For Each Case Study, decide upon the best modalities to use and be prepared to p

Question

For Each Case Study, decide upon the best modalities to use and be prepared to provide 4 rationale points and be prepared to provide physiologic/therapeutic justification for your choices Case Study #1 43 y.o. male Complains of: R-sided LBP w/ radicular pain down (R) LE, resulting in lateral leg cramping and difficulty walking subsequent to mild foot drop. Occupational Hx: FedEx Truck Driver (does lots of lifting) .Allergies: None Case Study #2 19 y.o. female Complains of: pain, stiffness, and minor swelling after a recent cast removal from (R) leg, subsequent to a distal fibular fracture. Now has difficulty with (R) ankle DF Medical history: chronic ankle sprains subsequent to playing NCAA Div.1 Soccer Allergies: None 30 year old male (R) lateral elbow swelling, inflammation & pain, insidious onset Recreational History: Competitive Tennis Player . Allergies: Adhesive tape

Explanation / Answer

Case study 1:

The best modalities I preferred in this case is Intermittent Lumbar traction. The chief complaints of the patient says unilateral LBP(right side), and right radicular pain(sciatica), right lateral leg cramp, and mild foot drop. The pathology of the condition may be unilateral disc prolapse that compress the right Lumbar nerve, thus resulting in pain, and cramp, and foot drop. The intermittent Lumbar traction modality gives the longitudinal force of the vertebra down ward and the stabilization provided by upper vertebrae. This separation between the vertebrae results in relocate the disc bulge from periphery to central, thus the compression reduces, and the signs and symptoms received. The other effects is stimulation of mechanareceptors while traction of soft tissue around the vertebre which reduce the localized pain.

Case study 2:

The post complications of cast applications commonly causes stiffness, pain, reduced range of motion, and decreased muscle strength. The best modality I preferred is wax bath with mobilization exercise. The temperature properties of wax increases circulation, extensibility of muscle, tendons fascia, and it stimulates the sensory nerve fibers which result in decreasd pain n relaxation. The mobilization exercise increases the ROM of joint and muscle strength.

Case study 3: The most common conditions of tennis players is tennis elbow , medicaly called "Lateral epicondylities". The foremost modalities I choose in this case is Cryotherapy(ice) and Ultrasound. The application of ice reduce pain spasm, swelling. The ultrasound on the lateral aspects promote repair of the muscles and tendons. The biological effects of ultrasounic waves promotes the fibbroblast(collagen and elastin), the main contents of connective tissue. The rate of protein synthesis which result in significant improvement in the rate of tissue repair. It also reduce pain the mechanism of pain relief is achieved via stimulation or mechanareceptors in the tissue thus pain reduction happens(pain-gate theory). The micromassage effect occurs at cellular level which helps in swelling reduction. Thus the ultrasound is often of use after soft tissue injuries, which helps to remove traumatic adhesion and reduce inflammation.

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