Abstract
Another concept relating to a specific phase in the backache problem is presented. A mechanical theory based on muscle imbalance is advanced to explain the clinical and roentgen findings. The patients complain of an upper lumbar backache that is aggravated at rest, awakens them at night, and is accompanied by pain that radiates along the last rib and to the groin. The clinical examination reveals an increased lumbar lordosis, postural scoliosis, a pelvic tilt, abduction and internal rotation of the femur on the side of the low iliac crest, and adduction of the thigh on the side of the high iliac crest. There is tenderness and hyperesthesia over the cutaneous distribution of the twelfth dorsal and first lumbar nerves. The treatment consists of elevation of the heel on the side of the low crest and muscle exercises. The roentgenographic examination confirms the clinical findings when the upright films reveal an acute costovertebral angle and a pelvic tilt.
Published Version
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