A week ago you were helping your son lift his rowing machine into the back of your large 4×4 when you felt a sudden pain in your back. The pain was initially quite severe and you nearly dropped the machine but managed to hold on. You had to go and lie down on the sofa after struggling back into the house.
The pain became a deep ache right across your lower back and after a few hours it started shooting down your right leg. For the last 3 days you keep getting shooting pains from your right buttock down the leg to the heel. You cannot work out what precipitates the pain but have discovered that lying still helps — however you are too busy to take to your bed.
The back pain has eased off a lot to just a mild dull ache. Your right foot keeps tingling and feels rather odd; sensation in the right foot seems altered. You feel you cannot push off with your right foot when walking and are finding stairs difficult.
Ideas: You think you have trapped a nerve in your back — “I think I have done something to my back and trapped a nerve.” (Last night a school friend who is a consultant physician at The London Hospital said it sounded like sciatica / possible prolapsed disc. Do not mention this unless specifically asked whether you have asked friends/family or consulted Dr Google.)
Concerns: “I am worried that I could end up with permanent nerve damage.”
Expectations: Expect a thorough history and examination. You will respect professional judgement, but your friend said you will probably need a scan. If a scan is not offered, question why not.
Feelings: If asked how you feel, say you are irritated and fed up because the symptoms disturb your sleep and interfere with your work.
No significant family history. Parents still alive and in good health (early 80s).
You have returned for your scan results. You are keen to hear what has been found. You are concerned that the scan has advised you to see a neurosurgeon.
Ask how long the NHS referral will take and whether you could be referred privately. You are due to go on a cruise in a couple of weeks and want to see someone before you go away.
Clinical details: Sudden onset lower back pain with signs of right-sided sciatica. Absent right ankle reflex. Reduced sensation right L5 dermatome. ? Prolapsed intervertebral disc.
Report: