A 70-year-old man presents with back pain that he describes as deep and aching. The pain is worse after activity and improves with rest. He denies any radiation of the pain, weakness, or bowel or bladder dysfunction. What could be the diagnosis and the next steps?
The patient's symptoms are suggestive of lumbar osteoarthritis or degenerative disc disease. The diagnosis can be confirmed with imaging studies such as an X-ray or MRI of the lumbar spine, which may show joint space narrowing, disc height reduction, osteophytes, and subchondral sclerosis. The treatment plan would include lifestyle modifications such as maintaining a healthy weight and regular low-impact exercise, pain relief with NSAIDs, and physical therapy. In severe cases or if conservative measures are ineffective, surgical intervention may be required.