Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic mechanical low back pain exacerbated by extension and prolonged standing. Reports intermittent radicular symptoms in the lower extremities, consistent with L5-S1 nerve root irritation. Pain is rated at [X]/10, localized to the lumbar region, with no bowel or bladder dysfunction.
Clinical Examination Findings
Physical exam reveals palpable step-off deformity at the L4-L5/L5-S1 level. Lumbar range of motion is restricted, particularly in extension. Neurological exam shows [intact/diminished] sensation in L5/S1 dermatomes, [intact/weak] motor strength in extensor hallucis longus and gastrocnemius, and [2+/diminished] patellar/Achilles reflexes. Negative straight leg raise bilaterally.
Treatment Protocol
Conservative management initiated including physical therapy focusing on core stabilization and pelvic tilt exercises. Prescribed NSAIDs for inflammation and activity modification to avoid heavy lifting and hyperextension. Follow-up imaging in [X] months to monitor for progression of Grade 2 slippage.