[28F] Experiencing severe hip and lower back pain with neurological symptoms

Patient Description

A 28-year-old female presents with severe, constant, and worsening hip pain described as a sharp ache on the outside, sides, and back, radiating to the back and thighs. The hip pain has been present for 6 months and is exacerbated by lying down and walking. The patient also reports a long-standing moderate lower back pain that has worsened in the past 6 months, particularly upon waking and at night, with some relief from lying down in various positions. Additionally, the patient experiences nerve tingling in the arms and legs, requiring tensing up to manage, as well as muscle and joint pain. There is a noted unexplained weight loss and stomach issues characterized by diarrhea. No recent injuries, fevers, or falls have been reported. No pregnancy is noted. The patient's medical history at this time is not fully detailed.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Fibromyalgia: This is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. It can also cause tingling in your arms and legs. The exact cause of fibromyalgia is unknown, but it most often starts after a physical trauma, surgery, infection or significant psychological stress.

    • Treatment typically involves a combination of medications, exercise, stress management measures, and healthy lifestyle habits.
  • Lumbar radiculopathy (sciatica): This condition occurs when a nerve root in the lower spine is compressed, causing pain and numbness to travel along the sciatic nerve, which radiates from the buttock down the back of the leg. It can also cause tingling in your arms and legs.

    • Treatment typically involves physical therapy, medications to relieve pain and inflammation, and in some cases, surgery.
  • Inflammatory bowel disease (IBD): This is a term for two conditions (Crohn’s disease and ulcerative colitis) that are characterized by chronic inflammation of the gastrointestinal (GI) tract. Symptoms can include diarrhea, abdominal pain, and weight loss.

    • Treatment typically involves medication to reduce inflammation and other symptoms, and in severe cases, surgery.

Please note that these are only possible diagnoses and you should consult with a healthcare professional for an accurate diagnosis.

What you can do

  1. Schedule an appointment with your primary care doctor. They can evaluate your symptoms and may refer you to a specialist if necessary.
  2. Keep a symptom diary. This can help you and your doctor understand what triggers your symptoms and how to manage them.
  3. Try gentle exercises like walking or swimming. These can help reduce pain and improve your overall health.
  4. Try to maintain a healthy diet. Certain foods may trigger symptoms, so it can be helpful to identify and avoid these foods.

What you should look out for

Seek immediate medical attention if:

  • Your pain becomes severe or unbearable
  • You have difficulty walking or moving
  • You experience sudden, severe stomach pain
  • You have blood in your stool

Please remember that while I strive to provide accurate information, I am not a doctor and this advice should not replace a consultation with a healthcare professional.

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11 mo ago

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People Also Ask


What are the common symptoms of fibromyalgia?

Common symptoms of fibromyalgia include widespread musculoskeletal pain, fatigue, sleep disturbances, memory issues, mood problems, and tingling in the arms and legs. The pain is often described as a constant dull ache that lasts for at least three months.


How is lumbar radiculopathy (sciatica) diagnosed and treated?

Lumbar radiculopathy, or sciatica, is typically diagnosed through a physical examination and imaging tests like MRI or CT scans to identify nerve compression. Treatment may include physical therapy, pain relief medications, anti-inflammatory drugs, and in some cases, surgery to relieve pressure on the nerve.


What are the symptoms and treatment options for inflammatory bowel disease (IBD)?

Symptoms of inflammatory bowel disease (IBD) include chronic diarrhea, abdominal pain, weight loss, and fatigue. Treatment options often involve medications to reduce inflammation and manage symptoms, dietary changes, and in severe cases, surgery to remove damaged portions of the GI tract.


What lifestyle changes can help manage chronic pain conditions like fibromyalgia or sciatica?

Lifestyle changes that can help manage chronic pain conditions include regular low-impact exercise like walking or swimming, stress management techniques such as meditation or yoga, maintaining a healthy diet, and ensuring adequate sleep. Keeping a symptom diary can also help identify triggers and manage symptoms more effectively.


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