Carol is a 52-year-old hairdresser. She has been referred by her primary care doctor because she has been having pain and weakness in her left leg. Carol works long hours and the more she stands, the worse the pain becomes. She says that she has had intermittent left lower back pain “for several years,” but in the last year she has noted increased pain radiating into the left lower extremity. She says that she hates complaining about herself but that she does find that she has trouble getting through the day because of the pain. By the end of the day, her left leg and foot often feel numb and tingling.

Carol reports that she has noticed that she has been having problems with her balance, and at least 3 times in the last month, she has tripped over her left foot and almost fallen. She rates the pain as 2/10 at best while sitting and resting and 9/10 on VAS by the end of the day or if she has to stand for more than 30 min without taking a break.

Carol has been taking four Advil three times per day for at least 2 months, but she does not find it particularly helpful. The Advil does not bother her stomach. She has not tried taking Tylenol. She went to her primary care doctor for her regular checkup, and her primary care doctor told her she needs to be seen immediately for her lower back and leg problems. She has not had any imaging studies. Carol does not believe that her weakness in her leg is getting worse, but she is not sure and she does note that her three trips over her left foot were all within the last month and she does not remember tripping prior to that. The pain, though, has not been getting worse in the last few months.

Carol has not gone to physical therapy or had any other treatments for the left leg symptoms. She says that she works 6 days per week and looks forward to her 1 day off so she can lie in her bed with her feet up. In this position she is the most comfortable and can get some rest. She says that she does not have the time or energy to go to the gym. She used to like to walk in the mornings before work but she has not been able to do that for “at least a year” because of the pain.