Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with localized low back pain, exacerbated by lumbar extension and rotational activities. Pain is mechanical in nature, often relieved by rest. No radicular symptoms, bowel/bladder dysfunction, or constitutional symptoms reported.
Clinical Examination Findings
Physical examination reveals localized tenderness over the spinous process of the affected lumbar vertebra. Range of motion is limited by pain during lumbar extension. Stork test (single-leg hyperextension) is positive, reproducing the patient's primary pain. Neurological examination of lower extremities is unremarkable with intact motor, sensory, and reflex function.
Treatment Protocol
Conservative management initiated, including activity modification to avoid hyperextension, physical therapy focusing on core stabilization and hamstring flexibility, and non-steroidal anti-inflammatory drugs (NSAIDs) as needed. Consider rigid or semi-rigid lumbar bracing if symptoms persist. Follow-up imaging in 6-12 weeks to assess healing.