The Psoas Syndrome, What is It?
It is one of the most common yet hidden causes of low back and hip/thigh pain.
When the iliopsoas is overworked, or too weak to handle the stress imposed on it, it can go into spasm, causing many of the regional muscles to compensate
and become hypertonic and painful as well. These muscles will draw the spine out of alignment, and may cause disc protrusion or herniation, typically at L4-L5. This causes irritation of the sciatic nerve. The reason back surgery is sometimes unsuccessful is that it does not address the real problem. Back massage is also seldom effective at treating psoas syndrome, because the deep right and left long muscles traverse the body internally and yet is only accessible from a very small area from the abdomen. The powerful psoas joins the Iliacus muscle and inserts into the lesser trochanter of the femur. Yet it begins beyond the top of the lumbar spine at T-12. (see the illustration below)
Symptoms
The classic symptoms of an iliopsoas muscle spasm are diffuse, achy lower back pain of a few days onset. The pain seems to spread to the rest of the low back, lower thoracic and into the gluteal and lateral hip/thigh regions. An important characteristic is initial pain upon rising from a seated position. Standing, walking and laying down may not be affected except in severe cases. Relief of pain is often experienced by sitting down. Extending the leg, however, as in driving with the foot on the accelerator, can make the pain worse. The pain is also worse from continued standing and from twisting at the waist without moving the feet.
Our Treatment
Effective treatment consists of two parts: office treatment and home treatment.
Office treatment: Hyptertonic back muscles are identified and relaxed. Misalignments of vertebra are identified and corrected. The spastic Iliopsoas muscle is heated with diathermy and gently stretched to relax it. It is later strengthen with rehab procedures to avoid further injury.
Home treatment: The patient needs to rest and perform stretch exercises taught them.
How Long?
Degree of pain and duration of the problem will determine the length of recovery.
Patients having severe, long-term, disk-like symptoms can expect 6 - 10 weeks for complete recovery. However, the patient should feel improvement within the first week of treatment.
