Review Question - QID 210855

A 57-year-old man presents to the ED complaining of back and left leg pain. He was lifting heavy furniture while helping his daughter move into college when all of sudden he felt a sharp pain at his back. The pain is described as severe, worse with movement, and shoots down his lateral thigh. The patient denies any bowel/urinary incontinence, saddle anesthesia, weight loss, or weakness. He denies any past medical history but endorses a family history of osteoporosis. He has been smoking 1 pack per day for the past 20 years. Physical examination demonstrated decreased sensation at the left knee, decreased patellar reflex, and a positive straight leg test. There is diffuse tenderness to palpation at the lower back but no vertebral step-offs were detected. What is the most likely etiology for this patient’s pain?