Question
Hi, i am 20 years old this year and i am enlisting into the army soon.(it's compulsory for all men to join the army in my country) I have been suffering from a lower back pain for several years. I slipped and fell on my buttocks and back when i was younger and this pain has continued ever since. I visited TCM clinics but it did not help much. The pain occurs when i am sitting down, lying down, standing, bending or carrying heavy stuffs. Getting up seated position also cause pain. I am also suffering from chondromalacia patella and flat foot. I have a specialist appointment after 2 weeks of my enlistment for my lower back, it includes consultation and x-ray scans. I am afraid that this pain will get worse during my National Service(NS). I have done some research and came upon the Straight Leg Raise(SLR). I tried doing it and i felt pain in my lower back when i lift my left leg(which is the leg for my chondromalacia patella) but no pain shooting down from the butt. I need your professional opinion on what i might be suffering from. Could it be a herniated or degenerated disc? Thank you for patiently reading this.

Xavier
Singapore

Answer
Hello Xavier,
I am reading your e-mail today Friday August 31, for the first time - I just received it this morning. I feel sad to hear about your pain.  You obviously have done your homework regarding your back pain.  While it is not possible for me to make a diagnosis with out examining you myself it seems possible that your back pain may be routed in your lumbar disc.  Such a problem as you describe it often is more likely to be a bulging disc as opposed to purely a degenerative disc, but again I cannot make a diagnosis in your case.  I would find a specialist like a chiropractor or an orthopedist so they could further evaluate the cause of your problem.  If your pain is also aggravated with a cough or a sneeze as well as a straight leg raise up to approximately 45 degrees then it becomes more suggestive of a space occupying lesion, which often is due to a disc problem.

Please go to www.backclinicsofcanda.ca to learn more.

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Wishing you a speedy recovery and a life of happiness,
Dr. Ron Nusbaum