Chronic low back pain Quiz: Ace Your Exams
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A 65-year-old woman presents because of six months of low back pain that radiates down the left leg into the foot. The pain is sharp and burning and is occasionally accompanied by numbness and tingling in the lateral aspect of the left leg. The pain worsens with prolonged sitting and improves slightly when lying flat. She has not had a fever, bowel or bladder dysfunction, or recent trauma. Vitals are within normal limits. On physical examination, there is limited lumbar spine range of motion due to pain, a positive straight leg test on the left side, and diminished sensation over the lateral calf. Strength testing shows mild weakness in dorsiflexion of the left foot. Reflexes are intact in bilateral upper and lower extremities. X-rays of the lumbar spine show mild degenerative changes. Which of the following is the best next step in management?
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