Treatment Details

S — Subjective Leah reports constant sharp buttock pain (7/10) and posterior right hip pain (7/10), worsening overall; symptoms improve with chiropractic care and worsen with movement. Reports increased bladder leakage and slight weakness upon standing. Pain decreases with gluteal contraction while seated and with supine knees-to-floor positioning; heat relieves and ice aggravates symptoms. Valsalva negative. O — Objective Right lower limb extension weakness noted; sensation intact across all LE dermatomes; remaining LE MMT equal bilaterally. Webster evaluation: right sacral restriction, inferior left pubic symphysis, bilateral round ligament tenderness with increased left tension, bilateral iliopsoas tension, right sacrotuberous ligament tension. A — Assessment Right posterior hip and buttock pain with right LE extension weakness consistent with sacroiliac/pelvic biomechanical dysfunction. Pelvic misalignment (right sacral restriction, inferior left pubic symphysis) with associated myofascial tension (bilateral piriformis, iliopsoas, round ligaments). Increased bladder leakage — monitor for possible lumbar/pelvic floor involvement. P — Plan Prone drop adjustment right sacrum; myofascial release bilateral piriformis; right sacrotuberous ligament release; bilateral iliopsoas release; prone drop adjustment left pubic symphysis (I→S LOD with HP). Adjusted: right L5, left C5, right C2, T8 (double thenar). Immediate post-care improvement with easier standing. PT scheduled tomorrow; instructed co-management with nurse midwife/PT/OB. Plan chiropractic care 2×/week ×2 weeks; next visit Friday. Monitor bladder symptoms and consider referral if persistent/worsening.