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Background for video vignette .
Acute low back pain – Discogenic
Context of assessment:
Initial musculoskeletal assessment in outpatient setting
Table 7: Background information for musculoskeletal vignette
Physiotherapy outpatient clinic
30 ‐ 40
Acute exacerbation of low back pain Discogenic in nature
Reason for attending physiotherapy
Acute episode of low back pain with intermittent posterolateral thigh pain
History of presenting condition
5 days ago while laying tiles at work went to stand up after prolonged flexion and reported severe pain in the low back and buttocks bilaterally. Presented to ED and CT performed. Prescribed Mobic and Panadeine Forte for pain and referred to Physiotherapy for review.
CT – L4‐5 broad based disc protrusion without thecal sac compression
No bladder or bowel changes No saddle paraesthesia No unexplained weight loss Pain with cough or sneeze Sleep disturbed due to pain at night – difficult to get comfortable No THREADS No P+N or numbness
Pain and stiffness worse in am Movement dependant otherwise
Past Medical History
HTN medication controlled, History depression
Coversyl HTN, Mobic and Tramal Current Pain, Panadol IM LBP, ciprimil Depression
Lives with wife and 2 children – son aged 10 and daughter aged 13 in 2‐level house with 13 internal stairs.
Self‐employed floor tiler and is involved in mainly manual duties.
Independent with all daily activities, active occupation but sed entary lifestyle. Not currently involved in any regular exercise and exercise tolerance is able to walk greater than 45 minutes.
Reduce pain and return to normal function Return to work