,
,Case Overview
Patient: Thomas Bennett (pseudonym), 54-year-old Caucasian
male
Chief Complaint: Chronic lower back pain for 20 months
Setting: Primary care clinic
Context: This Week 9 iHuman case study is designed for
advanced medical learners, focusing on the evaluation and
management of chronic pain in a primary care setting. The
iHuman platform emphasizes systematic history-taking, physical
examination, differential diagnosis, evidence-based diagnostics,
and multidisciplinary treatment planning. This case fosters
clinical reasoning, critical thinking, and holistic care, preparing
learners for complex patient encounters.
Patient History
, History of Present Illness (HPI)Thomas Bennett presents with a
20-month history of persistent lower back pain, primarily
localized to the lumbar region (L4-L5). He describes the pain as
a constant, dull ache, rated 5–7/10 on a numeric pain scale,
escalating to 8–9/10 with prolonged standing, heavy lifting, or
extended sitting. The pain occasionally radiates to the right
buttock but does not extend below the knee, distinguishing it
from radicular pain. Thomas reports morning stiffness lasting
15–30 minutes, which improves with light movement, such as
walking or stretching. He denies numbness, tingling, weakness,
bowel or bladder dysfunction, saddle anesthesia, or saddle-area
numbness. Over-the-counter ibuprofen (400 mg, 1–2 times daily
as needed) provides moderate relief (pain reduced to 3–4/10), but
the pain has progressively worsened, significantly impacting his
role as a warehouse supervisor and his ability to engage in
hobbies like fishing and woodworking. He denies recent trauma,
falls, or injuries and reports no systemic symptoms, including
,Case Overview
Patient: Thomas Bennett (pseudonym), 54-year-old Caucasian
male
Chief Complaint: Chronic lower back pain for 20 months
Setting: Primary care clinic
Context: This Week 9 iHuman case study is designed for
advanced medical learners, focusing on the evaluation and
management of chronic pain in a primary care setting. The
iHuman platform emphasizes systematic history-taking, physical
examination, differential diagnosis, evidence-based diagnostics,
and multidisciplinary treatment planning. This case fosters
clinical reasoning, critical thinking, and holistic care, preparing
learners for complex patient encounters.
Patient History
, History of Present Illness (HPI)Thomas Bennett presents with a
20-month history of persistent lower back pain, primarily
localized to the lumbar region (L4-L5). He describes the pain as
a constant, dull ache, rated 5–7/10 on a numeric pain scale,
escalating to 8–9/10 with prolonged standing, heavy lifting, or
extended sitting. The pain occasionally radiates to the right
buttock but does not extend below the knee, distinguishing it
from radicular pain. Thomas reports morning stiffness lasting
15–30 minutes, which improves with light movement, such as
walking or stretching. He denies numbness, tingling, weakness,
bowel or bladder dysfunction, saddle anesthesia, or saddle-area
numbness. Over-the-counter ibuprofen (400 mg, 1–2 times daily
as needed) provides moderate relief (pain reduced to 3–4/10), but
the pain has progressively worsened, significantly impacting his
role as a warehouse supervisor and his ability to engage in
hobbies like fishing and woodworking. He denies recent trauma,
falls, or injuries and reports no systemic symptoms, including
