Lower back pain is one of the most prevalent conditions that affect both men and women and might severely worsen the quality of life of an individual. In the current case, the patient suffers from lower back pain associated with intermittent pain in the left leg for a course of over one month. The first proposed diagnosis is sciatica, a common condition with the pronounced symptoms of unilateral leg pain, backache, and positive neutral tension test (Jensen, Kongsted & Kjaer, 2019). The symptoms of the patient align with sciatica. The second diagnosis is lumbar strain, which accounts for 70% of lower back pain due to traumas and is generally the consequence of muscle or tendon tear (Sayed, 2021). However, this diagnosis is not typically associated with other symptoms of the patient.
The third diagnosis is disk herniation, which is, alongside spondylolisthesis, synovial cyst, and piriformis syndrome, frequently the cause of sciatica (Gadjradj et al., 2017). Judging from the symptoms, the patient possibly suffers from disk herniation in the lumbar spine – L2-L3-L4 nerve complication associated with backache radiating into the anterior thigh and decreased patellar reflex (Gadjradj et al., 2017). The fourth diagnosis is spinal stenosis, which is generally noticed in older adults over 60 y.o. (Lafian & Torralba, 2018). However, this condition is caused by lumbar degenerative spondylolisthesis and is unlikely to affect the current patient. Ultimately, the last proposed diagnosis is osteoarthritis, a common joint defect that results in pain and stiffness (Kloppenburg & Berenbaum, 2020). However, osteoarthritis is generally not associated with the symptoms demonstrated by the patient.
Having examined the proposed diagnoses, the patient, most likely, suffers from sciatica or disk herniation, while lumbar strain, spinal stenosis, and osteoarthritis are unrelated conditions.
References
Gadjradj, P. S., Arts, M. P., van Tulder, M. W., Rietdijk, W. J. R., Peul, W. C., & Harhangi, B. S. (2017). Management of symptomatic lumbar disk herniation: An international perspective.Spine, 42(23), 1826-1834. Web.
Jensen, R. K., Kongsted, A., & Kjaer, P. (2019). Diagnosis and treatment of sciatica.BMJ, 367, 1-6. Web
Kloppenburg, M., & Berenbaum, F. (2020). Osteoarthritis year in review 2019: epidemiology and therapy.Osteoarthritis and Cartilage, 28, 242-248. Web.
Lafian, A. M., & Torralba, K. D. (2018). Lumbar spinal stenosis in older adults. Rheumatic Disease Clinics, 44(3), 501-512. Web.
Sayed, M. E. (2021). Mechanical back strain.Web.