A 35-year-old, healthy White male is complaining of right-sided, low back pain for 1 day. The pain began suddenly after lifting a box weighting 35 Ibs. at work. The pain radiates down the back of his leg to his right ankle. He has tried ibuprofen and ice without relief. His pain is

Review the following two (2) musculoskeletal disorder cases.
Case 1
A 35-year-old, healthy White male is complaining of right-sided, low back pain for 1 day.
The pain began suddenly after lifting a box weighting 35 Ibs. at work. The pain radiates
down the back of his leg to his right ankle. He has tried ibuprofen and ice without relief. His
pain is an 8 out of 10 (with 0 being no pain and 10 being the worst pain). He denies bowel
or bladder dysfunction, paresthesia, motor weakness, or fever.
• Past medical/surgical history: no major medical illnesses; no surgical history:
no previous hospitalizations.
• Social history: has smoked 1 pack of cigarettes a day for 15 years.
• Medications: none.
• Allergies: no known drug allergies.
• Vital signs: temperature 98.7°F; pulse 90 beats per minute; respirations 18 per
minute; blood pressure 126/78 mmHg; pulse oximeter 100%.
Physical examination revealed a well-nourished adult male without any acute distress.
Significant right paraspinal tenderness at L4-L5 was present with no midline tenderness.
Straight leg raise was positive at 30° to the right lower extremity. Straight leg raise was
negative to the left lower extremity. The remainder of musculoskeletal examination was
unremarkable (e.g., deep tendon reflexes, strength, and sensation). Other systems
examinations were unremarkable (e.g., heart, lungs, etc.).
Answer the following questions based on the Case 1.
1. What are your differential diagnoses? What are subjective and objective findings
consistent with the various differentials for low back pain?
2. Would you consider imaging for this patient? If so, what imaging would be
recommended and why?
3. What are the red flags of low back pain?
4. What are treatment strategies for this patient? What education would be provided
to the patient?
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Your Learning Objectives for the Week:
• Differentiate congenital and traumatic neurologic disorders, and summarize
mechanisms and causes of increased intracranial pressure and differentiate
intracranial bleeding disorders, infectious neurologic disorders, and vascular
neurologic disorders.
• Differentiate types of headache disorders, types of seizure disorders, degenerative
neurologic disorders, types of dementia, and cancers of the nervous system.
• Summarize structural and functional alterations associated with various mental
health disorders, schizophrenia and differentiate mood disorders and anxiety
disorders.
• Apply understanding of neural system alterations in describing various common
disorders such as headaches, dementia, depression, anxiety, spinal cord injuries, and
multiple sclerosis.
• Explain and summarize congenital and traumatic musculoskeletal disorder, and
summarize musculoskeletal injuries in child abuse.
• Differentiate disorders of the lower back, metabolic bone disorders, and
inflammatory joint disorders, and chronic muscle disorders and bone and muscle
neoplasms.
• Apply understanding of musculoskeletal system alterations in describing various
common disorders such as traumatic injuries, metabolic bone disorders,
inflammatory disorders, autoimmune disorders, chronic muscular disorders, and
tumors.