Regular readers will know that in my own practice, neural therapy is frequently intertwined with osteopathy. Often I find situations where either therapy might be helpful and it is not clear which one to choose.
A recent discussion with Nicolas Stamer of Germany (who will be speaking at the international neural therapy conference in Ottawa in May) made clear to me that I am not alone in this regard. In fact this question will be at least part of what he will discuss in his lecture.
This month I would like to present a simple case demonstrating this blending of “interference field” and “somatic dysfunction”:
A vigorous, healthy 64 year-old man presented with right hip pain that had begun suddenly with a chiropractic manipulation over a year before. The situation was unusual in that he had sought chiropractic care with no symptoms (at his wife’s urging!). The manipulation had been of his low back and was not particularly forceful.
Further chiropractic treatment could not reverse the pain. It was made worse by lying on his right side and it was disturbing his sleep. It was otherwise unaffected by posture or movement. In fact, he played ice-hockey regularly without difficulty.
His health was otherwise good with the exception of “borderline diabetes” (surprising given his slim physique). There was no history of serious trauma. Past surgery included an appendectomy as a child and a left anterior cruciate ligament repair at age 54.
Examination showed full range of motion of his right hip with the exception of tight hip adductors, slightly tighter hamstrings on the right and a right pubic “downslide”, i.e. less resistance to gentle caudad pressure on the right pube relative to the left, while supine. “Arcing” (a focal pulsation of about 60 cycles/min.) emanated from the right hip region. Craniosacral motion over the sacrum was severely restricted.
The arcing was treated using an osteopathic “unwinding” technique; the right hip adductors and hamstrings released and the pubes were restored to normal balance.
One month later, the patient returned reporting no improvement, and in fact, a worsening of his pain.
Neural therapists know that a worsening of pain after treatment of an interference field indicates that there is another nearby, more important, interference field. Re-examination of the patient showed the same muscle and pelvic ring imbalances as before, and with autonomic response testing a “therapy localization sign” (See page 51 of my book http://www.neuraltherapybook.com/) on the left side. Further searching revealed an interference field at the coccyx that was treated with the Tenscam device, with immediate restoration of blocked regulation.
One month later the patient reported complete abolition of the hip pain until a slight recurrence the night before the visit. Again an interference field was found at the coccyx and treated with immediate relief from the pain.
Another month later, he reported no pain at all.
I present this case because a combination of unilateral tight hip adductor muscles, combined with a pubic “downslip” or “downslide” (a more modern term would be “inferior pubes”) is an exceedingly common and easily treatable somatic dysfunction. It is often associated with anterior knee pain, especially in young adolescent girls, but pain may surface in other locations, as in my patient.
Treatment is very simple: With the patient supine on the examining table, the physician passively abducts the affected leg (the side with tight hip adductors) until some resistance is felt. At this point the patient is instructed to gently adduct the leg against resistance (isometric) for a slow count of five. Re-examination should show that the leg can be passively abducted a little farther. Repeat the resisted adduction, several times if necessary, until the leg can be abducted as far as on the opposite side. The position of the pubic bones should normalize and the treatment is then finished.
This treatment is almost always effective and does not need to be repeated. In my patient’s case, the failure of osteopathic treatment, and in fact, the patient’s worsening was totally unexpected. This was a distinct wake-up call that a nearby interference field needed to be found and to be treated.
This lesson can be generalized to other failures of manual treatment. Always look for an interference field if the treatment does not succeed.
The same can be said for failures of neural therapy. Another interference field or a somatic dysfunction is likely nearby. This is particularly important in the head where cranial somatic dysfunction is difficult to treat with procaine injections. Even the Tenscam (an energetic device) does not treat some cranial somatic dysfunctions as well as the hands do.
Please let me describe a recent case of PGAS (persistent genital arousal syndrome) in a 63 year old women. Her condition had begun five years previously and required orgasm (by self-stimulation) for relief. Her symptoms often occurred at inopportune times while in public places and needed orgasm for relief. Her husband was unaware of her situation.
There was a long history of past and present emotional trauma including caring for a severely disabled grandchild.
Autonomic response testing revealed blocked regulation by mercury from eight dental amalgam fillings. Interference fields were found in the lumbar ganglia and treated with intravenous procaine and nasal lidocaine sprays. She was referred for treatment of unresolved emotional conflicts/trauma by psychotherapy and EMDR (eye movement desensitization). Hypothyroidism, gluten/casein sensitivity, intestinal dysbiosis and nutrient deficiencies were treated.
A complicated, but rewarding case and now symptom-free!
Rob Banner MD