Recall: Diagnosing the Lumbar Spine

Steps for Treatment:

NEUTRAL, COMPRESSION, EASE

1. The patient is seated with the physician standing or seated on the opposite side of the dysfunction of the patient.
2. The physician places the patient into the position of treatment utilizing the Osteopathic Salute or with their arms across their chest. (Ex: L3 E RrSr: Physician on Left Side, Patient doing Salute with right arm)
3. Physician weaves their anterior arm over the patient’s arm to hold onto patient’s arm in Salute. (Ex: L3 E RrSr: Physician takes their left arm and weaves through the patient arms to hold onto the right arm of the patient)
4. Physician takes their posterior arm to monitor the dysfunction with their index finger and thumb at the right and left transverse processes. (Ex: L3 E RrSr Physician is monitoring L3)
5. Neutral:
   • The physician then positions the lumbar spine, decreasing the anterior posterior curve, and positioning L3 neutral on L4 using the torso.
6. Compression:
   • The physician then applies a gentle axial compression down to L3 until motion is felt
7. Ease:
   • While maintaining the axial compression, the physician rotates and sidebends the segment into the ease at the level of dysfunction (Ex: L3 E RrSr: Rotate and sideband to the right, followed by extension)
8. Hold compression 3-5 seconds
9. Release compression, return to neutral
10. Reassess

Video Tutorial: