Article

The medical management of low back pain (LBP) can be approached in a multitude of
ways. Classification via subgrouping is increasingly common in orthopedic
literature. Clinical diagnosis and treatment of LBP using the patient response
model (PRM) can assist clinicians in hypothesizing the origin of pain and
providing beneficial interventions unlike the widely used pathoanatomical model.
This case report involved a 52-year-old female with sudden onset of right-sided
LBP that radiated to the foot. These symptoms were accompanied by occasional
paresthesias in bilateral lower extremities. Magnetic resonance imaging (MRI)
confirmed disc bulges at levels T11-T12 and T12-L1. On the first of seven visits,
she reported 9/10 on the Numeric Pain Rating Scale (NPRS), scored a 24/50 on the
modified Oswestry disability index (mODI), and demonstrated lumbar flexion range
of motion (ROM) of 10 degrees . Using the PRM, the patient was classified as an
extension responder and was instructed to perform 10 repetitions of standing
lumbar extension every 2 waking hours. After 4 weeks of therapy, the patient
reported a 1/10 pain localized to the low back, scored 20/50 on the mODI, and
improved flexion ROM to 45 degrees .
Classification using the PRM yielded
positive outcomes with this patient's symptoms and daily function.

Langue : ANGLAIS