Effective Management of Chronic Low Back Pain and Sciatica in a 41-Year-Old Man
This case study discusses a 41-year-old man with a 20-year history of low back pain (LBP) who developed left sciatica after lifting his toddler. The pain was aggravated by sitting and bending but eased by walking. After 6 weeks with limited relief from ibuprofen and paracetamol, clinical findings indicated a significant L5/S1 prolapse with weakness and sensory alterations. Treatment included a sacral epidural and nerve root block, resulting in 90% pain reduction after 6 weeks. Physiotherapy focused on core stability and mobilization led to a pain-free outcome after 4 years.
Effective Management of Chronic Low Back Pain and Sciatica in a 41-Year-Old Man
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Presentation Transcript
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 • Lumbar flexion 30 degrees • Extension nil • S1 weakness and altered sensation • Absent ankle reflex • SLR = 30 degrees • No pain on palpation or percussion
L5/S1 prolapse • sequestration
Treatment • Sacral epidural and nerve root block • 3 weeks post injection 50% reduced pain • 6 weeks post injection 90% reduced pain
Treatment • Physio – core stability, neural mobilisation, aerobic fitness, hydrotherapy • 4 years on pain free
