45-year-old agricultural worker comes in to see you because he has unbearable back pain. He

45-year-old agricultural worker comes in to see you because he has unbearable back pain. He has to work in the fields, so rest is not an option. Your exam shows that all structures are intact. His pain is on both sides of his lower back and buttocks. What do you consider as you decide which actions to take? His nutritional status is closely related to what is causing his pain. Pain in both legs means that whatever is damaged is below the pelvic basin. He is too young to have arthritis, so you know that is not the cause. Agricultural work continuously aggravates any degenerative disc disease that is starting. You want to order an MRI to see whether degenerative disc disease has resulted in a herniated nucleus pulposus.

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