ETIOLOGY:
This
condition usually arises from a twisting and compression injury
and results from an invagination and pinching of the joint
capsule or synovial tissue. Acute pain, capsular swelling, and
resultant stress in foraminal contents may mimic the radicular
signs of a disc bulge.
APPROPRIATE CARE:
High velocity facet adjusting is used along with gentle
active exercise. This should respond well and heal without
residuals.
EXPECTED FREQUENCY AND
DURATION OF CARE:
Three sessions a week for 2 weeks
and 1 per week for 2 more weeks. A follow care of 1-2 times over
the next 4 weeks.
TOTAL: 8-9 VISITS OVER 8 WEEKS.
|
WEEK |
CARE |
PROGRESS |
M |
T |
W |
T |
F |
S |
|
1-2
|
Pain control
High velocity SMT |
75% subjective pain reduction
75% improved ROM
3 /week |
X |
|
X |
|
X |
|
|
3-4 |
Adjusting
Myofascial work
Home exercise |
90% subjective pain relief
90% imp. ROM
1 /week |
|
|
|
X |
|
|
|
5-8 |
Myofascial work PRN
Adjusting PRN
Home exercise |
Discharge
1-2 / month |
|
|
|
X |
|
|
ATTENUATING FACTORS: The degree of initial
injury and the conditioning of the patient prior to injury as
well as compliance with home care all contribute to recovery.
SMT = spinal manipulative therapy
(adjusting)
PRN = per required need (patient
requests)
Return to the "Low Back Pain" Guidelines Section
