Case Study – Irritable Bowell Syndrome
This is the case study of Mrs R a 38- year old fit and healthy woman, who presented with an chronic case of severe Ibs and lower back pain. She was diagnosed with IBS(irritable bowel syndrome) 15 years ago.
Aggravating factors: Symptoms get worse after eating but constant discomfort She complains of crampy abdominal pain, no bowel movements for several days. Problem: Onset of abdominal pain, bloating, gas, on occasion for about 15 years but more frequent for the past 12 years.
Easing factors: After bowell movement, eating ice cream seemed to calm the acid reflux in the stomach.
History of Problem: Diagnoised with IBS over 15 years ago. This condition has been chronic ever since. Diet and lifestyle has changed on the advice of doctors dietician etc.
She has seen her primary care provider as well as 2 local gastroenterologists who have performed routine lab studies, celiac serologies, colonoscopy with random biopsies – all of which were normal.
Blood tests came back as normal as well.
Due to the severity of symptoms, her GP had prescribed strong multilaxin, imodium, colofac and muscle relaxants.
Palpation: At lower a lot of pain and discomfort on palpation- with the patient supine. Local tenderness at the the gall baldder attatchment, stomach, asphosogus, colon and right kidney.
Visceral Manipulation is a gentle manual therapy that aids your body’s ability to release restrictions and unhealthy compensations that cause pain and dysfunction.
Restoring full range of movement of spinal joints through local mobilisation, manipulation, acupuncture, dry needling, cranial sacral fsm, visceral manipulation and inversion therapy. Restoring normal movement in all the internal organs with mobilisations and local soft tissue techniques.
Following 5 weeks of treatment, Mrs I is now functioning properly with full bowel movements without pain. Mrs I still has mild acid reflux because of the lining of the stomach been inflamed for so long, but I am confident we will be able to eradicate this.
Case Study – Hip Pain
Eight months ago Mr H slipped whilst at work, landed on his left side and twisted his hip at the same time. This was very painful and a lot of bruising came out over the next few days. He could not put any weight on the leg, so he went to have an X-ray at A&E. They reported no fracture around the hip or pelvis just inflammation.
Problem: This patient had some physiotherapy at the local hospital. His symptoms were not improving and he still needed to take a high levels of pain killers. He cannot walk for longer than 2 minutes before the pain in his hip worsens. Movements of the hip are painful and restricted, particularly on movement.
Daily pattern – his symptoms seem worse first thing in the morning and at the end of the day.
Medication – strong painkillers and anti-inflammatories
On examination he presented with generally good posture and muscle tone. He had no pain at rest. No bruising or swelling noted.
Movement: Active hip flexion (knee to chest) and abduction (leg out to side) were restricted to half range due to pain over the anterior and lateral hip. His walking was relatively normal with no limp.
Nerve movement: No neural symptoms noted, full nerve mobility not tested due to restricted range of movement.
Joints: The hip joint did not appear restricted; however this was difficult to test due to pain.
My clinical diagnosis was of trauma/twisting type strain to the anterior and lateral hip structures, particularly the psoas and TFL muscles.
Treatment: I discussed the presentation with the patient to ensure he had a good understanding of the problem and the likely outcome of treatment which he had not had from his previous treatment. I treated the area with a range of techniques and a graduated strengthening programme and light cardio-vascular exercise. His rehabilitation programme concentrated on achieving full active movement first and we then progressed to strengthening once this was achieved.
Outcome: He was seen six times over three weeks and he regained full range of movement and near full muscular strength. He was no longer taking pain killers and felt he “had his life back” following his treatment. The patient wished he had attended sooner rather than waiting eight months to see a specialist.