Maladaptive coping behaviors when presented with an acute lumbar lateral shift: a case study.

Abstract

Objective: Describe the influence of maladaptive coping behaviors on the clinical presentation and management of an acute lumbar lateral shift.

Case description: A 39-year-old male sought chiropractic care for acute low back pain with an associated lumbar lateral shift of three days duration. The symptoms had remained refractory to chiropractic care and medication provided by visits to the emergency room and an orthopedist. In response to the severity of symptoms, heightened cognitive and emotional factors propagated passive coping that resulted in bed rest and work absenteeism.

Outcome: Providing an understanding of pain from a biopsychosocial perspective combined with self-management strategies involving the method of manual shift correction and graded exposure exercises decreased pain and catastrophizing in four visits over five days. The Revised Low Back Oswestry scored 82%, 0%, and 2% disability and the Yellow Flag Risk Form scored 96, 8, and 34 at intake, discharge and six months follow up.

Conclusion: The method of manual shift correction is discussed as a favorable biomedical procedure for lumbar lateral shifts, with little attribution to the multidimensional nature of low back pain. This case depicts the influence of maladaptive coping behaviors on a lumbar lateral shift.