Symptoms:
1. Severe lower back pain
2. Radiating leg pain (sciatica)
3. Positive straight leg raise test
4. Pain worsened by sitting, improved by lying down
Risk Factors:
i. Heavy lifting
ii. Obesity
iii. Sedentary lifestyle
Diagnosis:
i. Clinical Examination: Identifying characteristic symptoms and performing physical tests such as the straight leg raise test.
ii. Imaging:
iii. MRI: Considered if symptoms persist beyond 6 weeks or if there are red flag signs.
Management:
Conservative Treatment:
. NSAIDs: First-line treatment for pain relief.
. Activity Modification: Encourage continued activity within pain limits.
. Physical Therapy: Exercises to improve strength and flexibility.
. Neuropathic Pain Medications: Amitriptyline, gabapentin, or pregabalin for associated sciatica.
Red Flags:
. Immediate referral for MRI and possible surgical intervention if symptoms such as saddle anaesthesia, urinary retention, or fecal incontinence are present (suggestive of cauda equina syndrome).
