Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic low back pain, localized to the lumbar region, exacerbated by extension and prolonged standing. Pain is mechanical in nature, occasionally radiating to the buttocks or posterior thighs, without significant neurological deficit. No history of bowel or bladder incontinence. Symptoms are partially relieved by rest and flexion.
Clinical Examination Findings
Physical exam reveals mild lumbar paraspinal muscle tenderness and palpable step-off deformity at the affected lumbar level. Range of motion is limited in extension due to pain. Neurological examination is intact: motor strength 5/5 in bilateral lower extremities, deep tendon reflexes 2+ and symmetric, no sensory deficits noted. Straight leg raise test is negative.
Treatment Protocol
Conservative management initiated: physical therapy focusing on core stabilization and lumbar flexion exercises. Prescription of NSAIDs for pain control. Activity modification advised to avoid heavy lifting and hyperextension maneuvers. Follow-up imaging in 6 months to monitor for progression of slippage.