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Functional Restoration for a Chronic Lumbar Disk Extrusion With Associated Radiculopathy

AJ Hahne, BPhysio(Hons), is a physical therapist with Spinal Management Clinics, Melbourne, Victoria, Australia
JJ Ford, PhD, MPhysio, BAppSc(Physio), Cred MDT, is General Manager, Spinal Management Clinics of Victoria, and Lecturer, School of Physiotherapy, University of Melbourne, Melbourne, Victoria, Australia

Address all correspondence to Mr Hahne at: ahahne{at}primus.com.au

Background and Purpose. The effectiveness of functional restoration (FR) for patients with lumbar disk herniation with associated radiculopathy (LDHR) is unclear. This case report describes how an FR program was used to rehabilitate a patient with such an injury. Case Description. The patient was a 26-year-old female child care worker with a 12-month history of back pain and a 4-month history of unremitting left leg symptoms. She had clinical and radiological evidence of an L5–S1 disk extrusion with associated left S1 radiculopathy. Interventions. The patient completed a 9-week FR program supervised by a physical therapist. Exercises then were continued more independently for a 2-year period at a public gymnasium. Outcomes. Following 9 weeks of supervised FR, the patient demonstrated marked improvement in symptoms and functional ability, and resolution of neurological signs. Fourteen months after commencing FR, a follow-up magnetic resonance imaging scan demonstrated resolution of the L5–S1 disk extrusion and relief of S1 nerve root compression. Functional improvements continued and were maintained 2 years following the start of intervention. Discussion. A patient with chronic LDHR who underwent FR made significant improvements. Research is needed to determine the efficacy of an FR approach for treating such patients.

Key Words: Back pain • Exercise therapy • Intervertebral disk displacement • Radiculopathy • Rehabilitation

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