LBP causing lateral calf pain

[misssaf]

Hi
I have been seeing a 59yr old woman who has lumbar pain, radiating into lateral upper calf/posterior knee.
Her symptoms are very diffuse and movement restrictions alter daily (one day flexn causes pain, the next its is fine) SIJ tests were negative although L345 are very close packed.
Stretching exercises (mainly flexion based as at the time it was OK) failed to resolve symptoms which are worst when sitting (although walking is now becoming a problem)
She has ongoing nerve sensitivity because of a wrist# which has been plated.

I have been treating her with maitland longitudinals initially bilateral & now unilateral. Initially these helped but last time they failed to resolve pain for more than 20mins. I have also mobilised superior tib/fib with temporary improvement. She keeps saying that all she wants is a massage?

I dont want to keep seeing her for treatment if she can be cured elsewhere - suggestions please.
Thanks

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[asha]

You do have to give more info on this. Was the onset sudden?
What does extension do to her.
Is L345 closely packed in flexion or extension.
Are there any am/pm variations in pain.
What is her SLR.
Until a full eval is done, it could be a whole lot of things that could be going on there.

[21stcenturyPhysio]

Gday...

Is the referred pain sharp and sickening or is it more dull and less easily localised?

21stcenturyphysio

[wutti]

hi, what about her posture. increased lumbar lordosis? sound like L5/S1 to me, maybe sponylolithisis. what is her job? lots of sitting? give more general infos please.
cheers

[arkesh_physio]

DID U CHECK PAIVMS?
What does it reveal??

[Usher8701]

Firstly rule out spondylolisthesis-dont know who the idiot but ignore whoever said that- unless shes been kicked in the back!
Going off her age and if she has had pain for a while(i.e last 3yrs) spondylosis-instant pain ?mechanism i.e lifting=bulge
Posterior calf pain i'm thinking L5 tried rot? I would grade it try get a 3 (maitland) then unilateral to centralise the pain. I would do unilateral with a transverse. Also when centralised do a PA.
Core stability exercises are good and easy to progress