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Response or Comment

Publication Date



This is the author's final version prior to publication in PM & R, Vol. 4, April 2012 pp. 304-311.


Point/Counterpoint Case Scenario: A 55-year old man presents to a pain clinic upon referral from his primary care physician. His symptom is axial low back pain. His pain started approximately 1 year earlier without a specific inciting event. He denies radiation of pain into the lower extremities. There is no bowel or bladder involvement. There is no directional preference. He reports pain "all the time," with minimal specific exacerbating or relieving factors. There is no medical-legal involvement. His medical history is significant for hypertension, hypercholesterolemia, obesity, and sleep apnea. He is a divorced father of 2 adult children. He is self-employed local truck driver, and his job also involves some loading and unloading of boxes, although he describes the weight of the boxes as "light." He notes a decreased capacity to coplete job-related activities but states that the pain medication (sustained-release oxycodone, 80 mg twice a day) allows him to work with minimal discomfort. Michael Saulinot, MD, PhD and Adam Schreiber, DO respond with treatment recommendations. Feature editor: Thomas Watanabe, MD.

case2.pdf (17 kB)