Abstract
A 60-year-old male patient with chronic low back pain, pain referring to bilateral superior buttock and thigh, and bilateral lower leg and feet tingling was seen for physical therapy for 15 session in outpatient physical therapy. Treatment was provided by a physical therapy student under the supervision of a licensed physical therapist. The patient was evaluated with manual muscle testing, straight leg raise, functional activity testing, repeated directional movements, the Oswestry disability index, and the fear-avoidance belief questionnaire, and then a plan of care was established. The patient’s primary problems were severe buttock and thigh pain that lead to limited standing/walking tolerance and restricted his ability to do prolonged yard work. The patient’s main goals were to reduce his worst pain, decrease lower leg and feet tingling, improve strength, improve standing and walking tolerance, return to routine yard work, and return to playing/coaching softball. The interventions used were matched-directional repeated exercises into flexion, symptom modulation techniques, strengthening for trunk stabilization and the lower extremity, lifting training, and sport-specific training. The patient achieved a decrease in his worst pain, an absence of lower leg and feet tingling, improved trunk and hip strength, improved standing tolerance but not walking tolerance, improved yard work capacity, and he committed to coaching youth softball. The patient was discharged from physical therapy with a home exercise program and advised to continue with an active lifestyle. At the end of the episode of care, the patient reported that low back pain persisted, but pain was at a lower intensity that allowed him to participate in softball related activities.