area. this greatly helps but then the next day i back

to the same problem.

just what to make of this?

thanks in advance.  

Answer
Sounds like you know human anatomy pretty well!

What most people fail to recognize is that the psoas is not only the psoas.  Its real name is the iliopsoas, because it conjoins with the tendon of the iliacus, lining the inside of the pelvic bone.

TrP therapy in my mind is pretty not worth it in the iliopsoas, because you simply can't reach it to work on it... it's inches deep, so that the only place you can touch it is about one inch in size... the muscle is almost a foot long.

The best way to manage the psoas is to gently stretch the muscle, not only long axis, which is the psoas proper, but to stretch the iliacus, as well.  Standing with one leg behind, feel the psoas stretch, but then bend to the side away from which you are trying to stretch.  THen twist away from the side you are trying to stretch, and get the rest of the iliacus.  See if this doesn't help it... we get amazing results with just this simple stretch.

Pain at the base of the neck is often due to what is happening below it in the thoracic spine.  Have you tried rolling back and forth on a foam roller in the mid back?  If this doesn't help, I would talk to a chiropractor and have them take xrays, just to see what's going on.

If you were in Seattle, I'd have you come here!

If you would like a referral, please contact me through my website, www.dynamicclinic.com

Dr. Peter Carr
Seattle, Washington