Dr Weinstein is Director, Surgical Outcomes Assessment Program, Professor of Surgery and Community and Family Medicine, Dartmouth College, and Director, Multidisciplinary Spine Center and Patient Preference Laboratory, Dartmouth-Hitchcock Medical Center, Hanover, NH.
Clinical Crossroads section editor: Margaret A. Winker, MD, Senior Editor, JAMA.
DR DALEY: Mr S is a healthy, active 45-year-old
attorney and father of 5 children who has low back pain and a numb left foot.
He lives in a suburb of Boston and his medical insurance is through a managed
care plan in Massachusetts.
Mr S has experienced intermittent episodes of low back pain after exertion
or physical activity for 17 years. He remembers first having an episode of
low back pain after playing basketball. During ensuing years, he had occasional
episodes of low back pain that responded to treatment with 1 or 2 days of
bed rest and nonsteroidal anti-inflammatory agents. He has never had a trauma
resulting in a back injury.
Weinstein JN. A 45-Year-Old Man With Low Back Pain and a Numb Left Foot. JAMA. 1998;280(8):730-736. doi:10.1001/jama.280.8.730