32 year old male with h/o sever lbp and pain on flexion with SLR negative from past 15 days with no past h/o surgery

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Multiple level degenerative disc disease There may not be root compression Ineffective disc can produce these symptoms Analgesics Muscle relaxants Gabapentin will help Lumbosacral corset

Hi! Joining the discussion a bit late, but your history seems to suggest that there's pain only on spinal flexion. Looking closely at the X-rays, there are early syndesmophytes at L1, 2 and 3. This could be due to a segmental instability like Spondylolisthesis. Or it could just be an incidental find. These sites aren't common for Spondylolisthesis, But as it was a case of trauma and if pain persists, then Standing Flexion and Extension views may help to understand the problem.

a basic blood investigation would rule out infection. until then a course of analgesic plus muscle relaxant, physio exercises and rehab should reduce his back pain . recurrent pain may be if he is obese , has sedentary job with improper sitting posture , infection , arthritis or disc pathology. lab reports, trial of above method and any associated cord compression symptoms will finalise the diagnosis.

PID D 11-12 &L1, advised absolute bed rest on hard bed for three weeks & analgesics sos.

loss of lumbar lordosis significant to severe muscle spasm.. moist heat, and IFT isometric back n abdominal myofacial release and MET and lower back stretching for 6-7 days and later on go for core stability exercises

where is the pain confined to ? Xray shows reduced disc space at T10 T 11, kindly add some more history like how pain started , Assoc fever , loss of weight , radiation of pain

patient is unable to describe the exact area of pain. The patient had a fall from stool but he has a h/o recurring lbp.no complaints of fever or weight loss
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adv m r i for d l spine

according to me ,ask patient that he or she is feeling pain at the time of walking and after sometimes is tht pain is going or not because this is the most imp symptom of spinal stenosis.and after that full physio treatment is given.

core strengthening exercises twice a day and back extensor exercises helps to reduce spasm and IFt for 10 days

as it's a case of injury.. bed rest for 1to 2 weeks would be helpful ... no exercise. cold compress can be given at start.

Bed rest will harm patient rather than helping him... If it's a case of lysis then it is considered... but just LBA...
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