A 48 year old male Caucasian laborer/heavy equipment operator presents with progressive worsening of neck tightness and ”locking” and right lumbar pain which began following a fall and fracture of the right 11th rib three weeks earlier. Left trunk rotation still produces pain in that area.   IRT was performed to fracture area, which corrected right quadratus lumborum and rectus femoris muscle weakness.  Subsequent manipulations for a Category II pelvic lesion, L4/5 subluxation, and thoraco-lumbar fixation were performed, resulting in significant lumbar and rib area pain relief.  No recurrence of pain in these areas was seen on the next follow-up visit.

-DR. ROGER A. YATES, OLD SAYBROOK, CT