BOWEN TECHNIQUE: CASE STUDIES 67 – 72

Case 67: Treatment of ear pain, dizziness, tinnitus and hearing loss

Felicity (50 years of age) came to the clinic complaining of chronic left-sided ear and jaw pain and hearing loss. She also experienced intermittent bouts of tinnitus and episodes of dizziness. The onset of these symptoms followed a severe ear infection ten months ago.

Felicity had seen numerous doctors and medical specialists and she had undergone various tests including a CT Scan and an MRI. The scans showed nothing remarkable and she was told the ear infection had damaged the nerves in the region and that she was suffering from a condition similar to labyrinthitis. She found the dizziness could be controlled by taking several prescribed medications (including benzodiazepine, venlafaxine and others) and she was learning to live with the reduced hearing capacity. Her main concern was the constant pain in her ear which often radiated into her jaw and the side of her head or face.

I assessed Felicity and found a left-sided dural drag. When she turned her head to the left her right leg became short. When she turned her head to the right her left leg became short again – She showed a classic Double Cervical Turn Test , +2CTT , indicating her primary issue was associated with her coccyx or sphenoid.

I moved quickly through the basic Lower Back, Upper Back and Neck work and noticed significant tension in the right paraspinal bundle in her neck. I placed my fingers just below the zygomatic arch on each side of her face and asked her to open and close her mouth so I could feel the movement of the condyles. As she opened her mouth her jaw made a loud ‘cracking’ noise and the condyles ‘jumped’ beneath my fingers. I asked her how long her jaw had been doing this and she told me it always clunks like that.

Over the next ten minutes I worked on her jaw, releasing the tension in the right TMJ. I also released some of the compensatory tension in the sternocleidomastoid muscle on the left side.

I concluded the treatment by checking her coccyx. Using the left leg as the lever, I applied a coccyx correction that left her with symmetry. I asked her to return in one week.

Felicity returned a week later saying she was very happy and very surprised as she had experienced quite a lot of improvement. The pain had reduced significantly and she had stopped taking some of her medications. She was also very surprised that the clunking of her jaw had reduced dramatically. The assessment was the same and I simply repeated the treatment protocol from the first session.

One week later she returned again and told me the improvements had continued. Her jaw was now moving much better and the pain had localised to a mild/dull ache inside her ear. The treatment was the same as before but I could feel the obvious improvement in the target tissues. I asked her to return again in two weeks for another session.

I saw Felicity yesterday and she was delighted with her progress. She has stopped all her medications and she is no longer experiencing pain. She has no more dizziness and no more episodes of tinnitus and she feels her hearing is now improving. I assessed her and found she was still holding symmetry.

Case 68:  Treatment of chronic coccyx pain (coccydynia) in a 47 year old male.

Anthony presented to the clinic complaining of constant pain around his coccyx (coccydynia). He had been suffering from persistent pain for almost a year however he could recall no specific event associated with its onset. He rated the pain as a 6-7 out of ten but it intensified at times (for example, when standing after a prolonged period of sitting). In these moments, he would experience severe shooting pains in his sacral region and into the pelvic floor. He had consulted doctors, chiropractors, and an osteopath but despite many sessions, he had not experienced any significant relief.

Assessment revealed a right-sided dural drag and the screening showed a Reverse Double Cervical Turn (2CTT-R). This screening presentation indicates the patient has two separate issues; one affecting the upper dural attachments and one affecting the lower attachments.

I applied some basic Lumbar, Upper Back and neck moves before deciding the scalenes on the right side of his neck were rigid and tense. Once I had released this area, I had him turn prone again and applied a Reverse Coccyx Procedure using the short right leg as the lever. He now showed symmetry so I asked him to return in a week for a follow-up treatment.

At the second session, I asked Anthony if he had noticed any changes. He told me his golf game had improved significantly but his pain levels were fairly similar. The session went exactly the same as the first one with regard to the assessment and treatment.

At the third session (another week later) Anthony stated that he was definitely experiencing less pain. He still showed a right-sided dural drag and the assessment and treatment were very similar to the first two sessions. I felt the scalene issue had almost resolved and I asked him to return two weeks later for a fourth session.

At the fourth visit Anthony said he had not enjoyed any further improvement. He hadn’t slipped back but he hadn’t made any further progress either. The assessment was still exactly the same but the scalenes now felt very ‘normal’ to me. During this session I targeted the pterygoid and temporalis at the left temporomandibular joint (the area felt hard and tense compared to the same tissues on the right side). I made a number of deep, firm moves and then let him rest. I then performed the same Reverse Coccyx Procedure, still using the right leg as the lever.

