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Forum Name: Spinal problems and back pain

Question: Sudden and severe lower back pain


 SSJPabs - Mon Oct 27, 2008 10:51 am

Hello, I am actually posting for my girlfriend since accounts are closed. I checked the forum rules and there did not seem to be a ban on this. If I violated any terms I apologize. Here is the situation, she wrote the following herself:

25-year-old female.
No past diagnoses or surgeries relating to back pain.
Family history doesn't include any back issues.
Current mediations: Ortho tri cyclin, Phentermine, levothyroxine.

Sudden and severe lower back pain, started about a week ago. I can't remember any incident where I might have injured it. It's the most severe when I first wake up in the morning or after exercising. Bad enough to make me gasp for breath, like getting the wind knocked out of you, but doesn't seem to limit my range of movement or physically prevent me from doing anything. Taking a deep breath causes some pain. I haven't found anything that relieves it in any way (Tylenol doesn't help, neither does rest, heat, ice etc.).
 Tom Plamondon PA-C - Mon Nov 03, 2008 8:18 pm

User avatar There are many causes of acute low back pain. In general most acute low back pain is self limiting. What is interesting with your case is that movement of the spine is not restricted nor painful. This leads me to think of internal structures of the body rather than the spine itself e.g. kidneys, lungs, pancreas,uterus etc as the source of pain. It would be worthwhile seeing for family physician who can take a complete history and focussed physical with appropriate tests.

Red flags for acute low back pain are: numbness or tingling in leg or legs, saddle paresthesia (numbness in the groin area), leg weakness, inability to urinate. In older folks, sudden onset, pain that wakes person at night, weight loss, fever, and hx of osteoporosis.

Some areas to think about: pain with urination, last menstrual cycle, hx of endometriosis, problems with ovarian cyst, pregnancy, diarrhea or constipation, nausea or vomiting, fever, cough, and abdominal pain or discomfort.

Musculoskeletal questions would be: Hx of scoliosis? Any pregnancies and deliveries - Sacroiliac joint problems occur more commonly in young and middle age women especially after pregnancy.

Again, follow up with family physician at this point is important.
 Tom Plamondon PA-C - Mon Nov 03, 2008 8:36 pm

User avatar Another thought on this stems from the fact that pain is worse in the morning and after exercise.
There may be a musculoskeletal cause of this.
Questions to ask are: Is the excercise program new or intensity increased recently? Is exercise high impact vs water aerobics? Are you a runner? How much weight do you carry (how much do you weigh) Any muscle tightness in the legs especially hamstrings? Any new shoes including athletic or dress? Any areas on the back itself that are tender to touch or tight?

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