Acute Lower Back Pain

The nerve roots that might be involved in causing acute lower back pain in the 42-year-old male are the sciatic nerve roots.  The pain results from lumbar radiculopathy (Nicol et al., 2020).

History Necessary for a Patient with Acute Low Back Pain

The history that would be necessary to collect related to the 42-year-old male who reports acute low back pain would include considering the patient’s age.  According to George et al. (2021), back pain becomes more common with age, starting at around 30 or 40 years.  Considering that the patient in the case study is 42 years old, they are therefore susceptible to acute low back pain.  The history of the patient would also consider the regular lifestyle of the patient and whether such a patient is involved in the exercise.  Unused and weak muscles in the abdomen and back might therefore lead to back pain (Traeger et al., 2021).  Assessing the patient’s current weight and history of weight can also help in significantly understanding the cause of acute low back pain in the 42-year patient.  Putting on extra weight can eventually put extra stress on the back of a patient resulting in acute low back pain.  The history of the patient would also include understanding the patient’s current occupation.  If the patient is in an occupation where they lift frequently, they can therefore be more likely to be using their backs in lifting instead of their legs which can contribute to the emergence of back pain (Seyed & Mohamed, 2021).  A history of diseases such as cancer and arthritis can also contribute significantly to back pain.  Understanding the history of a patient with psychological conditions such as anxiety and depression can therefore contribute to a greater risk of back pain.  This is because stress can eventually contribute to muscle tension, which can eventually contribute to back pain (Nicol et al., 2020).

 Physical examinations

The test that would be required to determine the origin of acute lower back pain in a patient, which might originate from sciatic nerve roots, would include physical examinations to evaluate whether the pain affects the range of motion of a patient.  Conducting a medical history of a patient would also be necessary to determine whether the pain might be caused by other chronic conditions (George et al., 2021).  Checking the reflexes of a patient for certain sensations would also be necessary, which would help to determine if the lower back pain is affecting the patient’s nerves.  More physical examinations would also be required for lower back pain, including imaging tests to allow the doctor to check for disk problems, bone problems, and problems with ligaments and tendons in a patient’s back.  The imaging tests that would be conducted for a patient with acute lower back pain would therefore include ultrasounds, X-rays, MRIs, and CT scans (See et al., 2021).  A bone density or bone scan test could also be suggested if the doctor suspected that the bones in the back are weak.  Conducting tests such as electromyography could go a long way in helping the doctor to identify any problems with the patient’s nerves (See et al., 2021).

The results of imaging tests would be used to determine whether physical problems such as nerve and muscle strain are the main causes of acute low back pain among patients.  Electromyography would also be used to determine whether the problem with a patient’s nerves might have contributed to the patient’s current acute low back pain.  The results of the imaging tests and electromyography could also be used to determine whether the acute low back pain that the patient is experiencing is a result of psychological issues such as anxiety and depression (George et al., 2021).

Differential Diagnosis

Muscle strain or sprain

Muscle strain or sprain would be the first condition that might be suspected as the cause of acute low back pain in the 42-year-old patient.  The ligaments and muscles in the back can tear or stretch because of excess activity.  Sudden movements can also cause strains and sprains (Nicol et al., 2020).

 Herniated disc

The second suspected cause of the acute low back in on the 42-year-old male patient would be the discs at the back, which are prone to injury, with this risk increasing with age.  The outside of the disk can therefore herniate, which is also known as rapturing or slipping of such discs.  The possible causes of herniated discs will therefore include degenerative changes or trauma (Seyed & Mohamed, 2021).

Sciatica

The acute low back pain in the 42-year-old patient might also be caused by a herniated disc pressing the sciatic nerve.  Sciatica can therefore occur as a result (George et al., 2021).

Spinal stenosis

Spinal stenosis can contribute to acute low back pain, which includes spaces in the spine narrowing and putting pressure on spinal nerves and the spinal cord.  Spinal stenosis will therefore be associated with the degeneration of different discs between the vertebrae (Traeger et al., 2021).

Unusual spine curvature

Different conditions can cause unusual spine curvatures, including kyphosis, scoliosis, and lordosis.  Such conditions might therefore be present at birth and can contribute to unusual curvature that can cause poor posture or pain while placing pressure on the tendons, muscles, vertebrae, and ligaments (Nicol et al., 2020).

References

George, S. Z., Fritz, J. M., Silfies, S. P., Schneider, M. J., Beneciuk, J. M., Lentz, T. A., Gilliam, J. R., Hendren, S., & Norman, K. S. (2021). Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021.  Journal of Orthopaedic & Sports Physical Therapy, 51(11), CPG1–CPG60. https://doi.org/10.2519/jospt.2021.0304

Nicol, A. L., Adams, M. C. B., Gordon, D. B., Mirza, S., Dickerson, D., Mackey, S., Edwards, D., & Hurley, R. W. (2020).  AAAPT Diagnostic Criteria for Acute Low Back Pain with and Without Lower Extremity Pain.  Pain Medicine, 21(11), 2661–2675.  https://doi.org/10.1093/pm/pnaa239

See, Q., Tan, B., & Kumar, D. (2021).  Acute low back pain: diagnosis and management.  Singapore Medical Journal, 62(6), 271–275.  https://doi.org/10.11622/smedj.2021086

Seyed, M. A., & Mohamed, S. H. P. (2021).  Low Back Pain: A Comprehensive Review on the Diagnosis, Treatment Options, and the Role of Other Contributing Factors.  Open Access Macedonian Journal of Medical Sciences, 9(F), 347–359.  https://doi.org/10.3889/oamjms.2021.6877

Traeger, A. C., Qaseem, A., & McAuley, J. H. (2021). Low Back Pain.  JAMA, 326(3), 286.  https://doi.org/10.1001/jama.2020.19715