Sacro Occipital Technique Pelvic Block Treatment for Severe Herniated Discs: A Case Study, Poster Presentation

Blum CLProceedings of the ACC Conference XI, Journal of Chiropractic EducationSpr 2004;18(1): 38-9

INTRODUCTION: The chiropractic profession is beginning to gather sufficient evidence that its conservative method of care is a viable option for patients suffering from lumbar disc herniation. Recently two papers were presented which discussed the positive outcome of Sacro Occipital Technique (SOT) pelvic block placement on the treatment of lumbar disc herniation. A 37-year-old patient presented at this office September 2002 due to an aggravation, a week earlier, of a prior work related injury, which occurred in 1997. He presented with a 1.3 cm concentric disc bulge at L5-S1 and an extruded disc at the L3-L4 level, extending 8-9 mm posteriorly and to the right per the radiologist’s report.

METHODS: Using various SOT diagnostic and treatment protocol for the treatment of lumbosacral discopathy, Category Three, the patient was treated with pelvic blocks or wedges. The majority of the treatment was performed with the patient prone and pelvic blocks placed under the pelvis according to leg length, cervical indicators, and determined by reduction of pain. Gentle distraction was placed to the herniated disc by leg traction and/or sacral traction and stabilization of the lumbar vertebral segment superior to the herniation. Psoas tension on the anterior aspect of the discs was “released” with the patient resting prone, on pelvic blocks, and with doctor’s hand placed under the patient with finger pressure directed anterior/posterior gently relaxing the muscle.

DISCUSSION: Following three weeks of treatment at intervals of 1-2 times per week the patient noted that he felt markedly improved and had no limitations in his activities or ranges of motion to a large degree. The patient received infrequent treatment following the initial 2 months and months following his initial MRI a follow-up MRI was performed (7 months later due to awaiting approval from his workers compensation carrier) which found a 3 mm diffuse disc bulge at L3-L4 and L4-L5 per radiologist’s report.

CONCLUSION: Many practitioners from a variety of technique disciplines utilize pelvic wedges or blocks as a chiropractic adjustment tool. DeJarnette introduced the pelvic blocks or wedges in the development of the Sacro Occipital Technique and their use is indicated by identifying specific criteria, with the positional placement under the pelvis is directed by identifying the short leg and pain reduction. Future studies are needed to determine whether the findings in this case history can be generalized to patients presenting with herniated discs of the magnitude found with this patient. Pre and post MRIs seem to be an important part of the process of determining a relationship between clinical findings and objective measurements of disc herniation. While it must be noted that sometimes disc herniations will resolve over time independent of treatment, this patient’s concurrent clinical findings during the course of care make further investigation into SOT pelvic block placement for similar conditions warranted.

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