Two weeks later Anthony returned for his fifth visit and he was very excited. He told me he had made a great leap forward since the last visit and any remaining pain could only be rated as a 1 out of ten. In addition, he no longer felt any shooting sensations on standing from the sitting position. I repeated the assessment and the treatment of the last visit, focussing again on the left TMJ and the coccyx.

Anthony came to see me today (two weeks since his last session) and he reports his improvement has continued and he no longer feels any pain or discomfort. I assessed him today and found a presentation of tonal symmetry. I checked his TMJ and found no abnormal tension. I told him to come back again if the pain ever returns.

Comment: This case highlights the “Lovett Brother” relationship that exists between the coccyx and the sphenoid bone. Bowen therapy (when applied appropriately) is remarkably efficient at restoring function to both these sites. This is both remarkable and unique as few remedial therapies are able to influence these structures efficiently.

Case 69: Chronic pain and a constant “giving way” sensation in the right hip

Martha (70years old) came to her appointment with the aid of a large walker. As she walked down the hall to the treatment room I could see she moved awkwardly with a severe limp. She told me she had many problems, including many years of ongoing lower back pain, hip pain, and leg pain, but her main concern now was that her right hip constantly felt as if it would buckle and collapse beneath her whenever she put any weight on it. This particular symptom had been constant for the past six months and had failed to improve with conventional therapy.

She lay prone on the treatment table for the initial assessment and I observed severe distortions through her lumbar spine and pelvis. Her right leg appeared a full 5 cm shorter than the left and her left buttock and lumbar spine were severely elevated. Just looking at the distorted structure in front of me almost made me feel discomfort!

I pulled her shirt up to look more closely at her lumbar spine and noticed significant scarring. I commented on it and she told me she had been the recipient of a kidney transplant just eight months ago. The new Kidney had been put into her left side. I enquired about other surgical procedures and she told me one of her hips had been replaced, as had one of her knees. I was so impressed by the leg-length discrepancy that I took a photo and showed her (see below). She joked that she was ready for the knackery (Knackery: a person or business who buys worn-out or old livestock and then slaughters them to sell the meat or hides). I told her I liked a challenge and that we would see if I was up to it.

I followed the basic process of applying some Lower Back and Upper Back moves and then had her turn supine for some neck work. The BRM’s were unremarkable so I moved to check her adductors. The left adductor was rigid and painful and the release surprised her. I told her I didn’t know how many layers there were to her problem but that had certainly been one of them.

After a two-minute wait, I came back and checked her anterior psoas. The right side was very tight so I released that too and took a short rest. At this point, Martha was obviously wondering what she had gotten herself into. I had her turn prone again and performed a reverse coccyx correction (using the right leg as the lever) which left her with symmetry. I was pretty impressed and I wanted to share my achievement with my subject so I took another photo and showed her the change (see below).

Martha returned a week later saying she felt little or no change. The presentation was the same so I repeated the treatment from the first session noting the tissues were changing compared to the previous week. The only difference in this session was that I finished with a posterior psoas release using the right leg as the lever.

At the third session, Martha was in good spirits. She told me she felt significantly less pain in her lower back and hip since the last visit. I repeated the same treatment and noted the adductors and anterior psoas had improved significantly. I focussed the third treatment on the coccyx and the posterior psoas region.

The fourth session made me laugh. She had been feeling a lot better so she had spent several hours driving around her farm on her quad bike. It had been many months since she had been able to do this but it did seem to have aggravated her back. The presentation was similar but the right leg was now only about 2 cm shorter. The work was focused on the same sites as the previous visit and I asked her to come back in two weeks because I was very happy with her progress.

At the fifth session, Martha moved much more freely. She still used her walker but she had much less pain and her hip only felt like it would give way beneath her on odd occasions. The treatment was a repeat of the previous session and I noted how much the left paraspinal area had changed since I had begun treating her – it felt much more normal now. I asked her to come again in two weeks

Today was her sixth treatment. She came in without her walker. She had no limp. She lay on the table and showed perfect symmetry. The distortions that had me feel so uncomfortable during her first visit had fully resolved. She said her pain had resolved by at least 90% and that she was feeling on top of the world! As I made particular moves to check various structures, I really couldn’t feel much out of place. I marvelled at the incredible healing power of the body and of the amazing capacity of this simple technique when it is used appropriately. I told her the knackery would have to wait a little longer.

