[19M] Experiencing chronic back pain with associated symptoms

Patient Description

A 19-year-old male reports a 6-month history of dull, persistent back pain that worsens throughout the day and with looking down. The pain is primarily located in the mid to upper back but occasionally affects the lower back as well. The patient rates the pain as a 6 out of 10 in severity. Accompanying symptoms include random muscle aches and occasional tingling in the arms. The patient also experiences changes in bladder control, presenting as frequent urination, and daily episodes of nausea, with severity ranging from 4 to 7 out of 10. No recent injuries, fever, unexplained weight loss, recreational drug use, known allergies, pre-existing conditions, or family history of back problems have been reported. The patient is not currently on any medications.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possible explanations for your symptoms:

  • Musculoskeletal Strain: This is a common cause of back pain, especially in younger individuals. It can occur due to poor posture, overuse, or strain. The pain is usually localized to the area of injury and may be associated with muscle spasms.

    • Treatment typically involves rest, physical therapy, and over-the-counter pain relievers.
  • Herniated Disc: This condition occurs when one of the discs that cushion the bones in your spine pushes out into the spinal canal, which can put pressure on your nerves and cause pain. This might explain your back pain and the tingling in your arms.

    • Treatment can range from physical therapy and medication to surgery in severe cases.
  • Kidney Problems: Conditions such as kidney stones or a kidney infection can cause back pain and changes in urination. However, these conditions are usually also associated with other symptoms such as fever and abdominal pain.

    • Treatment depends on the specific condition and may include medication or surgery.
  • Other conditions: There are many other conditions that can cause back pain and your other symptoms. These include conditions of the spine (like spinal stenosis or spondylolisthesis), infections, tumors, and certain systemic diseases.

What you can do

Given the duration and severity of your symptoms, it's important that you seek medical attention. A healthcare professional can perform a physical examination, order tests if necessary, and provide an accurate diagnosis and treatment plan. In the meantime, here are some things you can do:

  1. Try to maintain good posture, especially when sitting for long periods.
  2. Engage in regular physical activity, focusing on exercises that strengthen your back and core muscles.
  3. Use over-the-counter pain relievers as needed, but be sure to follow the instructions on the label.
  4. Stay hydrated and maintain a healthy diet.

What you should look out for

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

  • Severe back pain that doesn't improve with rest
  • Pain that radiates down one or both legs, especially if it extends below the knee
  • Weakness, numbness, or tingling in one or both legs
  • Unexplained weight loss
  • Bladder or bowel incontinence

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for accurate information.

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9 mo ago


People Also Ask


What are the common causes of persistent back pain in young adults?

Common causes of persistent back pain in young adults include musculoskeletal strain due to poor posture or overuse, herniated discs, and less commonly, conditions like spinal stenosis or systemic diseases. It's important to consider lifestyle factors and seek medical evaluation for a proper diagnosis.


How can a herniated disc cause tingling in the arms?

A herniated disc can cause tingling in the arms if the disc material presses on the nerves that travel from the spine to the arms. This pressure can disrupt normal nerve function, leading to sensations like tingling, numbness, or weakness.


What symptoms might indicate a kidney problem related to back pain?

Symptoms that might indicate a kidney problem related to back pain include pain that is more localized to the sides or lower back, changes in urination such as frequency or pain, fever, and abdominal pain. These symptoms warrant medical evaluation to rule out conditions like kidney stones or infections.


When should someone with back pain seek immediate medical attention?

Immediate medical attention should be sought if back pain is severe and doesn't improve with rest, if there is pain radiating down the legs, weakness or numbness in the legs, unexplained weight loss, or if there is bladder or bowel incontinence. These could be signs of a more serious condition requiring urgent care.

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