A 22yo Case Study

A 22yo. client complains of low back pain on their right side. They describe the pain as a dull ache while standing or sitting that worsens while laying and can become a shooting pain upon standing from a seated or laying position. The pain can be felt on their left side while bending, twisting, or walking. Client states that this began happening 4 months ago and has been getting progressively worse. They state that they have had no prior issues and have never had an injury or surgery that could cause the problem. I begin with a series of questions for the client. I ask how they feel at the moment and to rate any pain they are having on a scale of 0-10, 0 being none. Has anything changed in their life in the last 6-8 months i.e. new bed, new couch, new workout, or a new job? They state current pain is at 2, however, this morning they would have said a 5 they also state
First I have the client perform active free range of motion (AFROM) of the spine to the limit of their pain in a standing position. They present with pain on both sides when performing extension of the lumbar spine. Second I have the client supine on the table and perform passive relaxed range of motion (PRROM) to the point of any pain. The client presents with reduced range of motion in the right hip, specifically in extension. Since the PRROM test does not reveal pain in the Piriformis on either side we can possibly rule out piriformis syndrome and sciatic nerve lesion. To verify I have the client perform the Pace Abduction test which is negative, thus ruling out piriformis syndrome. I then have the client take a few steps across the room to see if they suffer any foot drop, the test is negative, possibly ruling out sciatica nerve lesion/s. I progress with the Ely’s test to check for shortened Rectus Femoris muscle which yields a positive result. This information leads me to believe that the client is suffering from