The patient states that he has had this pain in the past, but it usually went away, and it was never this severe and he has never had the tingling sensation that he is having now. He describes the pain to be located at the middle of his back, near the waist (mainly lumbar), and is exacerbated when he bends forward. There is numbness and tingling that radiates down the back of the right thigh to the toes. The pain and numbness has been increasing for the past three days without relief, and he has tried stretching, as well as over the counter Ibuprofen. He reports that the pain is so bad that he is currently out of work, has been having problems sleeping and the only thing that helps is the use of his friend’s medication (does not state which medication it is). His main concerns today are that he will not be able to return to work to make money; he has no health insurance and is concerned that he may have a herniated disk.
Includes similar back pain that was never this severe, and he sought the help of a chiropractor three years ago, and with manipulation, the pain was relieved. He denies any chronic medical problems, surgeries or hospitalizations. Reports increased weight gain. He does not seek medical attention on a routine basis, nor does he have any recent blood work or imaging studies. He reports having a penicillin allergy that causes rash, and does not take any prescription medication, however, has been taking ibuprofen 800mg every 4 hours for his pain and is compliant with the regimen. He is the sole offspring, and both parents are positive for hypercholesteremia, his father has prostate cancer and has a positive family history of heart disease.
A review reveals lumbar pain with radiation to the right buttock and positive for tingling and numbness to the toe. He denies urinary or bowel incontinence, nausea, vomiting, fever, abdominal pain or pain with urination, and no gross hematuria. He has decreased strength of the ...
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“MUSCULOSKELETAL CASE STUDY Essay Example | Topics and Well Written Essays - 4000 Words”, n.d. https://studentshare.net/nursing/765837-musculoskeletal-case-study.
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