Patient gives you a detailed medical history

Patient used to work in a factory, before going into construction work. He admits he's been having lower and upper back pain for many years. He was trying to manage by using occasionaly some pain medication or by dismissing his pain. Lately his knee pain has been so bad he's been having trouble walking up the stairs, kneeling down, lifting weights and doing his work. He had to stop from the construction work and is having difficulties making ends meet.