Abstract
A 31-year-old female patient with subacute low back pain with radicular symptoms was seen for 12 sessions over a period of 6 weeks at an outpatient orthopedic 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, inclinometry, manual muscle tests, the straight leg raise test, lumbar segmental mobility testing, the Oswestry Disability Index, and the Fear Avoidance Beliefs Questionnaire. A plan of care was established to address impairments such as pain, decreased range of motion, decreased lower extremity strength, neural sensitivity, and maladaptive psychosocial factors that limited activities such as lifting and sitting. These limitations affected the patient’s capacity to participate in normal work duties and care for her horses. The patient’s primary goals were to return to work and be able to perform heavy lifts to feed her horses. Main interventions used were manual therapy, traction, nerve mobility exercises, stretches, pain neuroscience education, graded return to functional activity, and low intensity aerobic exercise. The patient met goals for pain, range of motion, lower extremity strength, neural sensitivity, and lift mechanics. She did not meet goals for functional disability, fear avoidant beliefs, ability to care for her horses, and participation at work. The patient was discharged home with a home exercise program.