6/5/2020 E-Library - Information At Your Fingertips: Printer Friendly On May 17, 2007, respondent was again examined, and found to still have "left buttock pain radiating to his lower back and lateral side of his left thigh which is most severe at 8/10 on a pain scale x x x (which) is slightly relieved with intake of his pain medications." MRI scan was recommended[12] as well as epidural steroid injection and further physical therapy. When respondent was examined on June 4, 2007, Dr. Alegre found that he "still has low back pain radiating to his left lower extremity even with physical therapy. This is associated with numbness on the lateral aspect of his left leg and paralumbar spasm is still present."[13] Thus, further medication, physical therapy and epidural steroid injection were recommended. Respondent was confined at the St. Luke's Medical Center from June 13 to 19, 2007 and from July 24 to 27, 2007.14 On June 16, 2007,[14] he underwent epidural steroid injection,[15] as well as electromyogram and nerve conduction velocity (EMG-NCV) testing.[16] Respondent returned on June 20, 2007, complaining of headache and low back pain. He was diagnosed with stage 1 hypertension and given medication.[17] On June 29, 2007, respondent was evaluated by a spine surgeon who recommended provocative discography to find out whether he will need a disc replacement.[18] In his July 9, 2007 Progress Report,[19] Dr. Alegre noted the evaluation of respondent by a spine surgeon who declared that the EMG-NCV tests returned normal[20] and "beginning L5S1 disc herniation." Dr. Alegre further stated: The low back pain intensity is not commensurate with the alleged symptoms of back pain so that a Provocative Discography is recommended and the schedule will follow as the operating room right now is fully book [sic]. Likewise an incidental note of a probable small cyst in the left kidney was noted. Since this is only an incidental finding, we would need your approval to evaluate Ms.[21] On July 26, 2007, respondent underwent Provocative Discography[22] at the St. Luke's Medical Center which generated the following result: Finding: There is midposterior Grade 1 annular tear with contrast medium leakage more to the left. CONCLUSION: ELICITED AREAS ARE NOT CONCORDANT WITH USUAL PAIN BASED ON PATIENT'S EXPERIENCE.[23] elibrary.judiciary.gov.ph/thebookshelf/showdocsfriendly/1/61305 2/25