Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute onset of localized mid-lumbar back pain following [mechanism of injury, e.g., mechanical fall/lifting]. Pain is described as sharp, non-radiating, and exacerbated by movement, standing, or spinal loading. Patient denies bowel/bladder incontinence, saddle anesthesia, or progressive lower extremity weakness.
Clinical Examination Findings
Spine: Focal midline tenderness to palpation at the L1 vertebral level. No step-off deformity noted. Range of motion is severely limited by pain in all planes. Neurological: Motor strength 5/5 in bilateral lower extremities. Sensation intact to light touch in all dermatomes. Deep tendon reflexes 2+ and symmetric. Negative straight leg raise test bilaterally. No signs of myelopathy or cauda equina syndrome.
Treatment Protocol
Conservative management initiated: Activity modification with avoidance of heavy lifting and spinal flexion. Pain control via scheduled NSAIDs and/or acetaminophen. Orthotic bracing (TLSO) recommended for stabilization and pain relief. Referral to physical therapy for core stabilization once acute phase subsides. Follow-up imaging in 2-4 weeks to monitor for progressive collapse.