Issue link: https://www.massageandbodyworkdigital.com/i/72195
ESSENTIAL SKILLS may manifest itself in many different patterns: an ache in the lowest part of the back; pain down the thigh, within the thigh, in the outer lower leg, or down the back of the leg and into the heel; and so on. To make matters more confusing, the iliolumbar ligaments and the supraspinous and interspinous ligaments of the L1 to L5 vertebrae may also be injured simultaneously, causing overlapping pains (see "The Mystery of Low-Back Pain," parts 1 (December/January 2006), 2 (February/ March 2006), and 3 (April/May 2006)). For a more detailed explanation of some of these structures and drawing on a live model, visit Massage & Bodywork's digital edition featuring a video clip from the 2008 DVD "Orthopedic Massage Series—The Low Back: Assessment and Treatment Strategies for Soft Tissue Pain and Injury" by Ben Benjamin (link available on ABMP. com and Massageandbodywork.com). ONSET PATTERNS While the origination of back pain may vary a great deal from individual to individual, there are four basic patterns of pain caused by tears of the ligaments in the sacrum and posterior pelvis. In each of the following categories, pain in the lower back, buttock, thigh, and/ or lower leg may appear either suddenly or slowly over the course of many hours or several days. (Note: the terms sciatica and sciatic pain are commonly used as shorthand for a referred pain down the thigh and/or the lower leg. Sciatica is not a diagnosis, but simply a general term like stomach ache. Referred pain down the leg can be caused just as easily by torn ligaments or muscles as by a nerve compression from a bulging disc.) CATEGORY 1 Periodically, the person is immobilized by severe back pain—with or without leg pain—or leg pain alone. The pain is intense and may come on after 104 massage & bodywork september/october 2008 SUPRASPINOUS LIGAMENT SIDE VIEW INTERSPINOUS LIGAMENT