P03.12. A Case Report Series Demonstrating the Importance of Differential Diagnosis in the Successful Management of Low Back Pain Using Integrative Manual Therapy

Focus Areas: Integrative Approaches to Care, Alleviating Pain Similar clinical presentations of low back pain may be caused by diverse pathologies that require different courses of treatment. The effectiveness of Integrative Manual Therapy (IMT) treatment in low back pain is based on differential diagnosis ascertained through advanced manual palpation. Three case studies illustrate the efficacy of IMT in treating chronic pain when a precise manual diagnosis guides an individualized course of treatment. CASE 1: A 58-year-old male presented with longstanding low back pain with bilateral lower extremity paresthesia and numbness. Manual diagnostics revealed multifocal soft tissue tethering of neural structures at cranial, spinal, and peripheral levels. Biomechanical compromise of tethered neural components included caudal traction of the spinal cord and brain stem. Protective compensatory mechanisms causing joint compression further contributed to the clinical presentation. IMT intervention corrected these pathologies with full resolution of symptoms. CASE 2: A 50-year-old female presented with right shoulder pain and low back pain. She had a history of a fall off a horse 11 years prior and a deep vein thrombosis in the left leg 1 year prior. Manual diagnostics identified an old trauma to the IVC with scar tissue compressing the vessel. The IVC trauma was treated with IMT to resolve the scar tissue and improve venous flow, achieving complete resolution of symptoms. CASE 3: A 58-year-old female presented with low back pain with a history of right hip arthritis and Crohn's disease. Manual diagnostics revealed biomechanical protective reactions compensating for inflamed bowel. IMT treatment of bowel dys-function was effective in alleviating pain and achieving sustained biomechanical correction of the hip and sacroiliac joints. CONCLUSION: These cases demonstrate the importance of identifying the underlying etiology. The clinical relevance of these findings coupled with successful outcomes offer a new perspective on the traditional management of low back pain.