AOHC Encore 2023-309 Meet the Professor: A Problem Based Learning Experience

Video Transcription

Video Summary

In this video, Dr. Adrian Popescu discusses a case of low back pain caused by a fall. The patient is a 62-year-old man who works as a case manager in a hospital. He slipped and fell on the floor, hitting his right buttock. Initially, he experienced severe pain, but thought it would improve over time. However, two weeks later, he still had significant pain that affected his work and daily activities. He also experienced pain at night that woke him from sleep, as well as pain that radiated into his buttocks and thighs. The patient had a history of hypertension, hyperlipidemia, and some new onset kidney insufficiency.<br /><br />Dr. Popescu discusses the importance of a thorough history and physical examination to determine the possible cause of the patient's pain. He reviews the different possible pain generators, such as discogenic pain, facet joint pain, and sacroiliac joint pain, and the specific symptoms associated with each.<br /><br />The patient underwent an MRI, which showed a herniated disc at the L5-S1 level, as well as degenerative changes and modic changes at other levels. Based on the imaging findings and the patient's symptoms, Dr. Popescu diagnosed the patient with piriformis syndrome.<br /><br />Treatment options for piriformis syndrome include avoiding positions that worsen symptoms, physical therapy focused on stretching and strengthening exercises, and medications such as NSAIDs. Dr. Popescu emphasizes the importance of following up with the patient to monitor their progress and adjust the treatment plan as needed.<br /><br />Overall, this video highlights the importance of a thorough evaluation and a multidisciplinary approach to treating low back pain, considering both the biomechanical and psychosocial factors that may contribute to the patient's symptoms.

Keywords

low back pain

fall

62-year-old man

case manager

hospital

severe pain

night pain

radiating pain

herniated disc

piriformis syndrome