Date of Award

2018

Document Type

Scholarly Project

Degree Name

Doctor of Physical Therapy (DPT)

Department

Physical Therapy

First Advisor

David Relling

Keywords

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

Abstract

Background and Purpose. Low back pain is a major disabling diagnosis for adults over 60 with 36-70% suffering from this condition. There is little research demonstrating the effectiveness of physical therapy on the outcome of older patients with a lumbar disc herniation resulting in lumbosacral radiculopathy. The purpose of this scholarly project is to use a case report to explore the effectiveness of physical therapy in elderly patients with lumbosacral radiculopathy as the result of a L5-S1 disc herniation.

Case Description. The case study reviews an 81-year-old male who presented to physical therapy with insidious onset of left lateral hip pain resulting from a herniated L5-S1 disc. The examination and treatment techniques used to treat this patient were adapted from the Ola Grimsby Institute. The treatment focused on manual therapy to increase the mobility of the thoracic and lumbar spine and therapeutic exercises for lumbo-pelvic recruitment.

Outcomes. Upon discharge, this patient had full lumbar range of motion, 0/10 pain on the analog pain scale, and returned to performing all activities of daily living. He completed all of his recreational activities including walking more than two miles and swimming all strokes.

Discussion. This case study supports physical therapy for the treatment of L5-S1 radiculopathy resulting from a herniated disc in an elderly patient. This patient had very few comorbidities, an unlikely finding within the elderly population, that affected his outcomes. Although the current client demonstrated substantial improvements, further research needs to be done on a variety of patients with varying comorbidities over the age of 65.

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