A 38-year-old man presents with severe low back pain, which

[bob]

A 38-year-old man presents with severe low back pain, which has forced him to stop work as a bus driver. He has had back pain on and off for many years, on occasion with right-sided sciatica. The pain used to be helped by rest, but is now present more or less all the time and is stopping him from sleeping properly. The most likely diagnosis is:

A : mechanical back pain
B : ankylosing spondylitis
C : myeloma
D : osteoporosis
E : osteoarthritis.

In my opinion the answer is B.

Hmm....that only seems the likely diagnosis,the rest dont fit in at all.
he cant have osteoporosis,osteoarthritis has an early onset in joints with some injury,but dat too in knee or hip,but no history,myeloma,duznt seem like,mechanical...ofcurus NOT!

the answer seems to be (B)

Agree although AS is not helped by rest but by activity.

[dr-mex]

I think the answer is A. mechanical back pain.
AKA simple back pain is common in male patients age 20-50, it may radiate to buttocks and thigh.
In this case its importat the job the had; a bus driver. long time driving is associated with simple back pain.

but now the pain is not being relieved with nay rest whatsoever,and secondly the word sciatica is used....yeah his occupation duz have a link...but in aggravating his problem......i wud still stick to ankylosing spondylitis.

[dr-mex]

In fact the possible explanation is prolapsed disc, but is not in the options. We could consider sciatica as a lateralisin sign.