Keramat Ullah Keramat, Sajjad Ali, Jawad Ali.
Safe manual therapy with instant pain relief in the acute central low back pain.
J Pak Med Assoc Jan ;68(2):301-3.

Fifty five year old, previously healthy gentleman presented to the physical therapy, outpatient department (OPD) with complaint of severe low back pain. He sustained injury to his back after pulling a table and was seen 3 hours after the onset. He had a forward stooped posture and could hardly walk. He was on a wheel chair. The force he exerted was a pulling and twisting movement simultaneously. Key finding during the assessment were pain 10/10 on numeric pain rating scale, inability to extend his back, limited ranges of side flexion, normal range of flexion and severe tenderness at L5S1 level centrally. The rest of the examination findings were normal. He was treated successfully through novice manual therapy interventions and reported 75% (2.5 on NPRS) reduction in pain. Extension range returned to the normal with marked improvement in his ability to walk. The case was seen on 8th September, 2016.

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