Musculoskeletal /  arshpreet /  21 February 2020 /  111 views


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 





Patient age 

30 ‐ 40 



Floor Tiler 


Patient Build 



Main Presentation 

Acute exacerbation of low back pain Discogenic in nature




Reason for attending physiotherapy 

An 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 


Special Questions 

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 Behaviour 

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, Cipramil Depression 


Social History 

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. 


Functional History 

Independent with all daily activities, active occupation but a sedentary lifestyle. Not currently involved in any regular exercise and exercise tolerance is able to walk greater than 45 minutes. 


Patient Goals 

Reduce pain and return to normal function Return to work

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