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  • Causes and symptoms 2-3 months - GynZone · 2017-11-14 · plexus ). Symptoms: -Low back pain !! Explanaon: Innervaonens (ps) is located at segment s2- s4. The Piriformis muscle is
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14/11/17 1 Copenhagen 14. november 2017 Typical pregnancy and a.er birth problems, seen in an osteopathic therapeu7c perspec7ve. Pregnancy pain Prengancy pain, can and will be different from woman to woman. In a clinical view, it is impossible to define the cause of the pain, only from the symptoms In an osteopaDc view, we oEen find typical relaDons, that can explain causes and symptoms. -Typical causes and symptoms, 2-3 months. -Typical causes and symptoms, 3-5 months. -Typical causes and symptoms, 5-7 months. AEer the 7th month, all types of intervenDon to relieve pain is palliaDve Causes and symptoms 2-3 months Causes: -cervix uteri -uterus -uterosacral ligament Symptoms: -Low back pain !! Explana7on: InnervaDonens (ps) is located at segment s2- s4. The Piriformis muscle is innervated from these segments ( sacral plexus ). The uterosacral ligament is pulling on the sacrum. Sacrum and uterus, they mirror each other. ExplanaDon and illustraDon 2-3 months Piriformis and plexus lumbalis Uterosacral ligament Causes and symptoms 3-5 months Causes: -Kidneys/ plexus lumbalis -ligamentum teres uteri Symptoms: -Low back pain -Groin pain -Abdominal pain Explana7on: The growing uterus is pushing the kidneys cranial. The kidneys will compress and inflame the nerves behind, from the lumbar plexus. These nerves innervates the lumbar spine. The Ligamentum teres, will lengthen alot. Normal length is 15 cm. At the end of week 40, the length will be app. 40 cm. ExplanaDon and illustraDon 3-5 months • Ligamentum teres uteri • Plexus lumbalis

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Page 1: Causes and symptoms 2-3 months - GynZone · 2017-11-14 · plexus ). Symptoms: -Low back pain !! Explanaon: Innervaonens (ps) is located at segment s2- s4. The Piriformis muscle is

14/11/17

1

Copenhagen14.november2017

Typicalpregnancyanda.erbirthproblems,seeninanosteopathictherapeu7cperspec7ve.

PregnancypainPrengancypain,canandwillbedifferentfromwomantowoman.Inaclinicalview,itisimpossibletodefinethecauseofthepain,onlyfrom

thesymptomsInanosteopaDcview,weoEenfindtypicalrelaDons,thatcanexplaincauses

andsymptoms.-Typicalcausesandsymptoms,2-3months.-Typicalcausesandsymptoms,3-5months.-Typicalcausesandsymptoms,5-7months.AEerthe7thmonth,alltypesofintervenDontorelievepainispalliaDve

Causesandsymptoms2-3months

Causes:-cervixuteri-uterus-uterosacralligamentSymptoms:-Lowbackpain!!

Explana7on:InnervaDonens(ps)islocatedatsegments2-s4.ThePiriformismuscleisinnervatedfromthesesegments(sacralplexus).Theuterosacralligamentispullingonthesacrum.Sacrumanduterus,theymirroreachother.

ExplanaDonandillustraDon2-3months

Piriformisandplexuslumbalis Uterosacralligament

Causesandsymptoms3-5months

Causes:-Kidneys/plexuslumbalis-ligamentumteresuteriSymptoms:-Lowbackpain-Groinpain-Abdominalpain

Explana7on:Thegrowinguterusispushingthekidneyscranial.Thekidneyswillcompressandinflamethenervesbehind,fromthelumbarplexus.Thesenervesinnervatesthelumbarspine. TheLigamentumteres,willlengthenalot.Normallengthis15cm.Attheendofweek40,thelengthwillbeapp.40cm.

ExplanaDonandillustraDon3-5months

•  Ligamentumteresuteri •  Plexuslumbalis

Page 2: Causes and symptoms 2-3 months - GynZone · 2017-11-14 · plexus ). Symptoms: -Low back pain !! Explanaon: Innervaonens (ps) is located at segment s2- s4. The Piriformis muscle is

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2

Syndromeofroundligament. Arterieepigastricinferior,

anastomoses,withinternaliliacarteryandsupplyapartofuterus.Normalperfusionapp.4-5literblood/min.Duringpregnancythisincreaseswith30%toapp6literblood/min. SYMPTOMS:

Abdominalpain(afraidofloosingbaby)andgroinpain(labiamajor)ilioinguinalnervecompression.(nerveofvulvodynia)

Causeandsymptoms5-7monthsCause:-kidneys-VenacavainferiorSymptoms:-Lowbackpain-Problemswithlyingsuppine-Fluidinbody-Nausea

Explana7on:Kidneysagain,butinamorevasculartermnow.DevelopmentofvenuscongesDoninthepevisorgans.Becauseofthechangeofthelumbarlordosis,thevenacavainferiorwillbemevedanterior,compressedbetweenthespineandtheuterus.ThisleadstovenuscongesDonoftheskeleton,ligamentsandmusclesofthepelvis.

