The body is constantly sending signals about its health. One of the most easily recognized signals is pain. Musculoskeletal conditions comprise one of the leading causes of severe long-term pain in patients. The musculoskeletal system is an elaborate system of interconnected levers that provides the body with support and mobility. Because of the interconnectedness of the musculoskeletal system, identifying the causes of pain can be challenging. Accurately interpreting the cause of musculoskeletal pain requires an assessment process informed by patient history and physical exams
By Day 6 of Week 8
Respond to at least two of your colleagues on 2 different days who were assigned different case studies than you. Analyze the possible conditions from your colleagues’ differential diagnoses. Determine which of the conditions you would reject and why. Identify the most likely condition, and justify your reasoning.
COLLEAGUE 1
CASE STUDY
A 42-year-old male reports pain in his lower back for the past month. The pain sometimes radiates to his left leg. In determining the cause of the back pain, based on your knowledge of anatomy, what nerve roots might be involved? How would you test for each of them? What other symptoms need to be explored? What are your differential diagnoses for acute low back pain? Consider the possible origins using the Agency for Healthcare Research and Quality (AHRQ) guidelines as a framework. What physical examination will you perform? What special maneuvers will you perform?
COLLEAGUE 1 RESPONSE
What nerve roots might be involved?

The spine, muscles, intervertebral discs, and nerves make up the back (National institute of neurological disorders and stroke, 2020). The lumbar vertebrae (L1-L5) sustain the weight of the upper body. The intervertebral discs cushion the bones while the body moves (National Institute of neurological diseases and stroke, 2020). Anterior and posterior ligaments stabilize the vertebrae, while tendons connect the muscles to the spinal column (NIH, 2020). Eleven pairs of nerves connect the spinal cord to the brain, controlling movement and transmitting impulses (National institute of neurological diseases and stroke, 2020). Lumbar and sacral nerve roots are involved in lower back pain (National institute of neurological disorders and stroke, 2020). Sciatica pain radiates along the sciatic nerve’s course from the lower back to the hips, buttocks, and legs. Sciatica only affects one side of the body (Mayo clinic, n.d.).

How would you test for each of them?