Phone Visit
Narrative: SPRUCE MESSAGE VISIT Date: 2026-04-29 Encounter: Spruce text message CC: Back pain for the past two days without a known precipitating event. HPI: Miles is a child weighing 110 lbs who has had central low back pain (above the buttocks) for two days. He rates it as mild and non-sharp, describing it as 'just something there,' with pain worsening when walking but not when sitting. No known inciting event, no nodule present, and ibuprofen the night prior provided mild relief. Parent was uncertain whether to allow him to participate in soccer practice. Assessment: Dr. Hobbs assessed the back pain as 'not concerning,' suggesting a likely musculoskeletal etiology (possible muscle strain), though he noted curiosity given the absence of a precipitating event and encouraged further inquiry into a potential cause. Plan: Parent advised to trust their instincts regarding activity participation. Rest recommended as best practice for muscle strains, with guidance that activity may help clarify whether it aggravates symptoms. Ibuprofen dosing clarified: 400mg (10mg/kg/dose) every 8 hours as needed, given that Miles at 110 lbs has outgrown the children's formula dosing. Medications: - Ibuprofen 400mg every 8 hours as needed (10mg/kg/dose) (adjust) Key clinical quotes: "Sounds curious, not concerning." "rest is best for muscle strains when they happen and we also can learn if activity aggrevates anything." "10mg / kg / dose" Source: Spruce conversation t_25GF4V55J8800