[22F] With severe lower back pain and frequent vomiting

Patient Description

A 22-year-old female presents with severe lower back pain that started suddenly one day ago. The pain is described as sharp and worsens with movement, particularly when laying down. Heating pads provide some relief. The patient has a history of back surgery a couple of years ago and an injury from lifting a heavy weight about a year ago. Additionally, she has been experiencing frequent vomiting for the past day, especially after eating, occurring about once every other hour with significant volume each time. There are no specific food triggers and no blood in the vomit or stool. The patient also reports feeling drowsy, sore, and tired. She has a history of cancer diagnosed 10 years ago but is not currently taking any medications and has no known allergies.

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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:

  • Acute Back Pain: Given your history of back surgery and a previous injury from lifting a heavy weight, your severe lower back pain could be related to a musculoskeletal issue such as a muscle strain, ligament sprain, or even a herniated disc. These conditions can cause sharp pain that worsens with movement and may improve with rest and heat application.

    • Treatment: Initial treatment typically includes rest, avoiding activities that worsen the pain, applying heat or cold packs, and taking over-the-counter pain relievers like ibuprofen or acetaminophen. Physical therapy may also be recommended.
  • Gastroenteritis or Food Intolerance: Frequent vomiting, especially after eating, could be due to a gastrointestinal infection (gastroenteritis) or a food intolerance. Gastroenteritis is often accompanied by other symptoms like diarrhea and abdominal pain.

    • Treatment: Staying hydrated is crucial. Drink small sips of water or an oral rehydration solution. Avoid solid foods until vomiting subsides, then gradually reintroduce bland foods like toast or rice.
  • Dehydration: Frequent vomiting can lead to dehydration, which might explain your drowsiness, soreness, and tiredness.

    • Treatment: Ensure you drink plenty of fluids. Oral rehydration solutions can help replace lost electrolytes.

What you can do

  1. Rest and Hydration: Rest as much as possible and stay hydrated. Drink clear fluids like water, broth, or oral rehydration solutions.
  2. Heat Application: Continue using heating pads on your lower back to alleviate pain.
  3. Over-the-Counter Pain Relief: Consider taking over-the-counter pain relievers like ibuprofen or acetaminophen to manage your back pain.
  4. Bland Diet: Once vomiting subsides, try eating bland foods like toast, rice, or bananas.

What you should look out for

Seek medical attention if you experience any of the following:

  • Severe or Worsening Pain: If your back pain becomes unbearable or does not improve with rest and over-the-counter medications.
  • Inability to Keep Fluids Down: If you are unable to keep any fluids down for more than 24 hours.
  • Signs of Dehydration: Such as dry mouth, decreased urination, dizziness, or lightheadedness.
  • New or Worsening Symptoms: Such as fever, blood in vomit or stool, or changes in urination.

Please remember that this information is not a substitute for professional medical advice. It is important to consult with a healthcare provider to receive a formal diagnosis and appropriate treatment.

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5 mo ago


People Also Ask


What could be causing my sudden severe lower back pain?

Your sudden severe lower back pain could be due to a musculoskeletal issue such as a muscle strain, ligament sprain, or a herniated disc, especially given your history of back surgery and a previous injury. These conditions can cause sharp pain that worsens with movement.


Why am I experiencing frequent vomiting after eating?

Frequent vomiting after eating could be due to a gastrointestinal infection like gastroenteritis or a food intolerance. It's important to monitor for other symptoms like diarrhea or abdominal pain.


How can I manage dehydration caused by frequent vomiting?

To manage dehydration from frequent vomiting, it's crucial to stay hydrated by drinking small sips of water or oral rehydration solutions. Avoid solid foods until vomiting subsides, then gradually reintroduce bland foods.


When should I seek medical attention for my symptoms?

You should seek medical attention if your back pain becomes unbearable, if you cannot keep fluids down for more than 24 hours, if you show signs of dehydration like dry mouth or dizziness, or if you experience new or worsening symptoms such as fever or blood in vomit or stool.

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