Luca (32 years old)

Luca is a 32-year-old salesman who enjoys hiking in his spare time and generally feels active and healthy (normal BMI). Since 6 weeks, he has been suffering from low back pain, and has presented multiple times to your clinic.

At first, he visited your practice as the pain worsened and radiated to the left leg, despite initial self-medication (diclofenac 50 mg every 8 hours). The examination showed a positive straight leg raise test (Lasègue’s sign) and decreased strength in the left leg. Paracetamol, tramadol and cyclobenzaprine were added to his treatment.

After 5 weeks of oscillating pain despite multiple visits to the emergency service and several treatments with painkillers, prednisone was prescribed.

Twelve days after the last visit, Luca returns and walks with extreme difficulty. The low back pain is worsening to the point that he cannot sleep, despite the prescribed medications. Although he cannot exercise, he also lost weight. The clinical examination is unaltered, and no fever nor further symptoms were noted.