Current Subjective History

Maria is a 47 year old, 178 cm tall, primary school teacher. She is fit and healthy, exercising regularly with walking and kayaking.

On Jan 10^th 2012 Maria had an acute flare low back radiating bilaterally  down the posterior of her legs as far as the heals. Maria was unable to sit and struggled to do the normal activities of daily living with pain levels at 7/10 NRS. Maria admitted to some ongoing low back pain issues over the 2 years, but this tended to be local and settled without needing any medical intervention.

Objective Examination

Maria had grossly restricted lumbar flexion, was acutely tender to palpate the low lumbar spine and had bilateral restriction of SLR to 60 degrees, which was positive to dorsiflexion sensitisation. Reflexes and muscle strength were normal.

Diagnosis – low Lumbar soft tissue irritation, central and discogenic in nature.

Treatment

Leg pains settled with two treatments of gentle mobilisation and pain management modalities, along with strapping to prevent flexion stress, NSAIDS and pain killers. She was given standard biomechanical advice, for modifying her daily activities to reduce low lumbar flexion loads.

Relapse

However things flared badly a month later, with Maria being very distressed with an acute relapse including bilateral leg pain to the ankles again with gross flexion restriction and a bilateral SLR restriction to 70 degrees, but no neurological signs or symptoms. Pain levels were 8/10 NRS.

Spineangel®    ”Real World” biomechanical Management

Maria was fitted with a Spineangel® device to wear continuously for one week of biofeedback. This would enable her to make “real world” changes to her functional biomechanics. Changes Maria made through the biofeedback included modifications to grocery shopping, household cleaning and work postures. This involved better use of her leg power, and core stability muscles to reduce torso flexion loads on the low back, and making better use of sitting postures in the work environment.

Before being fitted with Spineangel®, Maria was completely unaware how often she bent down to the level of the children with their low desks and how much this was contributing her back pain. The gentle biofeedback provided by Spineangel was a constant reminder and now she either sits on a little stool or bends down on one knee.

On discharge Maria’s pain was at 1/10 with SLR to 90 deg on both legs. She still had some intermittent low back pain with prolonged sitting and this was addressed with seating alterations.

John Havill, Physiotherapist.

Spineangel Postural Training