Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic, localized low back pain exacerbated by lumbar extension, rotation, and prolonged standing. Pain is described as dull, aching, and non-radicular, with occasional referred pain to the buttocks or posterior thighs. Symptoms are relieved by sitting or forward flexion. No associated neurological deficits, bowel/bladder dysfunction, or constitutional symptoms reported.
Clinical Examination Findings
Lumbar spine examination reveals localized tenderness over the paraspinal facets at the affected levels. Range of motion is restricted and painful during extension and lateral rotation. Kemp’s test is positive for reproduction of localized pain. Neurological examination is unremarkable; deep tendon reflexes, motor strength, and sensory testing are intact bilaterally. Negative straight leg raise test.
Treatment Protocol
Initiate conservative management including physical therapy focusing on core stabilization and lumbar mobilization. Prescribe NSAIDs for inflammation and muscle relaxants as needed. Consider facet joint intra-articular corticosteroid injections or medial branch blocks if conservative measures fail to provide adequate relief.