The patient has been experiencing severe burning pain in their right lateral lumbar region for 5 months. Associated symptoms include pain and numbness radiating down the right leg. Physical examination and imaging showed an L5S1 disc protrusion compressing the right S1 nerve root, consistent with lumbar disc herniation. Treatment includes lidocaine injections, B vitamins, topical gels, and a pepper plaster with no relief of symptoms.

3. Right lateral lumbar region
5-6
Severe, burning pain
Continuous pain
5 months

5. Associated symptoms
Pain and numbness in the right leg
Right leg paraesthesia
Perineal numbness
Urinary retention
Neurological deficits which are limited to one
nerve root

6. Aggravating and alleviating
factors

7. o Lidocaine - intramuscular injection – 150-200 mg, once in 4-6 hours
o Nopain – B vitamin – intramuscular injection - - 200 mg, once in 24
hours
o Muscomed gel – twice a day
o Pepper plaster

8. Past medical History
Up to date with his vaccination
Underwent tonsillectomy at the age of 14
No chronic diseases
No hospitalizations
Often Undergoes medical checkups

9. Allergies
 Seasonal allergic rhinitis
 Spring
 Sneezing
 itchy, watery, red eyes
 Alertec - 1 pill a day

10. Family history

11. Social history

12. He has problems with digestion
Problems with passing urine
Bothered with muscular weakness in
the leg
Slight change in the prostate size
Names of the tests
done
Findings
A1C blood test No diabetes
CBC blood test No jaundice
HCV blood test No hepatitis
PSA blood test prostate specific antigen in norm

13. Physical examination

14. • X ray and CT
• L5S1 disc protrusion with right S1
nerve root compression
• lumbar disc herniation

15. Thank you