Outpatient Physical Therapy Management of a Patient with Chronic Low Back Pain and Lumbar Disc Herniation: A Case Study
Date of Award
Low back pain, athlete, neuromuscular coordination techniques, transverse abdominis, Medx treatment
Background and Purpose: Low back pain is a condition that affects 70% of the adult population between 18 and 65, as well as the young and elderly. Many people that have low back pain often have recurrent pain episodes. This negatively affects functional activities of daily living and living with chronic pain can take a psychological toll on the individual. The anatomy of the low back and the surrounding musculature play a pivotal role in standing and sitting tasks. The role of the physical therapist in treating an individual with low back pain is to identify the nature of the pain and what intervention the patient will best respond to in order to enhance their function. The physical therapist must rule in and out diagnoses through a thorough examination and evaluate the patient based on the findings. Any outcome measures utilized should assess functional tasks as well as subjective pain ratings and improvements in strength or range of motion. The purpose of this case study is to describe the physical therapy diagnosis and treatment of a 17 year old patient diagnosed with chronic low back pain.
Case Description: The present case study describes a 17 year old female patient during an episode of chronic low back pain. The high school athlete was limited- in social and athletic activities due to the chronic low back pain. The patient had previous episodes of low back pain that resolved without physical therapy treatment. The initial examination and evaluation as well as the subsequent interventions are listed in the present case study. The plan of care for this patient was described in detail and included the prognosis and functional outcomes following the treatment plan.
Intervention: Interventions include Medx treatment sessions on a biweekly basis. Other interventions include therapeutic exercises as well as neuromuscular retraining exercises.
Outcomes: The specific outcome measure used in the present study was the Focus on Therapeutic Outcomes. The patient made improvements in pain level as well as function. A primary goal of the patient was to be able to return to hockey with minimal pain levels. She was able to do so by the end of the 8 week rehabilitation period.
Discussion: The outcome of the present study was consistent with the current literature. The combination of progressive resistance exercises along with neuromuscular coordination techniques improved her function in recreational activities as well as activities of daily living. Pain was also decreased over the course of treatment. This may have been due to the patient's improved ability to contract her transverse abdominis during functional movements. Limitations of the current study were also discussed along with future study implications.
Fixell, Jake, "Outpatient Physical Therapy Management of a Patient with Chronic Low Back Pain and Lumbar Disc Herniation: A Case Study" (2021). Physical Therapy Scholarly Projects. 732.