Musculoskeletal Physiotherapy D

We recommend reading the 'Clinical Assessment Resource Package' prior to viewing any videos. Download the 'Clinical Assessment Resource Package' from: http://www.appeducation.com.au/videos... Background for video vignette . Diagnosis: Acute low back pain - Discogenic Context of assessment:   Initial musculoskeletal assessment in outpatient setting Table 7: Background information for musculoskeletal vignette DEMOGRAPHIC INFORMATION Setting Physiotherapy outpatient clinic Gender Male   Patient age 30 ‐ 40 Occupation Floor Tiler Patient Build Medium Main Presentation Acute exacerbation of low back pain Discogenic in nature CLINICAL HISTORY Reason for attending physiotherapy Acute episode of low back pain with intermittent posterolateral thigh pain History of presenting condition 5 days ago while laying tiles at work went to stand up after prolonged flexion and reported severe pain in the low back and buttocks bilaterally. Presented to ED and CT performed. Prescribed Mobic and Panadeine Forte for pain and referred to Physiotherapy for review. Investigations CT – L4‐5 broad based disc protrusion without thecal sac compression Special Questions No bladder or bowel changes No saddle paraesthesia No unexplained weight loss Pain with cough or sneeze Sleep disturbed due to pain at night – difficult to get comfortable No THREADS No P+N or numbness Pain Behaviour Pain and stiffness worse in am Movement dependant otherwise Past Medical History HTN medication controlled, History depression Medications Coversyl HTN, Mobic and Tramal Current Pain, Panadol IM LBP, ciprimil Depression Social History Lives with wife and 2 children - son aged 10 and daughter aged 13 in 2‐level house with 13 internal stairs.    Occupation Self‐employed floor tiler and is involved in mainly manual duties. Functional History Independent with all daily activities, active occupation but sed entary lifestyle. Not currently involved in any regular exercise and exercise tolerance is able to walk greater than 45 minutes. Patient Goals Reduce pain and return to normal function Return to work