Files and links (1)
Free to read and download, Open Access
Background: Imaging may provide positive, validating information to those with unexplained pain, but can also have detrimental consequences for those that may catastrophize over apparent objective tissue damage highlighted by imaging. Discernment with respect to a patient’s psychosocial response in matters such as these is crucial, as knowledge of imaging results may evoke a positive or negative response to their overall pain perception. The purpose of this case study is to describe one successful approach to framing dramatic imaging findings in a patient with severe low back pain (LBP), radiculopathy, and disability, yet responded positively to rehabilitation interventions with nearly full resolution of symptoms. Case Description: A 44-year-old male with a history of anxiety was referred to outpatient physical therapy one year after developing numbness and pain in his right foot. The pain progressed to allodynia, which occurred with any object brushing against his right foot. Outcomes: Over the course of 10 weeks, the patient reported decreased pain from 8/10 to 0/10 on the numeric rating scale (NRS) in his foot along with no symptoms remaining in his low back, despite MRI results demonstrating L3-L4, L4-L5, and L5-S1 disc protrusions with associated annular tears and discal material contacting the L3, L4, and S1 nerve roots. Discussion: This case outlines the importance of word choice and how to convey objective imaging results to a patient with pain-catastrophizing behaviors. It also demonstrates physical therapy rehabilitation measures that can assist in treating low back pain with radiculopathy.