Chapter 22a
Case Study: Low Back Pain - 1

Subjective - This patient is a 36 year old male professional truck driver. This patient's chief complaint is acute LBP located in the lumbosacral area which frequently refers posteriorly down his right leg to the right calf. Both the LBP and the leg pain are increased when sitting, forward bending, and when getting out of his truck. The leg pain is lessened when he walks. He has no complaint of weakness or numbness in his LE's. This pain began 2 weeks ago following a long drive. He has received no previous treatment for this problem. He was however, evaluated by his primary care physician who felt that his pain was of musculoskeletal origin. Radiographs were interpreted by a radiologist as being normal. He has mild HTN, otherwise his PMHx is unremarkable. His goal is to return to truck driving as soon as possible.

Objective - This patient has an erect posture, but he moves in a guarded manner. His leg length is equal, and his sacral base is level on the frontal plane. The LE girth is symmetrical. His range of motion is as follows: trunk FB is 50% with increased back and leg pain, BB is 25% with increased back pain but decreased leg pain, SB is 75% bilaterally and not painful, trunk rotation is WNL. SLR is limited to 45 degrees on the right and increases leg pain, otherwise the range of motion of LE's is WNL. Motor-Sensory function is WNL, DTR's are normal. Palpation increases his LBP over when posterior to anterior pressures are applied to the spinous process of L5 . The SI joint provocative tests are negative.


Treatment Plan:

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