male 60 complain of pain in back and both lower limb since two years. diagnose n management plz



what is the history of the patient? any trauma? any tingling and numbness.

fall before 9 years not much significant. yup there is but pain while walking n standing up, weakness

posterior lumbar osteophytes are there In the xray,make sure of SLR test.

SLR positive in both limbs and dorsi flexion leads more pain

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These case lumbar spondylosis with L5S1 disc prolapse, mainly give treatment physiotherapy like swd, ift, lumbar traction, back Extension exercise, isometric back exercise. . . And add to some painkiller & pregabalin-methylecobalamine upto 15 days. ..

Gv ful xray of lumbo sacral jt....pic isnt clear

It's disk space reduction and degenerative changes in spine, intermittent lumbar traction 90-90 position, swd,tens for rediculopathy,back extension exercise, core strengthening exercise, pelvic tilt, home care ergonomic advices sd be helpful

x ray dosent show this much abnormality. kindly go with MRI AND NCS. first we wil diagnose in clear manner den we wil go 4r treatment .I think dis is d best way to treat

xary is not clear and complete...go for fresh xray..not clear view of l5 and s1 in lateral view..some clinical assessment must b their before asking treatment!

these days this is a common issue... kindly go for basic treatment protocol... but ergonomic advise is must ...posture correction is needed for long term betterment... taught home exercise at the end to be followed by patient to remain fit nd healthy:)

xrays shows compression .. so first use heat modality then use 5 min static traction then next 5 min intermitant traction .. then spinal extension exercise & use precautions like don't do spinal flexion use hard bed maintain sitting ,walking & lying positions

use NDS treatment for nerve compression

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Intermitent lumbar traction 90-90 position, IFT can be given to reduce d pain progression back extension exercises hams nd cakf strecthing

I always wonder regarding the lumbar traction machine. if patient moves little bit up or down the traction will be on upper or lower segment. and I too know straps are bound around abdomen n thigh but still. plus what if traction is too much for patient but he/she feels that if Dr is giving these much it must be for my good so let me tolerate. n what if while in traction position power is gone? isn't there any manual traction technique? I saw one Physio stabilising back and pulling leg and giving traction of course it's very energy consuming. kindly educate

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if patient feels more pain then use anti inflammatory drug & if feel radiating pain then NIADS & methylcobalamin teb with calcium in normal pain use muscle relaxant only

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