I’m not seeing the attached MRI report, but still a ton of room for improvement with this patient. Did his QLF regress when he came in after the increased load/symptoms? Although you improved QLF quickly, you still haven’t touched SLR or strength. And importantly, the load on his low back was a ton. I would fully expect a flare up with 2 rounds of golf, long drives in the car, and long standing postures that are not typical for him. If the report reveals severe degen with neuro compromise it warrants a referral now but if not, I would take him to maximum improvement with very specific load management instructions.
Getting the image this early in care was super important for prognosis and severity purposes. Like I said, I don’t see it attached here so I don’t have all the info, but I would dial it in with him and keeping chipping away.