Case 70:  Treatment of acute sciatic pain

Edna (78 y.o.) presented to the clinic a fortnight ago complaining of ‘sciatic’ pain. She walked into the treatment room with the aid of a walking stick and she told me the pain had been fairly constant for the previous three weeks. It radiated from her lower back into her right hip and down the lateral margin of her right leg as far as her foot.

I conducted the standard tonal assessment and found her right leg appeared one inch shorter than the left and that this changed to a state of symmetry when she turned her head to the right (positive Cervical Turn Test).

I applied moves of the Lower and Upper Back Procedure (with no waits) and then had her turn over into a supine position so I could work on her neck. Using the moves of the Neck Procedure, I noticed the scalene muscles on the right side of her neck were extremely rigid and tense. The moves were a little uncomfortable so I felt the need to explain to Edna why I was ‘poking around’ her neck when she was actually here for the treatment of her sciatic pain. I told her that I had found a very significant problem in her neck and that I wouldn’t be able to resolve her sciatic pain if I didn’t release the neck issue first.

Edna was impressed. “A few weeks before I developed this sciatic pain, I cricked my neck! I didn’t mention it because the sciatica is causing me far more pain. You just do what you have to do”, she said.

Over the next ten minutes, I applied a number of moves to the affected area and allowed lots of time between them for the tissue to respond. Once I could feel the tissue had released I told her we could now take a look at what was happening in the lower back.

I had Edna turn prone once more so I could reassess and to my amusement, she now showed perfect symmetry. I asked her to get up and walk around a little to see how the sciatic pain was feeling. She walked for a bit and said it was still there. I think this is the moment that would be challenging for most therapists. Although I would understand the urge to address the presenting symptoms, instead I asked her to trust that I knew what I was doing and to come back next week for another treatment.

When Edna returned a week later for the follow-up treatment, she walked easily and no longer needed her walking stick. She told me the sciatic pain began to ease a few hours after the treatment and that it had continued to improve each day since. She told me she felt she was about 80% improved. I assessed her and she was still holding symmetry. I used the treatment to revisit the right scalenes and to continue their ‘rehabilitation’ (although they were a lot better, they were still tight and a little tender).

I saw Edna yesterday for her third visit. Her sciatic pain had fully resolved within a couple of days of the last treatment and she feels her neck is back to normal as well. I told her I thought her neck was about 70% better and that I would like to treat her again in a month to ensure it continues to improve.

Comment: The interesting element, in this case, is its simplicity. I was quite sure I would find a ‘second layer’ once I had released the neck issue. I had expected I would then need to address an issue associated with the sacrum or coccyx. If there was an issue with either of these sites, it resolved spontaneously once the cervical issue was addressed. The spine is one integrated, inter-related, whole unit, and targeted Bowen allows us to treat it as such.

Case 71: Using tonal assessment to justify additional treatment later in the day

Rick (70 y.o.) came into the clinic last week suffering severe pain in the left side of his lower back, extending into his left hip and thigh. He had been experiencing the pain for two weeks but in the last few days, it had become quite severe.

I had him lie prone on the treatment table and noted a massive dural drag that made his left leg appear at least 4 cm shorter than his right. In addition, he showed a positive Derifield sign, indicating sacroiliac joint dysfunction.

The treatment was pretty simple. I completed the Lower and Upper Back Procedures and then checked his neck. His neck was unremarkable so I had him turn prone again and applied a Reverse Coccyx Procedure using his left leg as the lever. This resulted in symmetry which held through a three-minute rest period so I had him get off the table and walk around the room. Rick was happy. He said he felt great relief from the pain and it was obvious that he could move much more easily. I told him to book in again for a week’s time for a follow-up appointment.

Later that same day, Rick came back to the clinic and he was in severe pain again. He told me he was really good for about three hours at which point he decided to put on some work boots so he could catch up on some work. As he lifted his leg to put the first boot on, he felt something suddenly shift in his lower back and within minutes the severe pain had returned.

I told him to hop on the table so I could take a look… His left leg was again 4 cm short and the knee flexion again showed obvious sacroiliac dysfunction. I put in the Lower Back Stoppers and applied another Reverse Coccyx Procedure just as I had about four hours earlier. The result was good. The procedure appeared to resolve the asymmetry so I let him rest for five minutes. After the rest period, the symmetry was still holding so I had him get off the table and walk around the room. After half a minute of careful consideration, he said the pain had gone again.

