A 34-year-old man reports the sudden onset of back pain after bending over to tie his shoe laces. There is tenderness over the lumbar spine on examination and leaning back worsens... A 34-year-old man reports the sudden onset of back pain after bending over to tie his shoe laces. There is tenderness over the lumbar spine on examination and leaning back worsens the pain. Neurological examination and straight leg raising is normal. What is the most likely diagnosis?
Understand the Problem
The question presents a scenario involving a 34-year-old man experiencing sudden back pain after bending over. The task is to determine the most likely diagnosis based on the given information, considering the location of tenderness and the effect of leaning back on the pain, while also noting the normal neurological examination and straight leg raising test.
Answer
Lumbar strain.
The most likely diagnosis is lumbar strain. Given the sudden onset of pain after bending, tenderness in the lumbar spine, and a normal neurological examination, a lumbar strain is the most probable cause.
Answer for screen readers
The most likely diagnosis is lumbar strain. Given the sudden onset of pain after bending, tenderness in the lumbar spine, and a normal neurological examination, a lumbar strain is the most probable cause.
More Information
Lumbar strain is a common cause of lower back pain, especially after activities involving bending or twisting. The absence of neurological deficits helps to rule out more serious conditions like disc herniation or nerve impingement.
Tips
A common mistake is to immediately assume a more serious condition like a herniated disc. However, in the absence of neurological symptoms, a simple muscle strain is far more likely.
Sources
- Ortho Flashcards by Daniel Hunt | Brainscape - brainscape.com
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