[24F] Experiencing upper back pain and fatigue with food cravings

Patient Description

A 24-year-old female presents with aching back pain rated 8/10 in intensity, localized to the upper back, and has been persistent for 3 to 4 days. The pain worsens from noon to 8 pm and during activities such as cleaning and dusting. Hot baths provide temporary relief. She also reports fatigue, a significant craving for sweet dishes, and a feeling of low energy. The patient experiences numbness in her legs when sitting in one position for too long and occasional leg weakness. She has a history of dengue and typhoid treated 4 years ago but no chronic illnesses. She has lost weight due to neglecting her health while working for the past 4 months. No fever, chills, or recent injuries are reported, except for a slip on the floor one year ago. The patient is not on any regular medications except for occasional use of Combiflam.

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Arora's Assessment

What might be happening

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

  • Musculoskeletal Back Pain: This is a common condition that can cause aching pain in the back. It can be due to a variety of reasons including poor posture, muscle strain, or injury like the slip you mentioned. The fact that your pain is relieved by hot baths and worsens with physical activity supports this.

    • Treatment typically involves physical therapy, pain relievers, and lifestyle modifications such as improving posture and ergonomics.
  • Chronic Fatigue Syndrome (CFS): This is a complex disorder characterized by extreme fatigue that can't be explained by any underlying medical condition. The fatigue worsens with physical or mental activity, but doesn't improve with rest. This could explain your tiredness and lack of energy.

    • Treatment for CFS focuses on symptom relief.
  • Eating Disorder: Your food cravings, long meal times, and recent weight loss may suggest an eating disorder. These are serious conditions related to persistent eating behaviors that negatively impact health, emotions, and the ability to function in important areas of life. The most common eating disorders are anorexia nervosa, bulimia nervosa, and binge-eating disorder.

    • Treatment usually involves a combination of psychological therapy and supervised weight gain.

Please note that these are just possibilities based on the symptoms you've described. You should consult a healthcare professional for an accurate diagnosis.

What you can do

  1. For your back pain, try to maintain good posture, take frequent breaks if you're sitting for long periods, and avoid lifting heavy objects. Over-the-counter pain relievers may help. Regular exercise can strengthen your back muscles and improve your posture.

  2. For your fatigue, try to maintain a regular sleep schedule, eat a healthy diet, and engage in regular physical activity. Avoid caffeine and alcohol, which can interfere with sleep.

  3. For your food cravings, try to eat balanced meals and snacks every 3-4 hours. Avoid skipping meals and keep a food diary to identify any patterns with your eating habits.

  4. It's important to seek help if you're struggling with your eating habits or feelings about food. You can reach out to a mental health professional or a support group.

What you should look out for

Seek immediate medical attention if:

  • Your back pain is severe, doesn't improve with rest, or if you have numbness or tingling in your legs, arms or chest.
  • Your fatigue is so severe that you can't perform your usual daily activities, or if you feel depressed, have trouble concentrating, or have unexplained weight loss.
  • You're unable to control your eating habits, you're excessively worried about your weight or body shape, or if you're using extreme measures to lose weight.

Remember, while I strive to provide accurate information, I'm not a doctor. Please consult a healthcare professional for a formal diagnosis and treatment.

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10 mo ago

People Also Ask


What are common causes of upper back pain and how can it be managed?

Common causes of upper back pain include poor posture, muscle strain, or injury. Management typically involves physical therapy, pain relievers, and lifestyle changes such as improving posture and ergonomics. Regular exercise and hot baths can also provide relief.


What is Chronic Fatigue Syndrome and how is it treated?

Chronic Fatigue Syndrome (CFS) is a disorder characterized by extreme fatigue that doesn't improve with rest and worsens with activity. Treatment focuses on symptom relief, including managing sleep, diet, and stress, and sometimes involves medications or therapy.


How can I manage cravings for sweet foods and maintain a healthy diet?

To manage cravings for sweet foods, try eating balanced meals and snacks every 3-4 hours, avoid skipping meals, and keep a food diary to identify patterns. Incorporating more protein and fiber into your diet can help control cravings.


What are the signs of an eating disorder and when should I seek help?

Signs of an eating disorder include persistent eating behaviors that negatively impact health, emotions, and daily functioning, such as extreme concern about weight or body shape. Seek help if you struggle to control eating habits or use extreme measures to lose weight.


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