Male patient, 44 years, CEO.
Since more than 10 years slight intermittent lumbar aching, mostly because of direct contact during football playing. After some days NSAID's OK. The last few months the pain is more severe and less intermittent. In the morning, when coming out of bed, there is some pain low lumbar right (disappears in 1 minute). During the day there is some discomfort in kyphotic sitting, but not in standing.
The lumbar examination in fully negative.
Is there a small nuclear internal derangement ?
Introduction of profylactic elements, without succes (even more pain).
The site of the pain is rather too high for a low lumbar disc protrusion (high lumbar-low thoracic). It turned out to be a muscle lesion of m. serratus posterior et inferior (the trunk rotation against resistance was his main positive sign).
The patient received 11 treatments of deep transverse friction and returned to normal function.
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