On examination the Rothwell patient has restriction on all lower back movements with a mixture of pain, stiffness and sciatic radiation on bending forwards and side bending to the right. On palpation the patient presents with increased tissue tension in all the lower spinal muscles with major trigger points in Right L4 / L5 and L5 / S1 as well as the right gluteal area, which on palpating this trigger produces the sciatic leg pain. Mr X has had no investigations to date.

Rothwell patient, Mr X, received 8 weeks of treatment, attending the clinic twice weekly. Treatment consisted of manual therapy to reduce tissue tension and manipulation techniques to improve spinal movements. Mr X was also given a specific exercise programme to strengthen inner and outer core muscles.

At the 8 week period, Mr X from Rothwell, had a 90% improvement and had almost no pain in and around the lower back.