Rick came to see me today (one week later) for the scheduled follow-up treatment. He told me he had experienced some minor soreness a few days after the correction but that he was pain-free and moving well and that he had been able to return to work. I assessed him and he showed symmetry.

Comment: This is about the only time I can say I have seen an effective correction suddenly ‘revert’ back to a state of dysfunction. The ability to assess afforded me the opportunity to re-apply the specific correction.

Case 72:  Treatment of chronic knee pain and inflammation

Michael (72 years old) presented to the clinic complaining of chronic swelling and pain in his right knee. He had suffered the pain and swelling continually for eleven years. About twelve years ago, he had undergone knee replacement surgery on his left knee and this had been very successful. Unfortunately, a short time after that surgery was performed, his right knee began to ache and swell. His surgeon advised knee replacement surgery for that knee too.

The initial surgery on the right knee failed to improve the swelling and pain so the surgeon repeated the procedure about a year later. In total, Michael had had his right knee ‘replaced’ four times and he has endured other minor surgeries too but without improvement. The pain and swelling had continued to persist for the last ten years. He had attended many months of physiotherapy treatment, some massage, chiropractic, and acupuncture treatments but all without any noticeable benefit. He was taking a multitude of anti-inflammatory and analgesic medications and for the past eleven years, he was still only able to move about with the aid of crutches, a walking frame, or in rare instances, with the support of a walking stick.

Michael had heard good reports about our clinic, from a friend, and so he decided to travel 350 kilometres to see if we could help. He limped into the waiting room using one crutch for support as he clearly could not weight-bear without pain.

I assessed him and noted his right knee was very warm and swollen compared to his left and that both knees were adorned with significant scars stretching more than 10 inches in length. Most importantly, however, I observed Michael had a right-sided dural drag of almost an inch. I carried out a number of screening tests but all were unremarkable.

I performed the Lower and Upper Back work and then decided to try the Psoas Procedure (detailed in the book on page 137) using the right leg as a lever. The paraspinal muscles on the left side of his spine felt like concrete. Each move brought moans of discomfort from Michael and mumbled curses from me. Using three or four deep moves over the erector spinae (spanning a range from about the second lumbar vertebra to the ninth thoracic vertebra) I released the rigid tissue and then I let him rest for three or four minutes.

I reassessed the dural drag and was surprised to see symmetry. I repeated the procedure a second time and noted, with some satisfaction, that the local tissue seemed to have already changed a little. I also noted his moans weren’t as loud as before. I had him turn supine and I applied some of the moves from the Knee Procedure to his right knee.

I checked his neck but I didn’t find much there that concerned me so I concluded the treatment. I told Michael that I thought the work I had done could help his knee but that we would need to wait four or five days in order to evaluate its effect.

That treatment took place two months ago. Michael came in for another visit today. As I entered the treatment room he was smiling broadly and he stood up and shook my hand. “I really only came here today because I’ve come down to pick up a tractor I’ve bought. While I was in town, I wanted to come back and tell you that you cured me.”

Michael went on to tell me that he had been pain-free since a week after the treatment. All the swelling and heat had resolved and he could weight-bear comfortably now and he no longer needed any support. He had stopped most of the medications he had been taking and had reduced the dose of the ones he was still taking (he was having to reduce one or two medications slowly because of the withdrawal effects). He told me he would be forever grateful to me and that he wanted to arrange a bus to bring a dozen friends from his little town in the bush about 350 kilometres away so I could cure them too.

I assessed him again and noted that he showed perfect symmetry. I worked the paraspinal tissues that had been so rigid at the first treatment and I found that they felt completely ‘normal’ now. I thanked Michael for coming back and sharing his progress.

Comment: This patient’s chronic knee swelling and pain began prior to the surgeon performing the total knee replacement. Instead of treating the primary issue, the medical approach was to simply replace the troubled joint. Unfortunately, the knee continued to inflame for more than a decade and all treatment interventions have been directed to the site of the inflammation rather than to the primary dysfunction that sits at its root. Throughout my career, I have seen many instances where chronic post-surgical ‘complications’ have be resolved using a holistic form of bodywork that identifies and resolves the underlying primary dysfunction (often at a distant location).