Limb girdle muscular dystrophy: a case report initially presenting to an outpatient musculoskeletal physiotherapy clinic with spinal pain and functional weakness.

This is a case report, so it describes a single patient and cannot show how common this pattern is or whether a treatment works. The initial exercise plan was influenced by subjective gains, and later review found no objective gains. Nerve and muscle strength testing in clinic did not identify the condition, and the paper notes myotome testing has sensitivity limitations. MRI showed paraspinal atrophy, but the paper states that atrophy is not the focus of investigation in limb girdle muscular dystrophy and is not evident in everyone. Creatine kinase can be elevated in other conditions and can be normal in some limb girdle muscular dystrophy cases. Genetic testing was not complete, so the specific mutation was not identified.

Do not conclude that physiotherapy should be avoided in people with spinal pain because the patient had no objective gains. This is a case report, and creatine kinase testing is not specific to limb girdle muscular dystrophy.