Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with localized right-sided lumbar pain, exacerbated by lumbar extension and rotation. Pain is described as dull, aching, and non-radiating, with no associated neurological deficits, bowel/bladder dysfunction, or constitutional symptoms. Symptoms are relieved by rest and flexion.
Clinical Examination Findings
Physical examination reveals localized tenderness over the right lumbar paraspinal musculature at the affected facet levels. Range of motion is restricted and painful upon extension and right lateral rotation. Kemp’s test is positive on the right. Neurological exam: intact motor strength, sensation, and deep tendon reflexes in bilateral lower extremities. Negative straight leg raise.
Treatment Protocol
Conservative management initiated: activity modification, physical therapy focusing on core stabilization and lumbar flexion exercises, and non-steroidal anti-inflammatory drugs (NSAIDs). Consider facet joint intra-articular corticosteroid injection or medial branch block if symptoms persist despite conservative therapy.