[23M] With chronic back pain

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Patient Description

A 23-year-old male has been experiencing chronic back pain that began either at the end of high school or the beginning of college. Initially, the pain was occasional tightness and soreness/achiness when sitting, standing, or sleeping, but it has become more frequent and severe over time. The pain is now almost a daily occurrence and has been localized to three specific areas: the lower right side of the spine, the mid-back spine area, and between the left shoulder blade and spine. The pain worsens with laying down, sitting, standing, or driving for prolonged periods and is relieved by sleep or Tylenol. The patient has not experienced any recent injuries, numbness, tingling, weakness in the legs, changes in bowel or bladder function, unexplained weight loss, or fever. There are no pre-existing conditions or chronic illnesses, and the patient is not taking any medications.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for your back pain:

  • Muscle Strain or Ligament Sprain: This is one of the most common causes of back pain, often resulting from overuse, improper lifting, or sudden movements. It can cause pain in specific areas of the back and may worsen with certain activities.

    • Treatment: Rest, over-the-counter pain relievers like Tylenol, and physical therapy can help. Applying heat or cold packs may also provide relief.
  • Herniated Disc: This occurs when the soft material inside a disc in your spine pushes out through a tear in the tougher exterior. It can cause localized pain and discomfort, especially if it presses on a nerve.

    • Treatment: Physical therapy, medications, and sometimes surgery are used to treat herniated discs. Avoiding activities that exacerbate the pain is also important.
  • Spinal Stenosis: This condition involves the narrowing of the spaces within your spine, which can put pressure on the nerves. It can cause pain in the back and may worsen with prolonged standing or walking.

    • Treatment: Physical therapy, medications, and sometimes surgical interventions can help manage symptoms.
  • Poor Posture: Prolonged sitting, standing, or driving with poor posture can lead to muscle imbalances and back pain.

    • Treatment: Improving posture, ergonomic adjustments, and exercises to strengthen the back and core muscles can be beneficial.

What you can do

While it's important to consult a healthcare professional for a formal diagnosis and treatment plan, here are some steps you can take to alleviate your symptoms:

  1. Maintain Good Posture: Ensure that you sit, stand, and sleep with proper alignment. Use ergonomic chairs and supportive mattresses.
  2. Exercise Regularly: Engage in low-impact exercises like walking, swimming, or yoga to strengthen your back muscles and improve flexibility.
  3. Use Heat or Cold Therapy: Apply a heating pad or ice pack to the affected areas to reduce pain and inflammation.
  4. Over-the-Counter Pain Relievers: Continue using Tylenol or other over-the-counter pain medications as needed, following the recommended dosage.
  5. Physical Therapy: Consider seeing a physical therapist who can provide targeted exercises and treatments to alleviate your pain.

What you should look out for

Seek medical attention if you experience any of the following:

  • Severe or Worsening Pain: If your pain becomes severe or continues to worsen despite self-care measures.
  • Numbness or Tingling: If you develop numbness, tingling, or weakness in your legs, which could indicate nerve involvement.
  • Changes in Bowel or Bladder Function: If you notice any changes in your bowel or bladder function, as this could be a sign of a more serious condition.
  • Unexplained Weight Loss or Fever: If you experience unexplained weight loss or fever, which could indicate an underlying medical issue.

Remember, while these tips can help manage your symptoms, it's important to consult a healthcare professional for a proper diagnosis and treatment plan tailored to your specific needs.

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8 mo ago

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People Also Ask


What are common causes of chronic back pain in young adults?

Common causes of chronic back pain in young adults include muscle strain or ligament sprain, herniated discs, spinal stenosis, and poor posture. These conditions can result from overuse, improper lifting, or prolonged periods of sitting or standing.


How can poor posture contribute to back pain?

Poor posture can lead to muscle imbalances and strain on the spine, which can cause or exacerbate back pain. Maintaining proper alignment while sitting, standing, and sleeping can help prevent and alleviate pain.


What are the treatment options for a herniated disc?

Treatment options for a herniated disc include physical therapy, medications, and sometimes surgery. It's important to avoid activities that worsen the pain and to follow a healthcare professional's guidance for managing symptoms.


When should I seek medical attention for back pain?

You should seek medical attention for back pain if it becomes severe or worsens despite self-care, if you experience numbness, tingling, or weakness in your legs, if there are changes in bowel or bladder function, or if you have unexplained weight loss or fever.


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2 Comments


Arora (Bot)#28060

8 mo ago

Hi Samuel, based on your symptoms, your back pain could be due to muscle strain, herniated disc, spinal stenosis, or poor posture. Treatments include rest, over-the-counter pain relievers like Tylenol, physical therapy, and improving posture. Applying heat or cold packs can also help. If your pain worsens or you experience numbness, tingling, or changes in bowel or bladder function, seek medical attention.

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Anonymous#4896

8 mo ago

Check out TENs units for temporary relief. I have spinal stenosis and it's more of a game of reducing inflammation any way I can. I eventually ended up getting an epidural which did work for a good 3-4 months.

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