Severe lower back pain

Chief complaint A 67-year-old female complains of increasing lower back pain for 1 week after she slipped and fell at home around 1 months back, Today she complained of severe pain when she tried to stand from a bed in the morning. She described pain as 9 out of 10. History No complaints of weekness or paresthesia She is on cyclobenzaprine, tramadol & meloxicam. She has osteoarthritis of her hands and knee. Vitals BP: 130/85 mmhg, RR: 30 B/m, Pulse: 89 b/m, Temp: 39.3 °C. Investigations Examinations shows area of pain is just above buttocks, its non-radiating, increased on walking and relieved on lying on side. Her lumbar paraspinal muscles were tense but not appreciably tender to palpation. Lower extremity tone, strength, and sensation were within normal limits. Diagnosis What do you see in the radiograph? Treatment How this case should be managed?

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? Grade 1 Listhesis of L3 over L4 Narrowing of IVD between C5 - S1 ? Acute Traumatic disc prolapse Bedrest, NSAIDS ,physiotherapy

Patient has fallen a month back yet she claims to have increase in pain in the past one week... Also the pain she describes is very severe hence I feel some more investigations could be needed... A hip xray jus to be safe would be recommended.. Check Vit D level and supplement as necessary. She has pain on weight bearing which does suggest a bony or muscular involvement..

Xray looks absolute normal Rest Radiculopathy Physiotherapy Entodac400 bd Myoril8 mg bd Dubinor hs

? SPINES PATHOLOGY .. ? SPONDYLOSIS.. NEED'S.. ANALGESICS ANTIINFLAMMATORY.. ORALLY AS WELL LOCALLY..

X ray : NAD ? Pivd with radiculopathy Adv: back rest Physiotherapy Tab Hifenac mr

Muscle spasm Tab TIZANIDINE 4mg. TDS Tab diclofenic 75mg. Sr Local application

Age related geriatric pathology. Vit.D.+ Calcium + vit B1/BY/B12../ Soya Milk

Normal xray take pain killer and rest

Xray shows wnl Treat symptomatic

Spondylosis spine

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