A 40-year-old female seeks PT for with a four-year history o…
A 40-year-old female seeks PT for with a four-year history of recurrent low back pain. Her primary functional complaints are an inability to tolerate sitting or standing for any extended period. She has been previously treated by a chiropractor three months ago who focused on heat, massage, and manipulation. These interventions provided temporary relief and did not improve her functional status. . Pain: Location: low back R > L side, intermittent R > L gluteal pain, worsens with sustained postures NPRS: 2/10 on average and 5/10 at worst Aggravating Factors: prolonged postures Imaging: Radiographs show degenerative changes to L4-L5 disc space Past Medical History: Autoimmune disorder in childhood with steroid use x 6 years. Meds: Meloxicam 7.5 mg PRN Social/Work: Caregiver-2 year old child Patient performs remote assistance and meetings (desk) work for 8 hours/day. . Outcome Measure: Oswestry Disability Index- 22%- sitting, standing, lifting are the greatest difficulty Examination Findings: Posture: Increased anterior pelvic tilt ROM: Lumbar flexion 75%, aberrant movement upon return. No change with repeated motions Lumbar Extension 50% without movement deviation Lumbar rotation 100% without movement deviation. Myotomes: strong DTR- +2 bilaterally LE Sensation: Intact to light touch. Special Testing: SLR- negative for neural tension bilaterally Slump – negative for neural tension Palpation: B PSIS tender, L4 increased tenderness greater than PSIS Please answer the below questions and state rationale for each answer. Please be as concise as possible, your first choices will be the ones graded.
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