History
A 64 year old male presented with a one year history of pain extending from the buttock to the outside of the thigh and stopping outside the ankle. He experienced numbness in the same distribution with weakness noted in the ankle. His symptoms were increasingly bothersome and impairing his ability to walk.
His previous non-operative treatment had included: formal physical therapy, chiropractic manipulation, anti-inflammatory medications, narcotic medications and a series of epidural steroid injections.
Examination
On examination, he was found to have restricted lumbar range of motion with pain on extension and weakness in his great toe and hip musculature on single leg stance (muscles affected by the L5 nerve root). His sensation was diminished down the right leg and sciatic nerve stretch testing was positive.
