Clinical Case Database / Category: Patient Management

Back pain

Publication details

Anil Khanna MRCS(Edin), MS (Ortho), Nikolaos Gougoulias, MD, PhD, Ruchika Dhar MBBS, Nicola Maffulli MD, MS, PhD, FRCS(Orth)
Foundation Years Journal, volume 3, issue 8, p.9 (123Doc Education, London, October 2010)

Abstract

A 46-year-old woman attended the A&E Department with a 7-day history of severe back pain. Radiation of pain down her left leg started 3 days before attending the hospital. The pain started when she bent down to lift up a heavy flower pot in her garden. She took paracetamol and Ibuprofen without much help with her symptoms. The pain gradually worsened, and she finds it difficult to move from her bed to the toilet and back. There is no history suggestive of bowel and bladder disturbance.

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Authors

Anil Khanna MRCS(Edin), MS (Ortho)

Depuy International Implant Research Fellow
University Hospital of North Staffordshire, Stoke-on Trent

Nikolaos Gougoulias, MD, PhD

CCT Orthopaedics
Clinical Fellow Royal Surrey and Frimley Park Hospitals

Ruchika Dhar MBBS

GP VTS
Nottingham University Hospital, Nottingham

Nicola Maffulli MD, MS, PhD, FRCS(Orth)

Centre Lead and Professor of Sports and Exercise Medicine
Consultant Trauma and Orthopaedic Surgeon
Centre for Sports and Exercise Medicine
Barts and The London School of Medicine and Dentistry
Mile End Hospital
275 Bancroft Road
London E1 4DG
n.maffulli@qmul.ac.uk

References

1. Troyanovich SJ, Harrison DD, Harrison DE. Low back pain and the lumbar intervertebral disk: clinical considerations for the doctor of chiropractic. J Manipulative Physiol Ther, February 1999, 22(2):96–104.
2. Strayer A. Lumbar spine: common pathology and interventions. J Neurosci Nurs, August 2005, 37(4):181–193.
3. Gregory DS, Seto CK, Wortley GC, Shugart CM. Acute lumbar disk pain: navigating evaluation and treatment choices. Am Fam Physician, October 2008, 78(7):835–842.
4. Hirayama J, Yamagata M, Ogata S, Shimizu K, Ikeda Y, Takahashi K. Relationship between low back pain, muscle spasm and pressure pain thresholds in patients with lumbar disc herniation. Eur Spine J, January 2006, 15(1):41–47.
5. Crawford CM, Hannan RF. Management of acute lumbar disk herniation initially presenting as mechanical low back pain. J Manipulative Physiol Ther, May 1999, 22(4):235–244.

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About the Clinical Cases Database

T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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