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A physical therapist is working with a 41 y/o old constructi…

A physical therapist is working with a 41 y/o old construction worker.  The patient complains of low back pain that occurred after lifting some heavy cinder blocks at his working site in Hudson Yards about 1 week ago.  He rates the pain a 7.0 on the VAS and says that it is worse on the right side of the lumbar spine but also radiates into the right buttock.  During your examination, you note that his active lumbar flexion, right rotation, and left lateral flexion are all limited and painful.  He has a (+) SLR test and Faber test.  His hip internal rotation PROM is 30 degrees on the right side and 38 degrees on the left hip.  Lumbar segments L3-L5 are painful and hypomobile upon Central P-A assessment.  He scored a 10 on the work-subscale of the Fear Avoidance Behavior Questionnaire and a 43.0 on the Oswestry Disability Index.  He has suffered from these types of episodes before and reports that he usually lays on the floor supine for three days and the pain goes away, however this time, his approach has not worked.  He has been prescribed cyclobenzaprine by his physician and states that it makes him feel better, although he can’t function properly because he feels loopy the next day after taking the medication. Based on your examination, what is the BEST intervention choice for this patient?  

Consider the following statement and then select the special…

Consider the following statement and then select the special test to fill in the blank: The _________ test works on the premise that if pain is present on passive provocation testing of the vertebral levels but disappears when the spinal extensors are active.  If this is (+), then the muscle activity and/or the mechanical support may be able to stabilize the segment and reduce pain, and the individual may therefore benefit from stabilization exercises.