[24M] With chronic lower back and hip pain

Patient Description

A 24-year-old male has been experiencing sharp lower back pain for over a year, which worsens when bending over at the waist and is alleviated by laying down or standing up. The pain intensifies with prolonged sitting and is somewhat relieved by applying ice. Imaging tests, including X-rays and MRIs, have returned normal results. The patient also reports sharp pain on the sides of both hips, persisting for a year, which began after diving onto a gym floor. There is no associated swelling, redness, warmth, numbness, tingling, or radiating pain down the legs, but there is stiffness and limited range of motion in the hips and lower back. The patient has no history of surgeries or medical conditions related to the back or hips and does not experience leg weakness or difficulty walking. The patient uses smokeless tobacco-free oral nicotine daily and acknowledges a diet potentially lacking in sufficient nutrients, particularly calcium and vitamin D. No medications are currently being taken, and there are no other pre-existing conditions or chronic illnesses.

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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 symptoms:

  • Chronic Lower Back Pain: This can be due to various reasons, including muscle strain, ligament sprain, or issues with the spine such as herniated discs or degenerative disc disease. Given that your imaging tests were normal, it might be more related to muscular or soft tissue issues.

    • Treatment: Physical therapy, exercises to strengthen the back and core muscles, and ergonomic adjustments to your sitting posture can be helpful. Over-the-counter pain relievers and anti-inflammatory medications may also provide relief.
  • Hip Pain: The sharp pain on the sides of your hips could be related to bursitis, tendinitis, or muscle strain, especially considering the history of trauma from diving onto a gym floor.

    • Treatment: Rest, ice, and anti-inflammatory medications can help reduce pain and inflammation. Physical therapy focusing on hip strengthening and flexibility exercises may also be beneficial.

What you can do

  1. Physical Therapy: Consider seeing a physical therapist who can provide you with specific exercises to strengthen your back and hip muscles, improve flexibility, and correct any posture issues.
  2. Ergonomic Adjustments: Make sure your workstation is set up ergonomically to reduce strain on your back and hips. Use a chair with good lumbar support and take frequent breaks to stand and stretch.
  3. Ice and Heat Therapy: Continue using ice to reduce inflammation and pain. You can also try heat therapy to relax and loosen tissues and stimulate blood flow to the area.
  4. Over-the-Counter Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help reduce pain and inflammation.
  5. Diet and Nutrition: Ensure you are getting enough calcium and vitamin D to support bone health. Consider dietary changes or supplements if necessary.
  6. Lifestyle Changes: Reduce or quit nicotine use, as it can affect blood flow and healing. Incorporate regular physical activity into your routine to maintain overall health and mobility.
  7. Use MDandMe: Journal your symptoms, track your progress, get insights, and share longitudinal medical notes with your healthcare provider.

What you should look out for

  • Worsening Symptoms: If your pain becomes more severe or starts to radiate down your legs, seek medical attention.
  • New Symptoms: If you develop numbness, tingling, or weakness in your legs, or if you experience any changes in bowel or bladder function, see a doctor immediately.
  • Persistent Pain: If your pain does not improve with the above measures or continues to interfere with your daily activities, consult a healthcare professional for further evaluation and management.

Remember, while this advice can help manage your symptoms, it is important to consult with a healthcare professional for a formal diagnosis and personalized treatment plan.

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3 mo ago


People Also Ask


What could be causing my chronic lower back pain if imaging tests are normal?

Chronic lower back pain with normal imaging results might be due to muscular or soft tissue issues such as muscle strain or ligament sprain. It could also be related to posture or ergonomic factors.


How can I manage hip pain that started after a traumatic event?

Managing hip pain after trauma can involve rest, ice application, and anti-inflammatory medications. Physical therapy focusing on strengthening and flexibility exercises can also be beneficial.


What lifestyle changes can help improve my back and hip pain?

Lifestyle changes such as engaging in regular physical activity, making ergonomic adjustments to your workstation, and reducing nicotine use can help improve back and hip pain. These changes can enhance overall health and mobility.


Why is it important to ensure adequate calcium and vitamin D intake for my condition?

Adequate calcium and vitamin D intake is important for bone health, which can support recovery and prevent further issues. A diet lacking in these nutrients may contribute to bone weakness and prolong recovery.


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