A 23-year-old man presented to the accident and emergency department (A&E) with back pain. History Usually fit and healthy, the patient suffered from throbbing lower back pain for the last six months. Always in the same position, the pain was there intermittently but increased in frequency over the last two weeks. The pain was worse at night and it often woke him from sleep.
He denied any trauma, weight loss, or symptoms related to his bladder or bowel movements. Examination by the general practitioner His general practitioner diagnosed occupation-related back pain in relation to the patient’s job as a farmer and recommended rest and several combinations of analgesia with little symptomatic relief. The patient described a marked improvement in his symptoms with aspirin, but the pain often returned after only an hour. He still woke up several times in the night due to the pain.…
