History A 23-year-old man presented to the accident and emergency department (A&E) with back pain. Usually fit and healthy, he has suffered from achy throbbing back pain for the last 6 months. Always in the same position in his lower back, it is there intermittently but has increased in frequency over the last 2 weeks. The pain is worse at night and it often wakes him from sleep. He denies any trauma, weight loss or symptoms related to his bladder or bowel movements.
His general practitioner diagnosed occupation-related back pain in relation to the patient’s job as a farmer, and recommended rest while prescribing several combinations of analgesia with little symptomatic relief. He does describe marked improvement in his symptoms with aspirin, but the pain often returns after only an hour. Waking up tonight, he was frustrated with the pain at home and attended A&E. Examination On…
