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spotty2093
spotty2093
29.10.2021 • 
Advanced Placement (AP)

Your patient is a 68 yo active female with an acute onset of LBP with radiating symptoms to the L lower leg. She reports that it came on fairly suddenly over the course of 48 hours. Symptoms have been ongoing now for about 3 months and have settled down some but not abated. She denies PMH for such pain but does report a fall from a horse several years ago in which she suffered a hairline superior pubic rami fracture. MRI shows multiple level low level OA changes with mild disc bulges. PT eval shows no objective signs of radiculopathy with (-) slump and SLR. Neuro and MMT assessment is WNL. Patient’s primary complaint now is L sided low back and buttock pain with radiating pain to greater trochanter, posterior thigh and lateral lower leg. She reports that this pain is dull and achy and unrelenting. She has not noticed anything in particular that makes it either worse or better. She tried PT and was given exercise only that has not given her any relief. Her MD just keeps prescribing pain pills which are helpful but not curative.1. What are your thoughts on why she is continuing to have pain? What are your thoughts on the etiology?2. Please set up a POC for the next two weeks including manual treatment, modalities, ther ex, and home care.3.She has now had 3 weeks of treatment and is doing much better. She still has some stiffness in the low back but her c/o radiating pain to the lower leg have abated. She has some mild TTP in the L trochanter area that persists. Please set up a POC for the next three weeks including manual treatment, modalities, ther ex and home activities.4.She is now 8 weeks out and ready for DC. She is doing much better in that her pain is gone and she has resumed nearly all of her activities. What would be your advice for her ongoing HEP?

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