Psoas Syndrome: The Great Imitator
The Psoas Syndrome causes level 10 pain in back, hip, leg with numbness in thigh and foot. The pain is so great, so constant, so incapacitating that it will cause visits to the ER, where an MRI may be ordered to rule out a herniated disk. The cause of the problem is not usually one of trauma and often unknown.
Fortunately, the problem is not common. Yet in the past month, we’ve treated 2 cases of this syndrome, the most recent case involving a young woman where 3 MRI’s were performed and one brain scan…all negative and 2 weeks of PT, not effective.. The reasons for the difficulty in diagnosing and treating this problem is the location and power of the psoas muscle. It’s origin is the anterior side of the lumbar spine, involving all 5 of the lumbar vertebra, where it is inaccessible (palpation is through the abdomen). The psoas runs downward and laterally where it is joined by the equally powerful iliacus muscle of the pelvis (one on the left and one on the right). The syndrome typically only affects one side, thank God. The joined ilio-psoas muscle runs to the back side of the hip joint, where it inserts. When this large, powerful hip flexor goes into spasm, it results first in hip pain then escalates into the highest pain levels, involving the low back, hip and leg.
Medication reduces the pain but does not solve the problem. Chiropractic care fixes the problem, but it involves deep trigger point therapy, which is also painful, but thankfully effective and relatively brief.