A MANUAL THERAPY APPROACH TO EVALUATION AND TREATMENT OF A PATIENT WITH A CHRONIC LUMBAR NERVE ROOT IRRITATION

The purpose of this case report is to familiarize the reader with the basic principles of the approach to manual therapy evaluation and trea tment pioneered by Maitland, an Australian physical therapist. This ap proach involves a complete subjective examination to determine the sev erity, irritability, nature, and stage of the patient's complaints. In this way, the therapist may reach conclusions as to the amount and vi gor of the physical examination and proceed with treatment in an analy tical manner Methodical reassessment is used to justify treatment prog ression. Comprehensive treatment and the rationale for this approach a re discussed. Though most physical therapists are familiar with the st raight-leg-raising test as a means of assessing low back pain and chro nic lumbar nerve root irritation, they are often not familiar with oth er tests that examine neural tissues, such as the slump test. The prop osed anatomical and biomechanical bases for these tests are discussed. The patient in this case study was a 50-year-old man with a physician 's diagnosis of a chronic lumbar nerve root irritation. The patient aa s evaluated and treated in eight visits using techniques designed to e valuate neural tissues. Reassessment indicated significant symptom red uction, and the treatment was modified accordingly. Patient management , including home exercises, is discussed. [Koury MJ, Scarpelli E A man ual therapy approach to evaluation and treatment of a patient with a c hronic lumbar nerve root irritation.