Multimodal Physiotherapy for Lumbar Disc Bulging in an Adolescent Athlete: A Case Report

Abstract

Background: Lumbar disc bulging is a common cause of low back pain and functional limitation, particularly in physically active populations, yet evidence on combined physiotherapy interventions in adolescent athletes remains limited.

Objective: To evaluate the clinical effectiveness of a multimodal physiotherapy intervention in reducing pain and improving function in a patient with lumbar disc bulging.

Methods: This case report followed CARE guidelines and employed a single-subject AB design. A 14-year-old female volleyball athlete diagnosed with L4–L5 lumbar disc bulging received a multimodal physiotherapy program consisting of transcutaneous electrical nerve stimulation, ultrasound therapy, and therapeutic exercise over three weeks (three sessions). Outcomes included pain intensity measured by the Visual Analog Scale, lumbar range of motion assessed using a goniometer, muscle strength evaluated with Manual Muscle Testing, and functional performance based on sport-specific activity. Data were analyzed descriptively across time points (T0–T3).

Results: Pain decreased from VAS 5 to 2, lumbar flexion improved from 60° to 75°, and muscle strength increased from grade 4 to 5. Functional performance improved with minimal residual pain (VAS 2/10), indicating clinically meaningful improvement.

Conclusion: A multimodal physiotherapy approach may provide clinically relevant benefits in pain reduction and functional recovery in adolescent patients with lumbar disc bulging and may serve as a potential conservative management strategy.