Case presentation
The patient was a 49-year-old Saudi man who presented to the KKT Clinic
at Qassim with severe low back pain radiating to both lower limbs. He
walked into the clinic with an antalgic gait, an abnormal pattern of
walking secondary to pain that ultimately causes a limp, and was holding
walls while changing direction. His history showed that he developed
back pain in 2016 and his back pain became more severe in 2018 when he
weighed 130Kg. It affected his work to the point that he was off work
for a year. In an attempt to relieve the back pain he underwent a
gastrectomy in February 2020. Before the surgery his VAS was 6 or 7/10
and after the surgery it became 9/10. He lost 35 kg but the increase in
back pain following the surgery caused him to stay in bed for a month.
Post surgery he also developed a deficit in vitamin B12, folic acid, and
iron. He took supplements and his vitamin and mineral values returned to
normal. When he presented at the clinic he had low back pain radiating
to both lower limbs, pain aggravated by standing, sitting, and walking,
and he experienced stress, a sleep disorder, and frequent headaches, but
had no history of other health disorders or accidents. Prior to
presenting at the clinic he had used pain medications and standard
treatments including physical therapy, osteopathy, and massage but none
of these improved his pain or sleep. The patient has given informed
written consent for his images and other clinical information to be
reported in this journal.