Case: Glen          

First Visit - The Initial Assessment - Pink Flags

Glen is 35. He is seen by you on the day of onset of his back pain. He describes that he was bending over to help one of his technicians take a metal sample from a heavy steel plate and while lifting the sample, he twisted and experienced a sudden acute pain in his lower back. He fell and had difficulty getting up and could not continue working.

Glen has constant pain which is exaggerated by sneezing or coughing; pain radiates down his posterior thigh and lateral calf. He has difficulty standing or walking for more than a few minutes. There has been no recent history of weight loss, fever, or infection. No problems urinating or defecating.

PAST: Glen has had occasional LBP but this has never restricted his activities. Other than appendectomy at age 14, he has had no serious illnesses; he has no history of cancer.

WORK: He has worked as a metallurgical technician for a number of years and was recently promoted to a supervisory position. His job requires occasional heavy lifting, but he is accustomed to doing this. He states that he does not find his work stressful.

FAMILY: He is married with no children.

EXPECTATIONS: The onset of pain was sudden and unanticipated; Glen does not know what to expect. However, he appears to be confident that the pain will ease and he will soon return to work.

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