ExplanaDonandillustraDon5-7months

Nutcrackersyndrome

ExplanaDonandillustraDon5-7months

MayThurnersyndrome

AEerbirth Normalbirth

Symptoms:-SciaDcpain-Coccyxpain

Explana7on:Thebabysheadcompressesthesacralplexus,thesciaDcnerveandthecoccyx,asitturnsinthebirthcanal.

Page 3: Causes and symptoms 2-3 months - GynZone · 2017-11-14 · plexus ). Symptoms: -Low back pain !! Explanaon: Innervaonens (ps) is located at segment s2- s4. The Piriformis muscle is

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ExplanaDonandillustraDonnormalbirth Normalbirth+epiduralSymptoms:-Coccyxpain-Lowbackpain-Headache

Explana7on:Epiduralanesthesiawillduetothevolume,inducecompressionontheduramater.Theduramaterhasalotofmechanoreceptosaswellasnociceptors.Theduramateritselfcanbecomeverypainfull(neurology).Thebodywilltrytocompensatetoanalteredmechanoreceptoricinput.ThiswilloEenhappen,wheretheduramaterinserts coccyxandc2.EffracDonwithPostponcturesyndromecanalsobethecase.

ExplanaDonandillustraDonepidural

Volumeofepidural

NormalBirth+episeptomiSymptoms:-Coccyxpain-Perineumpain-Cannotrideabike

Explana7on:Thepudendalnervecomesfromthes2-s4,itrunsbetweentheSSandSTligamentsandlast,itliesinthecanalofalcock. Bigriskofcompressionofthepudendalnerve.Apressureincreasementof10%(physiscalfromfibrosedDssusorvenuscongesDon)cancausemono-neuropaD.

ExplanaDonandillustraDonepiseptomiOsteopathictreatment

•  Toapplytoanyproblem!

ArDcularcomponent-ManipulaDon

Muscularcomponent-MET,strech

Ligamnetuscomponent-mobelise

Visceralcomponent-mobeliseviscera(adhesions)

Sacro-Occipitalcomponent-Cranialosteopathy(eg.Duralproblems,coccyxproblems)

Page 4: Causes and symptoms 2-3 months - GynZone · 2017-11-14 · plexus ). Symptoms: -Low back pain !! Explanaon: Innervaonens (ps) is located at segment s2- s4. The Piriformis muscle is

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OsteopathicPalpaDon

•  5qualiDesofpalpaDon1)  size(whenpossible)2)  shape(whenpossible)Mostforosteopaths!3)Tone4)trophicity(segment)5) MOBILITYversussurroundings(possibleadhesions)-otherorganseg.bladdervsuterus-parietalsystemeg.ceacumvsm.Iliacus.

Adhesion?

Duringlifenon-specificadhesionsoccour,inallindividuals.Afall,anoperaDon,pregnancy,abluntforce,aninfecDonareallpossiblecausesofadhesions.Ithasbeenshownthatadhesionscontainssensorynerveendings.ThisisapossibleexplanaDonofwherethepainisoriginaDng.

Adhesion?

Evenadhesionwithinanorganispossible.Eg.AdhesionofthecervixuterihavebeenproposedtocauseinferDlity,dysmenorrheaandvaginismus.

VisceralmobilitylossduetoadhesionCaninfluence

•  ThetoneofvisceralandmusculoskeletalDssue(eg.StressinconDnense)•  Thearterial,venousandlymphaDccirculaDonandthereforethetrophicstateoftheorgan.

•  ThesecreDonsoftheglandsinthewalloftheorganasaresultofthetrophicchangesandpoorvascularsupply.

•  Thetransitofcertainorgans.•  Andmore…….

WhyvisceraltreatmentScience!!!

•  36qpainavarageover3,7year•  Devidedrandomlyinto2groupsof18

•  GroupA,recivedvisceraltreatmentofthepelvisorgans,whichwasmostrestricted.

•  GroupB,recivedjointmobilizaDonofthepelvisareajoints,which

wasmostrestricted.

RESULTS A(visceral) B(joint)

VASpretreatment 6,9 6,7

VASonemonthfollowup 1,8 4,1

Exercisesforpregnant

•  Supine,legsbentandkneestogether.Rotatetoside,whilepusingintogrynfeldtspace.

•  All4.Husbandfingers/thumbsingrynfeldtspace,sidebentbothsides. -tofreethelumbarplexus

Page 5: Causes and symptoms 2-3 months - GynZone · 2017-11-14 · plexus ). Symptoms: -Low back pain !! Explanaon: Innervaonens (ps) is located at segment s2- s4. The Piriformis muscle is

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5

Kilder

•  RenzoMollinari(hlps://www.molinari-insDtute-health.org)

•  JeanPierreBarral(hlps://www.iahp.com/jeanpierrebarral/)

•  KåreMaispeciallægeireumatologi•  ArneBergspeciallægeianæstesi

•  Div.Bøger(besøgklinikkensstand)


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