Treatment of Low Back Pain

by Cranial Adjustment

Dr. William J. Boro

Chiropractic Center of Annapolis

Annapolis, MD | (410) 266-5054

www.nosnappingnocracking.com

Lower back pain is a commonly occurring reason

for patients to present themselves for

chiropractic care

This case report is to examine the clinical

connection between lower back pain and

dysrelationships of the cranium

Case History

• A 39 year old male policeman

• 5’9”, weighing 275 pounds

• Injury, 3-4 years previously, to his lower back

• PT had resolved the problem

• July 2011 knee injury created recurrence of LBP

• After March 2012 knee surgery, LBP became constant

and unresponsive to rest or physical therapy

• April 2012 he presented to this clinic for examination and

treatment

Assessment

• Knee pain 4/10

• LBP on flexion 5/10

• Low right hip

• Low right shoulder

• Left ear low

• Positive Trendelenburg test on the right

• Left arm fossa test positive in upper fossa

• Pressure to L5 spinous was positive to pain on the left

Muscle Testing Pre Treatment

Muscle Pre-Treatment

Transverse Abdominals +4 bilaterally

Psoas Major +4 bilaterally

Adductor Brevis +4 bilaterally

Gluteus Maximus +4 bilaterally

Multifidus +4 bilaterally

Iliocostalus Lumborum +4 bilaterally

Sternocleidomastoid +4 bilaterally

Splenius Capitus +4 bilaterally

Gluteus Medius +5 bilaterally

Muscle Testing Post Treatment

Muscle Pre-Treatment Post-Treatment

Transverse Abdominals +4 bilaterally +4 bilaterally

Psoas Major +4 bilaterally +5 bilaterally

Adductor Brevis +4 bilaterally +5 bilaterally

Gluteus Maximus +4 bilaterally +5 bilaterally

Multifidus +4 bilaterally +5 bilaterally

Iliocostalus Lumborum +4 bilaterally +5 bilaterally

Sternocleidomastoid +4 bilaterally +5 bilaterally

Splenius Capitus +4 bilaterally +5 bilaterally

Gluteus Medius +5 bilaterally +5 bilaterally

Results

• Shortly post-treatment the patient stated that he “felt

great and all the pain in his knee and his lower back had

resolved.”

• Next day: marked reduction of LBP that was sustained

and it was the first time in a month that he could walk

without a limp and not concurrently experience LBP.

• On reevaluation posture presentation revealed a right hip

low, shoulders level, and left ear low. Trendelenberg

was negative bilaterally, arm fossa test was negative

bilaterally, however the left sided pain at L5 spinous

process on pressure shifted superiorward to pain on

pressure at lumbar 4 spinous process, also on the left.

Discussion

The methods and chiropractic techniques used in this case

study were those developed by Richard Van Rumpt, DC

Van Rumpt Leg Check

Before After

Descartian System of 3-Dimensional Analysis

• Van Rumpt’s cranial mechanics are strictly spatial

• 3 patterns, anterior, posterior and mixed

• 4th pattern is anything

Each Bone in the Head Should be Tested

• Anterior

• Posterior

• Superior

• Inferior

• Medial

• Lateral

Anterior Subluxation Pattern

Test Sphenoid First

Full Anterior Pattern

Correcting Anterior Pattern

Posterior Subluxation Pattern

Test Sphenoid First

Full Posterior Pattern

Correcting Full Posterior Pattern

Facial Pattern

• Frontal

• Nasal

• Zygomatic

• Maxilla

Parietal and Occipital Analysis

• Parietals can go:

• Medial/lateral

• Anterior/posterior

• Occipitals can go:

• Medial/lateral

• Inferior/superior

Challenge of Sphenoid

Posterior

sphenoid

Anterior

sphenoid

Conclusion

• Little research demonstrating cranial dysfunction and low

back pain is found in the literature

• Unger noticed a change in cranial distortion patterns

from modification of pelvis via blocks

• Chinappi and Getzoff observed that position of head and

lumbar region are intricately linked

• Beck and Blum found a cranial adjustment improved

vision in a patient with visual dysfunction and LBP

• Fink discussed functional relationship between

craniomandibular system, C-spine and SI joint

Conclusion

• Considering the immediate response to treatment and

the prior unremitting nature of the condition in this case

study, further research is indicated.