Chronic Low Back Pain with Possible SI Involvement and Weak Abdominals: A Case Study

Background and Purpose: Chronic, non-specific low back pain is highly prevalent and is a cause for a large proportion of medical expenses along with many people’s pain and disability. This case report presents a variety of interventions implemented for a patient with low back pain and her reaction to therapy. Case Description: The case study presents a 42 y/o mother to three children. Her pain began about two years ago and has been persistent throughout that time. She has tried many different forms of treatment through medical physicians, physical therapy, and massage therapy but nothing has had long-term relief of her symptoms. This patient works parttime but loves spending time with her children and exercising through aerobic training, weight training, and group fitness classes. Interventions: Interventions included abdominal strengthening through supine and seated pelvic tilts, hanging knees to chest with biofeedback, and toe touches with a physio ball. Stretching of the anterior thigh musculature and hip capsule, which consisted of the goalie stretch, the couch stretch, and the warrior pose. A psoas release was performed on the patient, along with instructing the patient how to perform a self psoas release at home. Outcomes: Outcomes at discharge were favorable for this patient. She decreased her pain level from a 7/10 to a 1/10 and increased her lumbar range of motion to be within normal limits. More important, the patient was able to get back to the activities she was missing prior to outpatient physical therapy sessions. Discussion: The patient progressed well and tolerated physical therapy. More research is needed in regards to if there is any correlation between the psoas muscle and low back pain