... facets at L5/S1 on the right and diffuse scoliosis to the right in the thoracic and lumbar spine. No other significant bony or soft tissues abnormalities was demonstrated. Initial Examination Findings: Postural examination revealed an increase lumbar lordosis. Her range of motion was good in all movements however right rotation revealed pain in the L2-L4 region. Kemp's test was performed and revealed local pain in the L4 region. Sacroiliac provocation tests revealed pain in the sacroiliac joints. Hypertonicity and tenderness was noted in Paraspinal, Quadratus Lumborum and Piriformis muscles bilaterally and L2/3 and L3/4 joints were restricted and painful on joint play. Physical examination and neurological tests of the lower limb revealed no abnormalities. Differential Diagnosis: Working diagnosis was chronic facet syndrome with sub acute exacerbation with associated hypertonic Paraspinal muscles. Other possibilities included: L3/4 subluxation, Sacroiliac Joint dysfunction, myofacial pain syndrome of Erector Spinae, Quadratus Lumborum muscle (in order of likelihood). Treatment: Soft tissue therapy ...

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