Functional restoration for a chronic lumbar disk extrusion with associated radiculopathy

BACKGROUND AND PURPOSE: The effectiveness of functional restoration (FR) for patients with lumbar disk herniation with associated radiculopathy (LDHR) is unclear. This case report describes how an FR program was used to rehabilitate a patient with such an injury. CASE DESCRIPTION: The patient was a 26-year-old female child care worker with a 12-month history of back pain and a 4-month history of unremitting left leg symptoms. She had clinical and radiological evidence of an L5-S1 disk extrusion with associated left S1 radiculopathy. Interventions. The patient completed a 9-week FR program supervised by a physical therapist. Exercises then were continued more independently for a 2-year period at a public gymnasium. OUTCOMES: Following 9 weeks of supervised FR, the patient demonstrated marked improvement in symptoms and functional ability, and resolution of neurological signs. Fourteen months after commencing FR, a follow-up magnetic resonance imaging scan demonstrated resolution of the L5-S1 disk extrusion and relief of S1 nerve root compression. Functional improvements continued and were maintained 2 years following the start of intervention. DISCUSSION: A patient with chronic LDHR who underwent FR made significant improvements. Research is needed to determine the efficacy of an FR approach for treating such patients.