Treatment-based approach in a patient with chronic low back pain: a case report

Background and Purpose: It's said that 80% of people will experience low back pain (LBP) in their lifetime.9 Many different factors influence the cause of LBP such as age, gender, psychosocial, occupation, etc.1,2 There's also different types of LBP such as chronic, acute, and subacute. No two cases are alike, which makes standardizing a course of treatment in physical therapy very difficult.1,2 This case report looks at using the treatment-based classification system to direct the course of treatment with the expectations that it'll be multidimensional and unique to the patient. Case Description: The patient presented with signs and symptoms consistent with chronic low back pain. She fit both the stabilization and manipulation category for treatment. The patient's rehab potential was classified as excellent with estimated prognosis of 6 weeks. The patient's goals were to participate in flight school with no interruptions of pain, increase sitting/standing tolerance to over 1 hour with little to no pain to be able to perform school duties and activities like housework. The patient's treatment included: Manual Therapy, Neuromuscular re-education, and Ther-Ex in stabilization. Outcomes: The patient had significant improvements in all outcome measures taken after 4/6 weeks of treatment. These included ODI, FABQ, Pain rating, Prone Plank, and MMT. Discussion: By other research and this case report, it can be said that LBP has so many different factors that it's impossible to define what's the exact best way to treat each patient. We can, however, take the guidelines set by the APTA and Fritz to better classify and direct our treatment plan.