08/12/2021
Review of a female patient , age 65, came with a complain of back pain with tingling numbness in right leg , numbness in a typical pattern of sciatic nerve till knee and post tibial nerve below knee till ankle. She has taken physiotherapy else where many sessions of SWD and IFT .. but no relief in pain. She came to me 3 months back . I evaluated her . Pain on VAS ( visual analogue score of pain) showed 6 / 10 ( day 1 ) . MRI findings: disc bulge at L5- S1.. sciatic nerve compression .
She visited many orthopaedic doctors ,some suggested surgery , some suggested physiotherapy so she opted for physiotherapy and see if there is relief .. and came to me . On examination All her special tests positive , The muscle power of Back muscles ( Manual Muscle Test) power 2 on right leg.treatment on Day 1 No modalities focus only on exercises ,Neurodynamic exs ( lower limb tension tests ) and back strengthening exs, McKenzie exs
Day 2 : the pain came down to 4 / 10 , patient feeling better with nerv tension exs. Special tests Negative only Slumps test was positive
Treatment progressed back muscle strengthening exs , along with nerve tension test exercises
day 3 no pain at rest pain only on movement . Focused more on Nerve tension test exercises and McKenzie exercise and back strengthening exercises.
Day 4 : patient feeling better and continuing exs .. as of now she is Satisfied with physiotherapy exercises and is not opting for surgery
