32 year old male presents with back non radiating pain since the morning.

The patient has a history of

herniated disk but the current pain is described as unbearable since morning pain assessed at /10
presently. He noticed during coffee when he was unable to move w/o pain. The pain was not caused by
a fall and the patient had one Vicodin.

No allergies, stay at home with kids

ROS

Patient has no difficulty to urinate, no burning sensation during urinaiton, and takes, compression
fracture no

History

PMH: no drugs, not hiv tested, monogamous, nonsmoker, and thyroid pill, and water pill, po meds for
blood pressure

SHx 2 ya, hardware, takes Vicodin, not working today,

Physica: mild distress, nc at, nat, supple neck, lungs: clab, rrr, abdomen: no hepatis megaly, bilateral
equal 2+, 5/5 grip strength, equal bilater sensation to light touch, 6 cm lumbar scar lumbalectomy,
muscle spasm right paralumbar muscle, bilateral lower lumbar tenderness to palpation, has anal tone
and sensation, right leg lift normal, knee flex and pusch 5/5 bilateral, bilateral eq sensation to touch,
capillary refill 2+ intibia, patella normal reflux,