Dear kind physios, Dr Damien, Physiobob, JayPhysio,yawsy123

My orthopaedist diagnosed stenosis which is not so sever by MRI and referred to me.
But flexion-ex. in spine position did not relieve her pain. So I hypothesized the main cause is not stenosis but spondylolistheis which is confirmed by x-ray and step sign.
The patient can lie on back but has a pain and pins & needles(intensity is 2/10).She has not time when pain and P&N is alleviated perfectly. She cannot tilt pelvic and hold at first.
The reason, I assume, may be hypomobility.
Today(7 th treatment) I treated the patient and found that lumbar lordosis is too excessive and that there is spasm over the left L1/2 to T10/11. I concluded main problem is lumber hypomobility as she couldn’t tilt pelvic without hip full flexion. She had no pain in flexion-ex today.
I cannot still decide which is the main cause, stenosis or lithesis. But I’ll proceed flexion-ex, thoracic mobilization to P.B.O’sullivan exercise.
Thank you very much for many helps. I am very impressed that I could have kind replies so quickly from all over the world.

Best,regards,

Novice PT