Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic mechanical low back pain, localized to the lumbosacral junction, exacerbated by extension and prolonged standing. Reports intermittent radicular symptoms in the L5 dermatome, without bowel or bladder dysfunction. Pain is mechanical in nature, relieved by rest and flexion.
Clinical Examination Findings
Lumbar spine inspection reveals a palpable step-off at the L5-S1 level. Range of motion is limited in extension due to pain. Neurological examination: motor strength 5/5 in bilateral lower extremities, intact sensation to light touch in L5 dermatome, deep tendon reflexes 2+ and symmetric. Straight leg raise test is negative bilaterally.
Treatment Protocol
Conservative management initiated: activity modification, core stabilization physical therapy, and non-steroidal anti-inflammatory drugs (NSAIDs). Patient advised to avoid heavy lifting and hyperextension activities. Follow-up imaging in 6 months to monitor for progression of slippage.