Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with localized mechanical low back pain, exacerbated by lumbar extension and rotational activities. Pain is insidious in onset, non-radicular, and lacks associated neurological deficits (no bowel/bladder dysfunction, saddle anesthesia, or distal weakness). Symptoms are relieved by rest and flexion-based positioning. No history of trauma or constitutional symptoms.
Clinical Examination Findings
Lumbar spine examination reveals localized paraspinal tenderness at the affected level. Range of motion is restricted and painful during lumbar extension. Stork test (single-leg hyperextension) is positive, reproducing the patient's primary pain. Neurological examination is intact: motor strength 5/5 in lower extremities, sensation intact to light touch, and deep tendon reflexes are symmetric and 2+. No gait abnormalities observed.
Treatment Protocol
Conservative management initiated: activity modification to avoid hyperextension, physical therapy focusing on core stabilization and pelvic tilt exercises, and non-steroidal anti-inflammatory drugs (NSAIDs) for pain control. Consider rigid or semi-rigid lumbar bracing for symptomatic relief during acute phases. Follow-up imaging in 3-6 months to assess for healing or progression.