Answer 1

  • There are red flag symptoms involved with this case. Bilateral leg pain is a symptom of cauda equina therefore, it would not be safe to treat this patient. Additionally, Paul’s pain is consistent and cannot find comfortable positioning, this is a symptom of cancer, therefore, it would not be safe to treat this patient. 
  • Overall, this is not an appropriate referral unless these symptoms have been addressed with investigations from the family doctor. 
  • I would determine that this patient was not suitable for physiotherapy based on these two symptoms. Furthermore, I would send this patient to the emergency room if they could not find comfortable positioning, if they could, I would refer them back to the family doctor and document. 
  • If these red flag symptoms were cleared, the patient would benefit from physiotherapy. This patient would benefit from an assessment from physiotherapy as it is within the scope of practice to assess pain and nerve symptoms.
  • More elements of this case that need to be considered are if the patient is able to get transportation into the clinic safely.