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Hi World! Thank you for many helps when I posted last. Sorry for cross-posting. Today I want to ask about intermittent claudication. The detail of the case is as below. A 80 years old male has a symptom of intermittent claudication and presents with a few weeks history of right-sided low back pain(around PSIS) with radiation into the anterior? aspect of right thigh. One years ago he had a back pain after he walked for a long time and up and down many stairs.At that time he got well after the treatment of heat and electronial stimulation. He,at present,can walk only 10 meter without squatting for rest. He can ride a bicycle for a long time without pain. 1.X-ray(in my view) All lumbar spines have remarkable spurs. The interspace between the vertebral body of L5 and S1 seems to be narrower than others. 2.Inspection Moderate difficulty in turning on couch. 3.Palpation Tenderness over L5-S1 unilateral on R 4.Active movements Limitted extension.He complains of backpain after prone position for 3 minutes. 5.Dural signs nil 6.Neurological nil 7.Relieving(alleviating) posture He has already recognized most relieving(pain free)posture,which is lying on left side and rotating slightly left.When I rotate lumbar spine to the left further or to the right,he complains of pain. At the onset he couldn't lie on back without pain. 8.Interpretation Intermittent claudication reminds me of stenosis.The posture which opens left foramen of L5/S1 alleviates his pain.Unfortunately I have not lerned how to treat stenosis.It made me hasitate to do passive intervertebral movement test aggressively. In this case how do you develop(proceed)examination and interpretation? 9.Big question The difference between the concept of a orthopaedist and a PT about back pain has been a big problem for me. It seems that PT hasn't unique strategy for each diagnosis of orthopedist -- e.g.stenosis,spondylolisthesis ---. For example,Even if they are diagnosed stenosis by orytho.,PT tend to treat facet,ligament or muscle according to his hypothesis which is difficult to be understood by ortho.. This seems to be a big barrier to make orthopedists in Japan understand manual therapy.Here in Japan PT cannot do anything without their prescription,in which ortho used to order conventional physical therapy such as mechanical traction,hot pack,microwave and electronical stimulation. Is there a good answer for this question? Thanks in advance. Hiro Wood Japan