Abstract
A 56-year-old female patient with chronic low back pain with radiating symptoms was seen for 6 sessions in a 6-week period at an outpatient physical therapy clinic specializing in worker’s compensation. 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, manual muscle testing, neurodynamic assessment, the Oswestry Disability Index, and the Fear Avoidance Belief Questionnaire. The patient’s primary impairments included low back pain that radiated down the posterior aspect of the right lower extremity to the dorsum of the foot, trunk and right lower extremity weakness, mechanosensitivity of the sciatic nerve, and detrimental beliefs regarding physical activity. These impairments contributed to limitations in functional independence and walking tolerance and restricted the patient’s ability to fully participate in her work as a housekeeper. The primary goals for treatment were to centralize radiating symptoms, decrease overall pain, improve ambulation tolerance, and return to full-time work without restrictions. Primary interventions included flexion-based exercises, neural and soft tissue mobilization, trunk and lower extremity strengthening, and patient education. At the conclusion of care, the patient achieved symptom centralization, eliminated resting pain, demonstrated improved lower extremity strength, and held fewer detrimental beliefs regarding her symptoms. She was able to regain functional independence, exhibited improved ambulation tolerance, and returned to full duty without activity modifications. The patient was discharged to home with an individualized home exercise program for continued strengthening and independent symptom management.