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Mr Aamir is a 45-year-old physiotherapist who has had a history of occasional stiffness and pain in the lower back region for the past 3 years. 1 year ago he had an episode of disc herniation at L5 – S1 while lifting a heavy patient at work. This was treated with rest, NSAID, and physiotherapy at that time. Now, he has been referred to physiotherapy for recurrent episodes of stiffness and pain in the lower back region with occasional radiating pain over the left lateral and sole of the foot for 3 months. He is a non-smoker, non-alcoholic and has two children, lives with his wife on the 6th floor of an apartment.
He used to be a Tennis player for 4 years but now he rides a bicycle and occasionally goes for a walk around the park nearby his house. Mr Aamir helps his wife to clean the house and assists her in the kitchen during weekends. His physical examination showed a marked reduction of flexion and left side lateral flexion ROM at the lumbar spine and numbness over the sole of the left foot with a positive straight leg raising test on the left side. The patient is unable to stand on his left heel.
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