Abstract
A patient with low back pain and left radicular pain was seen for 10 sessions in a 6-week period from 6/26/19 to 8/2/19 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 at the initial encounter with the numeric pain rating scale, straight leg raise test, bubble inclinometer, joint accessory motion testing, Oswestry Disability Index, Fear Avoidance Beliefs Questionnaire, observation, palpation, and patient report. The patient was found to have moderate to severe pain, limited lumbar range of motion, and severe disability with functional activities. A plan of care was established with the main goals of decreasing pain, improving lumbar range of motion, decreasing lumbosacral neural tissue mechanosensitive, and reducing functional activity limitations, such as increase sitting, standing, and walking tolerance, increase lifting capacity, and being able to sleep through the night without sleep disturbance. In addition, the patient wanted to return to his usual cycling routine. Main interventions used were directional preference exercises into flexion, traction, modalities, manual therapy, massage, range of motion exercises, stretches, motor control exercises, education, and a home exercise program. The patient achieved the following goals: reduced pain intensity, increased sitting, standing, and walking tolerance, increased lifting capacity, sleeping without disturbance, and successful return to usual cycling routine. The patient was discharged with a home exercise program to remain living at home with his wife.