“A 30-year-old male IT consultant was referred to you by his personal trainer. He complains of low back pain for the past 2 weeks that has caused him to miss several days of work. He reports that the pain is primarily in the right lower lumbar region, although he occasionally experiences pain and numbness into the right gluteal region when sitting at work or performing a seated leg press at the gym. His symptoms are worse in the morning and typically improve once he gets started with his morning routine. He also complains of intermittent pain in the upper lumbar region. He rates his pain at 2/10 on a visual analog scale (VAS) during the majority of the day. At worst, the pain is rated as 7/10 on a VAS when he is sitting at his desk for prolonged periods. On physical examination, he has a normal gait. Lumbar flexion is painful. Repeated flexion reveals aberrant motion when returning to an upright position. Right rotation and right side-bending are painful and limited. Extension is limited at end-range but not painful. Hip mobility is within normal limits. Hip abduction strength is 4/5 on the right; otherwise, manual muscle testing is within normal limits. His Modified Oswestry Low Back Pain Disability Questionnaire score indicates a 50% disability. His Fear-Avoidance Beliefs Questionnaire work and physical activity scores were both 15. Segmental mobility assessment reveals hypomobility at the L4-L5 and L5-S1 segments”
Based on the available information, what would be the best intervention to start?
If so, the correct answer would be thrust manipulation.