Date of Award

2018

Document Type

Scholarly Project

Degree Name

Doctor of Physical Therapy (DPT)

Department

Physical Therapy

First Advisor

Schawnn Decker

Keywords

Conservative Treatment; Intervertebral Disc Displacement -- therapy; Radiculopathy -- therapy; Case Reports

Abstract

Background and Purpose: Low back pain affects millions of people annually. The most common cause of low back pain is intervertebral disc herniation and is often accompanied by radiculopathy symptoms in one or both lower extremities. Patients with disc herniation are typically prescribed conservative management prior to surgical intervention.

Case Description: The patient in this case report was a 53-year-old female diagnosed with a posterior-lateral herniation of the L5-S 1 vertebral disc. Her chief complaint was pain in her low back with radiating pain into the right buttock, with occasional peripheralization of symptoms down her right lower extremity to the lateral knee and toes.

Intervention: The patient was seen in physical therapy 2 times a week for 5 weeks for conservative management. Interventions used during the episode of care included therapeutic exercise, mechanical traction, and patient education.

Outcomes: At the end of 5 weeks of treatment, the patient did not see any functional improvement and was discharged to undergo elective spinal surgery. The patient did, however, report improvement of pain symptoms following the use of mechanical traction.

Discussion: Conservative management prior to surgical intervention remains a controversial topic. The patient in this case reported satisfaction following application of mechanical traction which may suggest possible clinical benefits of this intervention for pain relief in patients with intervertebral disc pathologies. However, the length of conservative treatment such as mechanical traction and therapeutic exercise required to show successful functional recovery from disc herniation needs further research.

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