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History

History. 41yr old man 20 year Hx LBP Left sciatica after lifting and carrying toddler Aggravated by sitting and flexion Eased by walking progressively worsening 6 week duration Tried ibuprofen and paracetamol . Clinical findings. Antalgic gait pattern Normal posture

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History

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  1. History • 41yr old man 20 year Hx LBP • Left sciatica after lifting and carrying toddler • Aggravated by sitting and flexion • Eased by walking progressively worsening • 6 week duration • Tried ibuprofen and paracetamol

  2. Clinical findings • Antalgic gait pattern • Normal posture • Lumbar flexion 30 degrees • Extension nil • S1 weakness and altered sensation • Absent ankle reflex • SLR = 30 degrees • No pain on palpation or percussion

  3. L5/S1 prolapse • sequestration

  4. Treatment • Sacral epidural and nerve root block • 3 weeks post injection 50% reduced pain • 6 weeks post injection 90% reduced pain

  5. Treatment • Physio – core stability, neural mobilisation, aerobic fitness, hydrotherapy • 4 years on pain free

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