Abstract
Introduction: This case report involves a female with low back pain who was treated with a modified Pilates Method exercise program combined with specific interventions. The hope is to provide a template for a comprehensive treatment plan for chronic low back pain that includes a Pilates based program. Case description: The patient is a 66-year-old female referred to physical therapy for back pain. Systems review The patient presented with decreased active and passive trunk flexion. Her hamstrings were tight bilaterally. The deep stabilizer muscles of her core and back were weak and palpation revealed a tight piriformis in her left hip. Clinical impression/diagnosis: It was believed patient’s pain was a result of abnormal posture, tight musculature, and poor core strength. X-rays supported this diagnosis. Prognosis: The patient was determined to be a good candidate for a combines Pilates lumbar stabilization program. Plan of Care: The goals included the ability of the patient to demonstrate neutral spine posture, restore normal flexibility to hip and knee musculature, increase core and lower extremity strength to normal, to ambulate at least 30 minutes outdoors and return to golf and exercise with a pain rating of <2/10. Interventions: The patient was progressed through 3 stages of Pilates rehabilitation. Sessions included manual stretching of bilateral lower extremities with a focus on pelvic balancing, myofascial release of her low back, deep tissue massage, posterior/anterior joint mobilizations and the use of microcurrent point stimulation. Outcomes: After 18 visits the patient reported no pain and goals were met. Discussion: The patient was seen several months later and was still pain free indicating the success of a combined approach to the treatment of chronic low back pain for a patient with lumbopelvic instability.