[28F] Experiencing severe lower back pain and stomach stiffness

Patient Description

A 28-year-old female presents with severe lower back pain and aches and stiffness in the center of the stomach for the past 3 days. The back pain is sharp, radiating through the sides and stomach, and worsens at night, particularly during the midnight hours. It is temporarily alleviated by Tylenol. The patient noticed a hard, immovable lump next to the spine on the right back side, which was identified the previous night. The stomach discomfort is described as a non-stop tight stiffness, impacting the patient's posture when sitting or laying down. This stiffness also makes bowel movements and passing gas painful. The patient has a history of asthma and bronchitis since the age of 4 but is not currently on any medications. No recent injuries were reported, but the patient mentioned being squeezed and pulled during play, which was followed by the onset of symptoms the next morning. No changes in urinary habits, numbness, tingling, fever, chills, or unexplained weight loss were reported. The patient's last bowel movement was described as normal in appearance.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possibilities:

  • Musculoskeletal Strain: Given the recent incident where you were squeezed and pulled, it's possible that you've strained a muscle or ligament in your back. This can cause pain, stiffness, and a lump (which could be a muscle knot or spasm).

    • Treatment usually involves rest, over-the-counter pain relievers, and gentle exercises or physical therapy as the pain improves.
  • Kidney Stones: These can cause severe pain in the back or side, and sometimes in the stomach. The pain can come in waves, fluctuating in intensity and possibly getting worse over time.

    • Treatment can range from pain management and drinking lots of water to flush out the stone, to medical procedures if the stone is too large.
  • Gastrointestinal Issue: Conditions like gastritis, peptic ulcers, or gallstones can cause severe stomach pain. The fact that you're experiencing pain when trying to pass a bowel movement or gas suggests a possible gastrointestinal issue.

    • Treatment depends on the specific condition and may involve dietary changes, medication, or in some cases, surgery.

Please note that these are possibilities based on the information you've provided, and not a definitive diagnosis.

What you can do

  1. Continue to take over-the-counter pain relievers as needed, but avoid taking more than the recommended dose.
  2. Try applying a warm compress to your back to help relax your muscles and alleviate pain.
  3. Stay hydrated and eat a balanced diet to help your body recover and to maintain normal bowel movements.
  4. Avoid heavy lifting and sudden movements that could exacerbate your back pain.
  5. Try gentle exercises or stretches for your back as the pain allows.

What you should look out for

Please seek immediate medical attention if you experience any of the following:

  • Severe pain that doesn't improve with rest or over-the-counter pain relievers
  • Blood in your urine or stool
  • Fever or chills
  • Nausea or vomiting
  • Difficulty urinating or having a bowel movement

Remember, I'm an AI and not a doctor. It's important to consult with a healthcare professional who can evaluate your symptoms and condition in person.

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10 mo ago

People Also Ask


What could cause a hard, immovable lump next to the spine?

A hard, immovable lump next to the spine could be a muscle knot or spasm resulting from a musculoskeletal strain. It could also be a benign growth or cyst, but it's important to have it evaluated by a healthcare professional to rule out other causes.


How can musculoskeletal strain lead to severe back pain and stiffness?

Musculoskeletal strain can occur when muscles or ligaments are overstretched or torn, often due to sudden movements or physical exertion. This can lead to sharp pain, stiffness, and sometimes the formation of muscle knots, which can cause discomfort and limit mobility.


What are the symptoms of kidney stones and how are they treated?

Kidney stones can cause severe pain in the back, side, or stomach, often described as sharp and cramping. The pain may come in waves and can be accompanied by nausea, vomiting, or blood in the urine. Treatment includes pain management, increased fluid intake, and sometimes medical procedures to remove larger stones.


What gastrointestinal issues could cause stomach pain and stiffness?

Gastrointestinal issues such as gastritis, peptic ulcers, or gallstones can cause stomach pain and stiffness. These conditions may lead to discomfort during bowel movements or when passing gas. Treatment varies depending on the specific condition and may involve dietary changes, medications, or surgery.


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