Evidence Based Physiotherapy Management of a Patient with Chronic Low Back Pain having Multiple Disc Herniation with altered Lumber Spine: A Case Report

Abstract

Background: Chronic low back pain is one of the most debilitating health issues in the world. Patients with chronic low back pain (CLBP) frequently exhibit a lumbar lateral shift (LLS). The most frequent presentation is a shift that is contralateral to the side of pain. Purpose: The purpose of this case study is to provide an overview of the management and rehabilitation of the patient with LBP with LLS by using specific problem-oriented treatments. Case Report: In this case study, a 48-year-old female patient has persistent low back pain and discomfort that has lasted for 15 years associated with lumber shift for 6 months. On physical examination, the Numeric Pain Rating Scale, Oswestry Disability Index, Back Pain Functional Scale, and Straight Leg Raise were evaluated on the initial visit to physical therapy and after discharge. She visited 3 times a week over 1 month period, by this point, she had received prophylaxis, manual and self-shift correction techniques, stretching and strengthening of weak muscles to quickly correct deformities and lessen pain, as well as rehabilitation to a high level of function and long-term follow-up at three months. Outcomes: The patient reported NPRS = 8/10, ODI = 68%, and BPFS = 24% on the initial visit. At discharge, the patient reported a 0 on (NPRS & ODI), and BPFS =91% with the ability to return to full work and no associated symptoms or complaints. Conclusions: The integrated physiotherapy approach implemented in this case study was effective in relieving the patient's persistent low back pain and altered lumber spine and it returned the patient to a higher level of functional activity within only 4 weeks. KEY WORDS: Low Back Pain, Physiotherapy, Manual therapy, Strengthening.