A 72-yr-old woman with a 3-yr history of worsening low-back and left-leg pain presented for evaluation and treatment. The pain was described as sharp and achy, with an intensity of 6/10 on the verbal analog scale. The patient's pain was palliated with standing and walking and provoked by sitting. The pain was located in the left-low back with radiation down the posterior thigh to the medial ankle. On physical examination, manual muscle testing revealed 4/5 strength in the left L4-L5 myotomes, with full strength in the remaining lower-extremity myotomes. Palpation revealed tenderness over the left-lower paraspinal muscles. Reflexes were +2 and symmetric at the patella and Achilles tendons, Babins-ki's sign was absent bilaterally, and no clonus was present. Straight leg raise, facet maneuver, FABER test, Gaenslen's test, and femoral stretch test were negative bilaterally. She was given nambutenone 500 mg orally twice a day and was placed on physical therapy and ice.
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