ABSTRACT
This chapter presents a case study of a 45-year-old man who works in a retail outlet presents to the Urgent Treatment Centre with increasing lower back pain for the last 3-4 months. This man is suffering from mechanical back pain. Mechanical back pain may originate from anywhere from the paraspinal muscles, vertebral joints or intervertebral discs and is primarily caused by a physical problem. In this case, the patient is suffering from sciatica as indicated by pain radiating down the left leg. Sciatica is primarily a physical problem whereby lumbar intervertebral discs become dehydrated usually with age and use and then prolapse causing impingement of exiting nerve roots. In this case, the diagnosis was confirmed with a positive sciatic stretch test. In terms of imaging, plain radiographs are not recommended with mechanical back pain or sciatica. Treatment depends on underlying cause, and a range of options are available, including supervised physiotherapy, caudal epidural injection and surgery.
