I wanted to see if anyone has had any experince dealing with a patient with a "Vacuum Phenomenon" (L5-S1) displayed on x-ray. This patient flexed forward three weeks ago, and felt pain and muscle spasm. They have DDD and disc herniations at L3/L4, L4/L5, and L5/S1. The muscle spasm has not settled down over the last three weeks, and they remain shifted to one side+++.
We have tried manual traction/mobs, flexibility exercises, U/S, Acupuncture, soft tissue technique. Does anyone have any suggestions for further intervention?

Thanks!

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