hi folks,

i have a patient 22/f with LBP since last 2 years
here are the details,
there is no significant H/o lifting weight or fall etc
pain pattern-c/o pain in the lower lumbar area,(constant pain)
- central pain in lower lumbar region,without any
radiation to LE's.
-prone lying & side ly eases the pain 2 some
extent
-supine ly increases the pain,sitting for 30mins
increases pain

ROM- L.flxn-painful & restricted
L.extn- pain at end range
side flxn-painful b/L
rotn-painful b/L
o/e- mildly increased thoracic kyphosis,slightly decreased lumbar lordosis
no neurological deficit found,
central PA over L4,L5 produces same pain
hams tight b/L, pyriformis tight b/L
SLR- produces same pain(central pain over L4,L5)at
70 degrees b/L
slump test-produces same pain b/L
b/L SLR -produces same pain
stretching of pyriformis also produces same pain

investigations- R factor-negative 4 RA
HLA -neg for AS
X ray-appears normal in AP & LAT views,no osteophytes
treatment-
neural mob in slump posn
central PA over L3-L5-(gr2)
b/L lat PA over s1
mckenzies extn exs , stretching of hams,pyriformis & MET for pyriformis

i have treated pt for 2 seatings,there is no relief as of now.
central PA increases pain that subsides aftr 10 mins but patient doesn't get relieved of her original symptoms .
Am i too vigorous with the treatment.

all suggestions are welcome,
waiting 4 postings immediately

thanking you in advance

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