Pelvic pain in Maigne’s syndrome—a multi-segmental approach
Abstract Background Maigne’s syndrome is a poorly understood condition that affects the thoracolumbar junction. The symptoms can range from pain in the low back, pelvis, hip, lower abdomen, and groin. These symptoms can have bio-mechanical and neurophysiological attributions due to the complexity of...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2022-01-01
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| Series: | Bulletin of Faculty of Physical Therapy |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43161-021-00062-8 |
| _version_ | 1818753242378534912 |
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| author | Tejinder Singh Parijat Kumar |
| author_facet | Tejinder Singh Parijat Kumar |
| author_sort | Tejinder Singh |
| collection | DOAJ |
| description | Abstract Background Maigne’s syndrome is a poorly understood condition that affects the thoracolumbar junction. The symptoms can range from pain in the low back, pelvis, hip, lower abdomen, and groin. These symptoms can have bio-mechanical and neurophysiological attributions due to the complexity of spinal mechanics. Thoraco-lumbar junction (T12-L1) is a transitional zone with a higher degree of mean angular motion and a mean translation motion than T10-T11 and T11-T12. This higher degree of translational and rotation mobility predisposes these segments to a higher degree of stress, making them more prone to biomechanical faults such as dysfunctions and positional faults. These altered static and dynamic mechanics can create a cascade of problems along the biomechanical chain. The co-existence of thoracolumbar junction problems with pelvic pain and dysfunctions strengthens the idea of regional interdependence. Case presentation The patient is a 44-year-old Caucasian male who reported pain in the low back with symptoms radiating to the right hip, iliac region, lower abdomen, and gluteal region. The patient tested positive for Sacroiliac joint dysfunction with both Laslett’s cluster testing and palpatory sacroiliac examination. In addition, the segmental examination showed restriction in thoracolumbar junction with positive skin rolling test and hypomobility in manual segmental testing. Thus, the manual therapy treatment targeted the thoracolumbar junction and sacroiliac joint to address the underlying biomechanical dysfunctions. Conclusions The manual therapy targeting both sacroiliac and thoracolumbar spine can improve pelvic and thoracic spine mobility. In addition, therapeutic exercises can focus on enhancing anterior and posterior chain force generation capacity. This combined approach helped improve functional outcomes with a significant decrease in the Modified Oswestry Disability index and significant improvement on Visual analog scale. |
| first_indexed | 2024-12-18T05:04:15Z |
| format | Article |
| id | doaj.art-2fa77eacce0e448487ee2757bca813fa |
| institution | Directory Open Access Journal |
| issn | 1110-6611 2536-9660 |
| language | English |
| last_indexed | 2024-12-18T05:04:15Z |
| publishDate | 2022-01-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Bulletin of Faculty of Physical Therapy |
| spelling | doaj.art-2fa77eacce0e448487ee2757bca813fa2022-12-21T21:20:03ZengSpringerOpenBulletin of Faculty of Physical Therapy1110-66112536-96602022-01-012711410.1186/s43161-021-00062-8Pelvic pain in Maigne’s syndrome—a multi-segmental approachTejinder Singh0Parijat Kumar1International Sports and Orthopedic and Manual Therapy, Integrity RehabInternational Sports and Orthopedic and Manual Therapy, Integrity RehabAbstract Background Maigne’s syndrome is a poorly understood condition that affects the thoracolumbar junction. The symptoms can range from pain in the low back, pelvis, hip, lower abdomen, and groin. These symptoms can have bio-mechanical and neurophysiological attributions due to the complexity of spinal mechanics. Thoraco-lumbar junction (T12-L1) is a transitional zone with a higher degree of mean angular motion and a mean translation motion than T10-T11 and T11-T12. This higher degree of translational and rotation mobility predisposes these segments to a higher degree of stress, making them more prone to biomechanical faults such as dysfunctions and positional faults. These altered static and dynamic mechanics can create a cascade of problems along the biomechanical chain. The co-existence of thoracolumbar junction problems with pelvic pain and dysfunctions strengthens the idea of regional interdependence. Case presentation The patient is a 44-year-old Caucasian male who reported pain in the low back with symptoms radiating to the right hip, iliac region, lower abdomen, and gluteal region. The patient tested positive for Sacroiliac joint dysfunction with both Laslett’s cluster testing and palpatory sacroiliac examination. In addition, the segmental examination showed restriction in thoracolumbar junction with positive skin rolling test and hypomobility in manual segmental testing. Thus, the manual therapy treatment targeted the thoracolumbar junction and sacroiliac joint to address the underlying biomechanical dysfunctions. Conclusions The manual therapy targeting both sacroiliac and thoracolumbar spine can improve pelvic and thoracic spine mobility. In addition, therapeutic exercises can focus on enhancing anterior and posterior chain force generation capacity. This combined approach helped improve functional outcomes with a significant decrease in the Modified Oswestry Disability index and significant improvement on Visual analog scale.https://doi.org/10.1186/s43161-021-00062-8Maigne’s syndromePelvic painSacroiliac jointThoracolumbar spine |
| spellingShingle | Tejinder Singh Parijat Kumar Pelvic pain in Maigne’s syndrome—a multi-segmental approach Bulletin of Faculty of Physical Therapy Maigne’s syndrome Pelvic pain Sacroiliac joint Thoracolumbar spine |
| title | Pelvic pain in Maigne’s syndrome—a multi-segmental approach |
| title_full | Pelvic pain in Maigne’s syndrome—a multi-segmental approach |
| title_fullStr | Pelvic pain in Maigne’s syndrome—a multi-segmental approach |
| title_full_unstemmed | Pelvic pain in Maigne’s syndrome—a multi-segmental approach |
| title_short | Pelvic pain in Maigne’s syndrome—a multi-segmental approach |
| title_sort | pelvic pain in maigne s syndrome a multi segmental approach |
| topic | Maigne’s syndrome Pelvic pain Sacroiliac joint Thoracolumbar spine |
| url | https://doi.org/10.1186/s43161-021-00062-8 |
| work_keys_str_mv | AT tejindersingh pelvicpaininmaignessyndromeamultisegmentalapproach AT parijatkumar pelvicpaininmaignessyndromeamultisegmentalapproach |