Date of Award


Document Type

Scholarly Project

Degree Name

Doctor of Physical Therapy (DPT)


Physical Therapy


Low Back Pain -- therapy; Case Reports


Background and Purpose: When it comes to low back pain, McKenzie theory is considered highly effective for evaluating and treating patients with low back symptoms. There are three main classifications within McKenzie theory; postural, dysfunction, and derangement syndromes. The main focus of this case will be on the dysfunction classification and its subcategory adherent nerve roots (ANR). Dysfunction syndrome is characterized by pain due to deformation of structures and tissues that limit ROM causing pain at end range. ANR's are caused by scar tissue build up encompassing nerve roots due to trauma or surgery that produces symptoms when nerve tension is present.

Case Description: The patient is a 32 year old male who presents with low back pain which later was diagnosed as a lumbar extension dysfunction and RlE ANR.

Interventions: Treatment focused on correction of dysfunction and ANR through prone press ups and nerve flossing. Treatment goals were to decrease pain, increase spinal ROM, and improve functional abilities.

Outcomes: Treatment lasted 9 weeks from initial evaluation with a total of 10 visits. Upon discharge the patient displayed full and pain-free spinal ROM in all directions with SlR, and slump test being negative with improved functional mobility at home and work.

Discussion: The patient reported high satisfaction with treatment outcomes. Additional studies would be beneficial due to limited research in the area of ANR's and dysfunctions.