Mr P is a 55 year old IT manager who presented with a long history of right leg pain(sciatica), worse in the last 3 months. The pain was down the front of the leg with associated tingling and stopped him from lying on his right side, often waking him at night. Mr P was having regular Chiropractic treatment without improvement.
Examination revealed some postural problems, but back range of movement was satisfactory. He had shortened hamstrings and psoas muscles, but the most significant physical finding was several large trigger points and tension within the right subscapularis muscle, on the inside of the shoulder blade. This muscle is an important stabiliser of the shoulder joint. Further enquiry lead to Mr P revealing that he had hurt his right shoulder before his leg pain had started, and that it had always been “niggly” and he had just put up with it.
Treatment to release the subscapularis muscle improved Mr P’s leg pain within 4 sessions. He was able to lie on his right side and the leg pain was not waking him any more. This case illustrates how dysfunction in areas far removed from a person’s symptoms may contribute significantly to those symptoms, and it is important to assess the whole musculoskeletal system when symptoms develop.