Abstract
A case study is presented where unilateral left subscapular pain was treated by mobilisation to the first lumbar segment, as assessment according to the Maitland concept revealed this to be the source of pain. In the treatment of spinal pain, assessment needs to be systematic and where necessary, should include the whole spine, if treatment is to be specific and effective1.
Highlights
Pain from ligam entous capsular and myofascial structures as well as from facet joints and the dura m ater can be referred to a re a s d is ta n t fro m their so u r c e, that is, producesoma tic referredpain 1'2'3'4'5 It is th epurposeofthisstudy to i ll ustrate the need to assess the spin e below as well as above the area of pain, if the so u rc e o f this s o m a tic referred pain is elusiv e
Thi s st ud y is based on the Ma itland co nc ep t, the ke y sto n es of which are: the need for continuous analytical assessment and the relationship between joint movement and pain response 1
" Assessment is t he k e y to success 1 11 a n d it maybeclearlyseen from this study that the whole spine m ay need to be assessed and that treatment should not commence until the patient's exact pain has been reproduced
Summary
A project su b m itted to the O rth o p a ed ic M an ip u lative Therapist G roup of the South African Society of Physiotherapy in partial fulfilm ent o f the p o st-g rad u ate cou rse on orth o p ae dic m anipulative therapy
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