Multimodal Physiotherapy in Multilevel Lumbar Disc Herniation with Suspected Sciatic Nerve Entrapment: A Case Report

Abstract

Background: Lumbar disc herniation may produce radiating pain, weakness, and activity limitation. Evidence describing physiotherapy management during acute inpatient care remains limited, and symptoms related to lumbar pathology may overlap with suspected sciatic nerve entrapment.
Objective: To describe the assessment, physiotherapy management, and clinical changes observed in a patient with multilevel lumbar disc herniation and suspected sciatic nerve entrapment during inpatient care.
Methods: This single patient case report involved a 59 year old male fisherman with disc herniation at L3 to L4, L4 to L5, and L5 to S1. Assessment included the Visual Analogue Scale, Manual Muscle Testing, Lasègue test, hip provocation tests and the Indonesian Oswestry Disability Index. Two physiotherapy sessions were delivered on 2 and 4 May 2026 and included short wave diathermy, manual therapy, neural mobilization, Dynamic Neuromuscular Stabilization, stretching, walking exercise, and additional procedures documented at the second session. Outcomes were compared descriptively.
Results: VAS decreased from 1 to 0 at rest, 5 to 1 during movement, and 7 to 2 with palpation. Hip flexor MMT increased from 3/5 to 4/5, and the Lasègue test changed from positive at 60° to negative beyond 90°. Baseline ODI was 40% and was not reassessed. Structured post discharge follow up was not documented.
Conclusion: Short term improvement in pain, hip flexor performance, and the Lasègue finding was observed during multimodal inpatient care. The absence of a comparator, brief observation, incomplete information on medication and other confounders, and measurement variability preclude causal attribution to the intervention or individual components.