Lumbar Case Studies

Lumbar radiculopathy (sciatica)and other types of back pain is one of the most frequent and essential spinal condition that a physical therapist commonly treats. Lumbar radiculopathy is a sciatic nerve root irritation or compression at the lower spine (Fuller & Goodman, 2015). A person with sciatica experiences a sudden pain, tingling sensation and weakness from the lower back radiating through the buttocks, groin and all the way own to the leg and feet depending on the affected nerve root irritation, usually from L1 to S1 ( Ropper & Zafonte, 2015).

MRI of the lumbar spine obtained on 05/19/15 revealed at L2-3, endplate osteophyte formation and disc bulge contribute to a mild degree of spinal canal stenosis and a mild degree of bilateral neural foraminal compromise. At L3-4, a disc bulge eccentric leftward and endplate osteophytes formation are responsible for a mild degree of spinal canal stenosis, a mild degree of right neural foraminal encroachment, and a moderate degree of left neural foraminal encroachment. At L4-5, there is a diffuse disc bulge and endplate osteophyte formation which effaces the ventral aspects of the thecal sac and are responsible for a moderate-to-severe degree of spinal canal stenosis, a mild degree of right neural foraminal encroachment, and a severe degree of left neural foraminal encroachment. At L5-S1, a shallow disc bulge and endplate osteophyte formation contribute to a mild degree of left neural foraminal encroachment, without compromise of the spinal

Treatment plan includes saliva toxicology, lumbar MRI with and without contrast and lumbar back brace to provide symptomatic relief for chronic low back pain and to reduce pain by restricting mobility of the trunk and to support the weak spinal muscles. Goal is to facilitate healing of the lumbar spine.

11/13/14 MRI of the lumbar spine showed 4mm left paracentral and foraminal disc protrusion at L4-5, which mildly impinges upon the thecal sac and the proximal left L5 nerve root. The disc protrusion also moderately narrows the left foramen and lateral recess. There was also a 2mm posterior central disc protrusion at L5-S1. A 2mm disc bulge at L2-3 was seen. There was a mild degenerative facet and ligament flava hypertrophy at L4-5 and

Almost half a million people in the US suffering from lumbar spinal stenosis and many more experiencing cervical spinal stenosis.

DOI: 6/26/2002. The patient is a 64 -year-old female patrol officer who sustained a work-related injury to her back, shoulder and legs due to constant driving at work. As per OMNI, the patient is status post lumbar surgery on 1/13/11 and epidural steroid injection on 9/24/12. MRI of lumbar spine with and without contrast dated 6/6/12 revealed congenitally shortened pedicales at the L1-L2 level but no impingement on the thecal sac or nerve roots at this level is identified; desiccated L2-L3 disc with bilateral facet joint arthropathy resulting in moderate bilateral neural foraminal stenosis but no impingement on the thecal sac or nerve roots at this level is identified; desiccated L3-L4 disc with bilateral facet joint arthropathy resulting in moderate bilateral neural foraminal stenosis but no impingement on the thecal sac or nerve roots at this level is identified;

If you were shown how to do any exercises to improve motion and strength in your back, do them as directed by your health care provider.

Newton, the IW has reached MMI. Total Whole Person Impairment (WPI) rating is 17%. Future medical care for the lumbar spine includes nonsteroidal anti-inflammatory medications (NSAIDS), muscles relaxants, physician follow-up visits for acute exacerbations, and additional physiotherapy sessions for any acute exacerbations that do not improve after 6-8 weeks of medications and additional lumbar epidural injections. Any further diagnostic studies are not anticipated, unless there is a significant acute exacerbation or aggravation that does not improve after 6-8 weeks of conservative treatment. Lumbar surgery is not recommended or anticipated.

In the summer between my sophomore and junior year, I had started to feel agonizing pain in my lower back. After seeing a specialist and going over the MRI, I was diagnosed with Lumbosacral Disc Disorder with Radiculopathy. Overall, the MRI revealed lumbar degeneration and congenital abnormalities of the lumbar spine with spondylolisthesis and instability. The problem causes low back pain with left leg weakness and numbness. The congenital abnormality of my spine was there since birth which is very rare; however, I do not have the most severe case compared to other people diagnosed with the same problem.

MRI of the lumbar spine obtained on 07/15/08 showed post-surgical changes at L4-5 and L5-S1, multilevel degenerative changes, most prominent at L4-5 and L5-S1, and foraminal narrowing at L4-5 and L5-S1.

Current request is for 1 Left Lumbar Transforaminal Epidural Steroid Injection at the L5 Level under IV Sedation and Fluoroscopy between 12/23/2015 and

DOI: 11/13/2014. Patient is a 32-year old male technician who sustained injury at the time he was breaking loose a pulser component, he felt a sharp pain to his right side, low back buttocks and right leg. The patient was subsequently diagnosed with lumbar degenerative disc disease, radiculopathy and, lumbar spinal stenosis. Per MRI of lumbar spine without contrast dated 12/23/14 revealed at L4-5 there is disc space height loss, disc bulging and facet degenerative change; at L5-S1 there is posterior disc bulging resulting in mild narrowing of the central canal, and; at T11 to T12 there is posterior disc bulging resulting in mild narrowing of the central canal. As per focused history and physical dated 3/17/15, patient is presented to the office

On 12/19/2017, the claimant presented with lumbar pain. She had continued constant nagging pain with radicular pain in the left lower extremity. She had weakness and numbness. In 2012, she underwent L4-S1 fusion. She had lumbar medial branch block in 04/2017, which helped with the axial low back pain by more than 50%, but the radicular pain becomes severe. She stated that the previous bilateral L5 and left S1 selective nerve root block on 06/21/2017 provided 100% pain relief for 3 days before the pain gradually returned. She also had epidural steroid injection and trigger point injection, which did not help with the pain. The alleviating factors include medication, rest, heat, and TENS unit. The previous physical therapy and chiropractic care had helped significantly. Objective findings showed positive straight leg raise test on the left with tenderness in the left lower lumbar area and bilateral

Low back pain (lumbago) is a very common illness. It has been estimated that up to 80% of a normal population are affected at some time in their lives. Every five visits to the doctor can be related to pain in the back and the total societal cost of back pain was estimated in 1995 to amount to almost 30 billion. Acute lumbago has a good prognosis with over 60% pain-free within 2 weeks and 80-90% within 3 months. Back pain that lasts for more than 3 months, however, a worse long-term prognosis with a high risk of becoming chronic. The chance to be rehabilitated back to work after sick leave for more than 6 months because of back pain have been shown to be low. One can roughly divide the low back pain in two groups; low back pain without leg pain (lumbago, rygginsufficiens) and low back pain with leg pain (ischialgi, lumbago-sciatica).

In one of her physical therapy sessions, she complained of left sided low back pain especially during squats. On assessment, there was straightening of the lumbar spine and tenderness over the left lumbosacral region and sacro-iliac joint. MRI scan of the lumbar spine showed premature degeneration of the L5/S1 disc and inflammatory changes in the sacro-iliac joint.