Subjective Data Chief Complaint (CC) : lower back pain. History of Present Illness (HPI) A 64-year-old Hispanic male presents to the office with complaints of lower back pain. The pain started suddenly a few days ago; it is dull, and it is accompanied by feelings of tightness. Associated symptoms are stiffness in the lower back and limited range of motion. The pain worsens with movement, and Advil taken recently did not relieve pain for a long period of time. The patient notes that resting helps to a degree, but as he gets up or sits for too long, the pain starts again. He rates the severity of pain at 6/10 and says that it never happened before. Medications  1. Lipitor 10mg daily – for lowering high cholesterol  2. Norvasc 5mg daily – for antihypertensive therapy  3. Diovan 60 mg daily – for antihypertensive therapy  4. Multivitamin one tab daily – for general health Allergies NKA. Past Medical History (PMH) The patient has a history of high cholesterol and diabetes mellitus. He takes medications and has both conditions under control. HR also uses medications for antihypertensive therapy to prevent cardiovascular problems. HR did not have any issues with severe back pain in the past. Past Surgical History (PSH): No history of major surgeries. Sexual/Reproductive History The patient is heterosexual, has had one long-time partner for years, uses protection. Personal/Social History The patient does not smoke cigarettes or use drugs, but he drinks alcohol recreationally once a week or less. He is married and has two adult children who live separately. His work is not strenuous, but he enjoys doing yard work which often requires physical activity such as lifting. Immunization History His immunizations are up to date – Influenza November 2018, Td booster three years ago. Significant Family History The patient has two younger sisters. The first one is 59 years old; she was recently diagnosed with diabetes type 2. The second sister is 57; she has hypertension which is well-controlled. HR has two children – a daughter 40 years old, generally healthy, and a son 35 years old, healthy. HR also has three grandchildren – 17, 13, and 10 years old. Lifestyle The patient has recently retired from his full-time job, but he still accepts some work inquiries as he is an electrician. He has a wife of 36 years; she is 60 years old, and they live together. HR’s children visit them often, and they spend some time with grandchildren as well. He prefers to work to ensure financial stability and keep busy. He likes to do yard work and look after the house, but he also spends much time inside, watching TV. Review of Systems General: No fever, chills, sweats, recent weight change, or fatigue. HEENT: Head: no recent injury or trauma, no hair loss. Eyes: no changes in vision, HR wear reading glasses and has hyperopia, diagnosed around three years ago. No blurred or doubled vision, no yellow sclerae. Ears: no hearing loss, ear infections, or discharge. Nose: no rhinitis, changes in the sense of smell, or sinus infection. No sneezing or congestion. Throat: no sore throat, difficulty chewing or swallowing. Neck: No pain in the neck, no stiffness or injury. The patient has no history of neck pain, disk suppression, or degradation. Respiratory: No pain, cough, no history of allergy, asthma, emphysema, or lung injury. Cardiovascular: No chest pain, discomfort, m