Concluded Case

Backpain, sciatica

30y/F ,house wife #H/o-no h/o DM and thayroid&fall down #C/o-back pain with tingling sensation in right leg , difficulty in walking sitting and supine, difficult in forward bending and backword bending Other ADL activities #O/E- tenderness-grade2(in lumbar region paraspinally ROM- decrease (due to pain) MMT-GRADE3 DTR-normal Special test-SLR and figure of four is +ve #Radiology examination- -modic type2 degenerative chany showing at L5-s1 level -Diffuse disk bulge at L3-L4,&L4-L5 level Please kindly give me your valuable suggestions Doctor Thank u

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Concluded answer

MRI showing there thecal compression at the label of L5 S1. as the diameter is much less than the normal suggestive spinal canal stenosis Initially conservative treatment Back extension exerscises Limbo Sacral belt to use Cap Vit D3 60K weekly for at least 12 weeks If not relieved decompression may be helpful.

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MRI showing there thecal compression at the label of L5 S1. as the diameter is much less than the normal suggestive spinal canal stenosis Initially conservative treatment Back extension exerscises Limbo Sacral belt to use Cap Vit D3 60K weekly for at least 12 weeks If not relieved decompression may be helpful.

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PIVD. Showing SLR and Figure of four positive. SCIATICA . Physiotherapy is necessary. some exercises and posture correction and stretching and strengthening exercises will start . And ELECTROTHERPUTIC MODALITIES for pain relief . After consulting a expert physiotherapist. Start physiotherapy sessions.

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MRI finding of disc bulge are not severe to require surgical treatment Adv Conservative treatment with physiotherapy, pain management and vitamin supplements especially vitamin D

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L5 -S1 disc with compression of theca,hypertrophy ligaetum flava with narrowing of canal at that site. Medical management fails ,needs surgery.Pt will become better after surgery

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Focus on local muscle strengthen of the spine with stretching piriformis, hams,quads & strengthen same.

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L5/S1 disc bulge with canal stenosis Will benefit from surgery Neurosurgery evaluation

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PIVD at L5/S1 level. Start all the PIVD management protocols.

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NAD ADV PHYSIOTHERAPY

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