Back Pain

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What it feels like: stiffness and pain centered anywhere in the back, sometimes radiating into the legs or buttocks, and possibly originat-ing after heavy lifting or injury.

What can make it worse: coughing, sneezing, walking, movement, menstruation.

What can make it better: antacids, leaning forward, bed rest. The most common form of back pain results from strain in thelower back.

Your Doctor Visit

What your doctor will ask you about: urinary incontinence, diffi-culty or pain with urinating, blood in urine, pain or numbness in thebuttocks or legs, abdominal pain, hip pain, fever or chills, nausea,vomiting, flank pain, vaginal discharge.

Your doctor will also want to know whether you have ever had an X-ray, CT scan, or MRI of yourspine, or any other tests of your backbone, and what they showed,and whether you have ever had surgery on your spine.

Your doctor will want to know if your back pain began after aback injury or fall, and the precise location of the pain.

Your doctor will want to know if you or anyone in your family hashad any of these conditions: cancer, recent surgery, spinal fracture.

Your doctor will want to know if you’re taking any regular medications, particularly steroids or anticoagulants.

Your doctor will do a physical examination including the following: pushing on your abdomen, listening to your abdomen with a stethoscope, pelvic exam (in women), muscle spasms in the back,  tenderness in the back, spinal curvature and flexibility, reflexes in thelegs and feet, strength and sensation in the feet and calves.

WHAT CAN CAUSE BACK PAIN, AND WHAT IS TYPICAL FOR EACH CAUSE?

Cause: Muscle strain
What is it: Injury to muscles
Typical symptoms:Muscle spasms near thespine, pain does not moveto the legs, often beginsafter lifting

Cause: Spinal fracture
What is it: A break in one of the bones of the spine,  called vertebrae
Typical symptoms: Severe, persistent pain,  tenderness, often the result  of back injury or fall

Cause: Osteomyelitis
What is it:The most common form of arthritis, or inflammation of the joints
Typical symptoms:Limited range of motion of  the spine, often accompanied by pain in otherjoints, more common inthe elderly

Cause: Ankylosing  spondylitis
What is it: Arthritis affecting the   spine
Typical symptoms: Stiffness, lower back pain,  reduced flexibility in thespine, more common inyoung men

back pain – shingles

Cause: Shingles
What is it: Re-activation of the virusthat causes chicken pox; more common in the elderly who have had chicken pox
Typical symptoms: Painful skin sores

 

Cause:  Peptic ulcer
What is it: Severe irritation of thestomach lining
Typical symptoms:Abdominal pain or tender ness, pain in the mid-backregion, sometimes relievedby antacids

Cause: Pancreatitis
What is it: Inflammation of the  pancreas, the organ that  produces insulin, which  regulates sugar; often  associated with history  of heavy drinking or gallstones
Typical symptoms: Pain in the upper  abdomen, sometimes in  the back, nausea, vomiting, sometimes weakness and  rapid heart rate

Cause: Abdominal  aortic  aneurysm
What is it: A swelling in the aorta,   the largest blood vessel   in the body
Typical symptoms: Acute upper abdominal  pain, sometimes a pulsing  can be felt in abdomen,more common in peopleover 50

Cause: Kidney stones (See chapter  on Urine  Problems.)
What is it:  The presence of a stone   made up of mineral salts   in the kidney
Typical symptoms: History of passing blood or  “gravel” in urine, severe  pain radiating to groin or  testicle

Cause: Pyelonephritis
What is it: Kidney infection
Typical symptoms: Pain in the sides, upperabdominal tenderness, difficulty or pain with urina-tion, blood in urine, fever

Cause: Gynecologic  disease
What is it: Disease affecting the   reproductive organs in women
Typical symptoms:  Pain in the lower part of  the abdomen or sacrum,  vaginal discharge, painmay change according tomenstruation

Cause:  Prostatitis
What is it: Infection or inflammationof prostate
Typical symptoms: Changes in urination,  lower abdominal pain

Cause: Neurological damage
What is it: Damage to the spinal   cord
Typical symptoms: Pain radiating to legs,  inability to move legs, trouble moving legs, bladder problems, often theresult of spinal fracture (seepage 14) caused by aninjury

Cause: Herniated  intervertebral  disk
What is it: A disk between vertebrae protrudes into the space  that holds the spinal  cord, squeezing it
Typical symptoms:  Pain radiating into legs or  buttocks, aggravated by  sneezing or coughing,  often begins after lifting

Cause: Spinal stenosis
What is it: A narrowing of the spinal  column that leads to a pinching of the spinal  cord and nerves
Typical symptoms: Unsteady walk, thigh weakness, lower back pain that radiates into the  thighs, often relieved by bending forward

Cause: Tumor in  vertebrae
What is it:  Malignant and abnormal   growth of cells in the vertebrae, the bones that  make up the spine
Typical symptoms:  Severe, progressive pain,  more common in older  patients and people with a history of cancer

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