OMT Lumbar Somatic Dysfunction


The OMT Lumbar Somatic Dysfunction provides High Yield information that is needed for the COMLEX Level 1, 2, and 3, Medical School, Residency, and as practicing Physician.



OMT Lumbar Somatic Dysfunction

Degenerative joint disease
  • Presentation:
    • – risk factors for osteoarthritis
    • – better w/ rest, worse w/ activity
  • Diagnosis:
    • – x-ray shows joint space narrowing, osteophytes
  • Management:
    • NSAIDs and acetaminophen
    • OMT

Osteoarthritis – affects hands, neck, lower back, hips and knees
US federal government / Public domain
Disc herniation
  • Presentation:
    • – positive straight leg raise
    • – most common at L5/S1 (affecting S1 nerve root)
    • – sciatica
  • Diagnosis:
    • MRI
  • Management:
    • conservative early (surgery if refractory)

Herniated disc on MRI
Mjorter at Dutch Wikipedia / Public domain
Musculoskeletal strain
Spinal stenosis
  • Presentation:
    • – Due to foramina narrowing
    • – Back pain worse with extension and better with flexion

Spondylopathy

SpondylosisDegenerative spine
SpondylolysisOblique
Fracture of pars, Scotty dog collar
SpondylolisthesisLateral
Anterior slippage

Scoliosis

functional scoliosiscorrects w/ side bending
structural scoliosisdoes NOT correct w/ side bending
dextroscoliosisright scoliosis
apex at the right
(sidebent left)
levoscoliosisleft scoliosis
apex to the left
(sidebent right)
Rotoscoliosislateral deviation of the spine from the normally straight vertical line 
Cobb Angle
Def. – angles formed by perpendicular lines from top and bottom most segments of scoliosis
Cobb AngleSeverityTreatment
< 20 degreesmild scoliosisOMT
20 – 45 degreesmoderate scoliosisOMT and Bracing
> 50 degreessevere scoliosisSurgery
> 75 degreesscoliosis w/ CV involvementSurgery

OMT Lumbar Somatic Dysfunction Techniques

Counterstrain (Lumbar)
Anterior Lumbar Tender Points
AL1– Location: medial aspect of ASIS
– Muscle: Iliopsoas
– Vector: M–>L
-Treatment position: F STRA
AL2– Location: medial side of AIIS
– Vector: M–>L
-Treatment position: F SART
AL3– Location: Lateral side of AIIS
– Vector: L–>M
-Treatment position: F SART
AL4– Location: Inferior side of AIIS
– Vector: I–>S
-Treatment position: F SART
AL5– Location: ANTERIOR aspect of pubic ramus
– inferior to the pubic tubercle
– 1 cm lateral from symphysis
– Muscle: adductor longus
– Vector: A–>P
-Treatment position: F SARA
Lumbar Counterstrain Tenderpoints
Powellle / CC BY-SA
Posterior Lumbar Tender Points
PL1-5 sp– Location: spinous processes of L1-L5- lateralize to a side
– Vector: P–>A (PL–>AM)
-Treatment position: E SARA
PL1-3– Location: transverse processes of L1-3
– Vector: PL–>AM
-Treatment position: E SART

Reference

  • Blausen.com staff (2014). “Disc Herniation” &quot;Medical gallery of Blausen Medical 2014&quot;. WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436.
  • Blausen.com staff (2014). “Spinal Stenosis” &quot;Medical gallery of Blausen Medical 2014&quot;. WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436.
  • Blausen.com staff (2014). “Scoliosis” &quot;Medical gallery of Blausen Medical 2014&quot;. WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436.