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Significant daily mental stress and mild depression due to ongoing divorce. Taking adderall and methamizole. Suggest?

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Orthopaedic Surgeon
Practicing since : 1998
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36yr old male. 5'11. 178lbs. In good physical shape. Exercises 3x/wk (runs 10-18mi/wk on treadmill, 3hrs/wk of push ups & chin ups/pull ups, 1hr/wk of abdominal exercises & 45min/wk stretching). However, has not exercised for past 2wks. Significant daily mental stress & mild depression/sadness primarily due to extremely antagonist ongoing divorce; job plays minor role in stress. Current medical conditions: OSA (moderate & no current CPAP/BIPAP use); ADHD (currently taking 45mg adderall 1x/day in AM) & Hyperthyroid (currently taking 5mg tapozole/methamizole 1x/day & all blood levels within normal range for past 12 months). Other medical history: Stress fractures in same lower left vertebrae @ ages 14 & 16 & 21; usually tighter than average leg muscles (although current flexibility actually better than average); multiple foot & ankle sprains-R&L of varying degrees due to soccer; appendectomy 2008; achilles tendon rupture & repair-L 2003 due to soccer; rotator cuff partially torn & repaired 1998.
Current medical issue: moderate to severe lower back pain & stiffness. Unable to rise from seated position w/o difficulty, pain or stiffness. Unable to walk w./back straight w/o difficulty, pain & stiffness; forced to walk slowly hunched over & leaning forward. Unable to bend over or squat to pick up items, tie shoes, etc... w/o difficulty, pain or stiffness. Pain & stiffness centers at middle of lower back & radiates out to both sides & occasionally up spine to mid/lower back.
Initial onset: 36hrs ago. Early in AM, bent over @ waist to pick up shoes & experienced very sudden pain & stiffness in back upon returning to upright position. Had slept on small couch & ottoman, in awkward position for approximately 4hrs the night before. Interested in probable diagnoses & best courses of treatment in order to eliminate or lessen problem. Thank you in advance.
Posted Wed, 16 Oct 2013 in Bones, Muscles and Joints
Answered by Dr. Vaibhav Gandhi 47 minutes later
Brief Answer:
Probability of muscle sprain is more.

Detailed Answer:

I have studied your case.

According to your symptoms this looks as acute lumbar muscle sprain in your lower back.
Most probably due to bad posture or sudden jerk.
Another differential diagnosis can be lumbar disc bulge leading to sudden onset of pain.Intervertebral disc compresses spinal cord and leads to lower back pain.

When such patient comes to our hospital we usually do x XXXXXXX to rule out any nerve compression.
MRI spine will show any disc bulge is there or not.
And when muscle sprain is confirmed muscle relaxant, analgesic and neurotropic medication can be started.You may need few days rest for early recovery.
Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help.
Physiotherapy like ultrasound and interferential therapy will give quick relief.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

Take care
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