21 year old male with low back pain

This young man is 70 inches tall and 280 lbs. He hurt his back at his place of employment two years ago, and has been treated with physical therapy and two lumbar epidural steroid injections, with little benefit. He continues to have low back pain and came to me mostly to fill out his disability paperwork. Some people cannot afford treatment, even when it’s relatively inexpensive. I have treated him a couple of times, but he is not going to be able to treat enough to see if I can help him. I’m going to have a serious conversation with him about his long term outcome. I can’t keep him off of work forever.

One long term issue that doesn’t require treatment is his obesity. At 21 years of age, he has a serious problem that will get worse unless he takes measures to change his behaviors. That means, eating differently, biased to protein, and cutting the carbs. He can have his fill of vegetables, but he has to cut out processed carbs, e.g. grains, and starches too. Given his youth, he’ll lose the weight fast.

As you’ll see, he has significant disc degeneration with signal loss at L5-S1, and the axial images show a herniated disc, biased to the left.

21 year old male with low back pain

On a related note, I almost always ask patients about their personal lives because it has bearing on their medical issues, and because I care. I asked this young man how he talks to, and he said, “no one”. Did he want to make me cry? So I’m going to get involved in his life if he’ll let me. He seems to be another very decent young man, like too many these days, without an older male to talk to. That may seem unrelated to his back pain, but it is related, and may be more important.

If I can help you with your back or neck pain, call me at 404-558-4015.