Question

You are called for a 48-year old man who is complaining of back and leg pain. Your assessment finds pain and tenderness in his lower back with tingling through his left buttock and down his left leg. He tells you that he has been moving furniture; what would you suspect?

Answer 1

The symptoms described point to sciatica, potentially caused by a herniated disc, which would align with the recent physical activity of moving furniture. Diagnosis requires a physical examination possibly supported by imaging, leading to a treatment plan involving medication, physical therapy, or surgery.

Step-by-step explanation:

The condition described, with pain and tenderness in the lower back, tingling through the left buttock, and down the left leg, particularly after a physical activity such as moving furniture, suggests that the 48-year old man could be experiencing sciatica, which is usually caused by irritation or compression of the sciatic nerve. This condition often results from a herniated disc, lumbar spinal stenosis, or a degenerative disk disease. The pain can be sharp or dull and is typically felt on one side of the body.

Considering this individual's age and activity, a herniated disc seems a likely culprit, as it can occur due to strain, increased pressure on the lower back, and the tearing of the outer ring of the spinal disc, allowing the inner portion to herniate out. This herniated disc then impinges on the nearby sciatic nerve causing symptoms.

Proper medical evaluation, including a physical examination and potentially imaging tests, can help diagnose the specific cause and determine the most appropriate treatment, which might include medications for pain and inflammation, physical therapy, or in some cases, surgery.