[23F] Experiencing severe back pain and neurological symptoms

Patient Description

A 23-year-old female is reporting severe back pain, rated 8/10, with stiffness and a sensation that her back might snap, particularly in the morning and at night. She has a history of scoliosis diagnosed at age 7 and has undergone two knee surgeries at ages 16 and 19. Recently, she has noticed large knots at the base of her back, which are prominent and painful upon movement or pressure. The patient also experiences radiating pain into the buttocks and legs, described as a mixture of tingling and shooting pain, rated 5/10 in severity. Additionally, she reports numbness in her limbs, frequent diarrhea, pain in the shoulder and neck area, and chest tightness. She has been diagnosed with inappropriate sinus tachycardia and is currently on medications for ADHD, anxiety, depression, and IST, including Escitalopram, Hydroxyzine, Trazodone, Nebivolol, and Guanfacine, without reported side effects. No recent injuries, fever, unexplained weight loss, saddle anesthesia, or changes in bladder or bowel control have been reported. No known drug allergies or family history of spinal conditions or tumors are present.

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Arora's Assessment

What might be happening

Based on the information you've provided, the following conditions might be causing your symptoms:

  • Musculoskeletal conditions: Given your history of scoliosis and the description of your symptoms, it's possible that your back and leg pain could be related to your spine's curvature. The knots you're feeling could be muscle spasms, which are common in people with scoliosis.

    • Treatment typically involves physical therapy, pain management, and in some cases, surgery.
  • Nerve-related conditions: The numbness in your legs and the fact that your arms and legs fall asleep quickly could be due to nerve compression or damage. This could be related to your scoliosis or a separate issue such as a herniated disc or spinal stenosis.

    • Treatment often involves physical therapy, medication for pain relief, and sometimes surgery.
  • Fibromyalgia: This is a chronic condition characterized by widespread pain, fatigue, and tender points throughout the body. It's more common in women and often starts in young adulthood.

    • Treatment typically involves a combination of medication, exercise, stress management, and healthy lifestyle habits.

Please note that these are just possibilities. You should consult a healthcare professional for an accurate diagnosis.

What you can do

  1. Consult a healthcare professional: Given the severity of your symptoms, it's important to seek medical attention as soon as possible. This could be a primary care provider or a specialist such as a rheumatologist or neurologist.

  2. Pain management: Over-the-counter pain relievers such as ibuprofen or acetaminophen may help temporarily relieve your pain. However, these should be used sparingly and under the guidance of a healthcare professional.

  3. Physical therapy: A physical therapist can provide exercises and stretches that may help relieve your pain and improve your mobility.

  4. Healthy lifestyle: Regular exercise, a balanced diet, and adequate sleep can help manage symptoms of many chronic conditions.

What you should look out for

Seek immediate medical attention if you experience:

  • Sudden, severe pain
  • Loss of bladder or bowel control
  • Weakness or numbness in your legs
  • Difficulty walking or moving
  • Unexplained weight loss

Remember, this advice is intended to be general in nature, and specific causes may need different approaches. Always consult with a healthcare professional for accurate information.

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10 mo ago

People Also Ask


What are the common symptoms of scoliosis and how can it affect daily life?

Common symptoms of scoliosis include uneven shoulders, one shoulder blade that appears more prominent than the other, uneven waist, and one hip higher than the other. It can lead to back pain, stiffness, and in severe cases, breathing difficulties. Daily activities may be affected due to discomfort and limited mobility.


How can nerve compression or damage manifest in the body?

Nerve compression or damage can cause symptoms such as tingling, numbness, muscle weakness, and sharp, shooting pain. These symptoms often occur in the area served by the affected nerve and can lead to difficulties in movement and sensation.


What is fibromyalgia and what are its typical symptoms?

Fibromyalgia is a chronic condition characterized by widespread musculoskeletal pain, fatigue, sleep disturbances, and cognitive difficulties. It often includes tender points on the body and can be accompanied by other symptoms such as headaches and irritable bowel syndrome.


What are some effective pain management strategies for chronic back pain?

Effective pain management strategies for chronic back pain include physical therapy, regular exercise, maintaining a healthy weight, using proper body mechanics, and medications such as NSAIDs or muscle relaxants. In some cases, alternative therapies like acupuncture or chiropractic care may also be beneficial.


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