[19F] Experiencing intense lower back pain and dizziness

Patient Description

A 19-year-old female presented with sudden onset of intense lower back pain that began today, described as shooting pains rated 9 out of 10, triggered by movement and unrelieved by any position except when still. Alongside the back pain, she experienced an episode of lightheadedness and nausea, rated 6 out of 10, accompanied by a feeling of shakiness in her arms and legs, which has been ongoing for 2 days. The dizziness occurred once, lasting a few minutes after standing for an extended period. The patient reported no recent injuries, loss of sensation, bladder or bowel control issues, fever, weakness, numbness, severe abdominal pain, changes in urine, unexplained weight loss, or known allergies. No medications are currently being taken, and there is no past medical history of note, except for a family history of a spinal defect in her mother.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are a few possibilities:

  • Musculoskeletal Strain or Sprain: This is a common cause of back pain, especially if it's related to movement. It can occur due to overuse, improper lifting, or sudden awkward movements. The pain can be severe and is often described as a shooting pain. Rest, over-the-counter pain relievers, and physical therapy are common treatments.

  • Kidney Stones: These are hard deposits made of minerals and salts that form inside your kidneys. They can cause severe pain in your back or side, along with other symptoms like nausea and vomiting. However, you didn't mention any changes in your urine, which are often present with kidney stones. Treatment can range from pain management to surgical removal of the stone.

  • Orthostatic Hypotension: This is a form of low blood pressure that happens when you stand up from sitting or lying down, and it could explain your episode of lightheadedness and near fainting. It's usually harmless and lasts for a few minutes, but it can be a sign of more serious problems in some cases. Treatment usually involves lifestyle changes or medication adjustments.

  • Anxiety: This can cause a variety of physical symptoms, including shakiness and lightheadedness. However, you mentioned that you don't feel anxious. It's still worth considering, as anxiety can sometimes manifest primarily as physical symptoms.

What you can do

While it's important to see a healthcare professional for a formal diagnosis, here are some things you can do in the meantime:

  1. Rest and avoid movements that trigger your back pain.
  2. Try over-the-counter pain relievers for your back pain, but be sure to follow the package instructions.
  3. Stay hydrated and try to eat regular, balanced meals.
  4. If you feel lightheaded, sit or lie down right away and slowly get up again when you feel better.
  5. Monitor your symptoms and write them down to share with your doctor.

What you should look out for

Please seek immediate medical attention if you experience any of the following:

  • Severe pain that doesn't improve with rest or over-the-counter pain relievers.
  • Loss of bladder or bowel control.
  • Severe abdominal pain.
  • Blood in your urine.
  • Persistent or worsening nausea and vomiting.
  • Fainting or loss of consciousness.
  • Chest pain or difficulty breathing.

Remember, it's important to consult with a healthcare professional for a formal diagnosis and treatment.

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10 mo ago

People Also Ask


What are common causes of sudden intense lower back pain in young adults?

Common causes of sudden intense lower back pain in young adults include musculoskeletal strain or sprain, herniated discs, kidney stones, and less commonly, infections or spinal abnormalities. It's important to consult a healthcare professional for an accurate diagnosis.


How can orthostatic hypotension be managed or prevented?

Orthostatic hypotension can often be managed by staying hydrated, rising slowly from sitting or lying positions, wearing compression stockings, and avoiding prolonged standing. In some cases, medication adjustments or specific treatments may be necessary.


What symptoms should prompt immediate medical attention when experiencing back pain?

Immediate medical attention should be sought if you experience severe pain that doesn't improve with rest or over-the-counter pain relievers, loss of bladder or bowel control, severe abdominal pain, blood in your urine, persistent nausea and vomiting, fainting, or chest pain.


Can anxiety cause physical symptoms like shakiness and lightheadedness even if I don't feel anxious?

Yes, anxiety can manifest as physical symptoms such as shakiness and lightheadedness, even if you don't consciously feel anxious. It's important to consider this possibility and discuss it with a healthcare provider if these symptoms persist.


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