Multiple Sclerosis (MS) and Back Pain
34 year old female with a long history of relapsing-remitting MS. She was living with her husband and young family. She was off work with symptoms and struggling with her mental health.
Presenting problems:
- Lower back pain 7/10- 9/10 (score of pain).
- Pain and increase in pins and needles in her right leg.
- Mobility and balance deterioration.
- Decline in mental health due to worry that she was having a relapse of her MS.
- Unable to work due to pain and mental health decline.
Assessment:
- Asymmetry around pelvis.
- Poor biomechanics of feet and ankles.
- Spasms and restriction through soft tissue.
- Restricted movement through the lumbar spine joints.
- Reduced core and lower back muscle activity.
Treatment:
- Manual therapy to lumbar spine.
- Soft tissue mobilisations and release to lower back and leg.
- Nerve stretching.
- Muscle stretching.
- Exercise focussing on core stability.
- Home exercise plan to maintain achievements made in sessions.
- Referral to NHS orthotics services, letter to GP to refer for mental health services, liaised with MS nurse and suggestion of Pilates class.
Outcomes:
- Pain reduced from constant to occasional 3/10 pain.
- Returned to work after 3 months.
- Improvement in mood.
- Attendance at a Pilates class.
- MS Impact Scale improvement from 87 to 65.
- No new relapse in MS. Returned to normal levels of functioning.
