title: Cranial Treatment and Spinal Manipulation for a Patient With Low Back Pain: A Case Study.
abstract: OBJECTIVE
  The purpose of this case study is to present chiropractic management of a patient with chronic low back pain by focusing on the craniomandibular system.
  
  
  METHODS
  A 37-year-old man consulted a chiropractor for pain in the lumbosacral area with radiation down the anterolateral side of the upper left leg. The symptoms started after a fall the previous year. Examination showed a post-traumatic chronic L4-L5 facet dysfunction and left sacro-iliac joint dysfunction. Chiropractic spinal manipulation to the lumbar spine and pelvis gave only temporary relief from the pain.
  
  
  RESULTS
  A year later a bone scintigraphy was conducted, in which a lesion was found over the right sphenoid area. Cranial treatment of this area was added to the chiropractic treatment plan. After this treatment, the patient reported that he was pain free and could return to normal activities of daily living.
  
  
  CONCLUSIONS
  The clinical progress of this case suggests that for some patients, adding craniosacral therapy may be helpful in patients with low back symptoms.
authors.affiliation: Private Practice Dordrecht, The Netherlands.
authors.forename: Wayne
authors.initials: W
authors.lastname: Powell
authors.affiliation: Private Practice, Borger, The Netherlands.
authors.forename: Simone F C
authors.initials: SF
authors.lastname: Knaap
keywords: Craniomandibular disorder; Low back pain; Sphenoid bone; Stomatognathic system