A 32 year old man hurt his back doing sit ups. He had back pain referring into his right leg. Initially he was treated by his GP with anti- inflammatories which only helped temporarily.
He was seen by a spinal surgeon who ordered an MRI scan which showed some minor wear and tear in the discs and joints in his lower back and also a small disc bulge which was irritating a nerve. Surgery was not indicated in this case but he had an epidural injection to help reduce the pain.
Following this he was referred to physiotherapy. His leg pain had resolved but he was still getting some back pain with certain movements and positions.
Over time he had developed different movement strategies to avoid the pain and although he now had reduced pain, these altered movement strategies had persisted. This was causing him to move and load the joints in his back differently and was causing pain for a different reason.
In physiotherapy we worked on restoring normal movement patterns and normal muscle function in his lower back to help restore normal controlled movement of the joints and help control the amount of load going through the discs.
Quite quickly he was moving normally without pain.