Flexion Directional Preference in a Patient With Low Back Pain, Utilizing Mechanical Diagnosis and Therapy: A Case Report

Abstract

Background Low back pain (LBP) is a complaint commonly seen by primary care physicians. Societal efforts to prevent LBP have led to more erect work environments to avoid excessive lumbar flexion. This case report involves an individual presenting with acute LBP after a hyperextension injury. Case Presentation The patient was assessed using Mechanical Diagnosis and Therapy (MDT), which is based on symptomatic and mechanical responses to repeated and sustained movements. The patient required movements into flexion, with modifications in loading strategies. Outcome and Follow-Up The patient was able to return to his prior level of function after 5 treatment sessions over 14 days and remained symptom free at long-term follow-ups. He was able to manage his symptoms without further health care management. Discussion This case report demonstrates that not all individuals require lumbar extension movements. It also demonstrates the clinical reasoning involved in a thorough MDT assessment, resulting in the resolution of symptoms. JOSPT Cases 2022;2(1):44–49. doi:10.2519/josptcases.2022.10006