Abstract
A 60-year-old male patient presented to physical therapy with a medical diagnosis of facet joint osteoarthritis and degenerative disc disease. He had a one-year history of low back pain secondary to renal cell carcinoma, a radical nephrectomy, and subsequent bedrest. He was seen for 8 sessions in a 6-week period at an outpatient physical therapy clinic. Treatment was provided by a student physical therapist under the supervision of a licensed physical therapist. The patient was evaluated with the Straight Leg Raise Test, the Slump Test, the Fear Avoidance Beliefs Questionnaire, the Modified Oswestry Disability Index, and the 30 Second Sit to Stand Test. A plan of care was established to address moderate low back pain, severely impaired lumbar range of motion, moderately weak lower extremity musculature, shortened hamstrings, moderate fear of movement, and moderately limited walking tolerance. The main goals for the patient were decreasing low back pain, increasing lumbar range of motion, decreasing fear of movement, and independent exercise participation at the gym. The main interventions used were patient education, manual therapy, lower extremity strengthening, and lumbar stretching. The patient responded well to physical therapy and showed significant improvements in lumbar mobility, lower extremity and core strength, walking tolerance, and fear avoidance behaviors. He was able to perform more of his work duties and return to the gym. The patient was discharged with home and gym-based exercise programs.