[31F] Experiencing chronic pain and neurological symptoms

Patient Description

A 31-year-old female presents with a complex medical picture characterized by chronic, severe lower back and hip pain that has persisted for 18 years. The pain is described as both sharp and dull, with a severity rating of 8 or 9 out of 10. It is exacerbated by bending, lifting heavy objects, and prolonged sitting, and does not significantly improve with rest. Additionally, the patient reports frequent heartburn, particularly when consuming acidic foods, and rates the severity as 7 out of 10. The patient also experiences tingling and numbness in the feet and hands, which occur when sitting down or after extensive walking, and can progress to numbness. This has been ongoing for approximately 3 years. Furthermore, the patient frequently feels overheated and has recurring jaw and teeth pain. There is no mention of recent injuries, surgeries, or specific medical diagnoses related to these symptoms.

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Arora's Assessment

What might be happening

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

  • Chronic Back Pain: This is a common condition, especially in adults. It can be caused by a variety of factors, including injury, strain, or conditions such as arthritis or disc problems. Chronic back pain is often described as a dull ache or a sharp, stabbing sensation.

    • Treatment typically involves a combination of medication, physical therapy, and lifestyle changes such as improving posture and strengthening the back muscles.
  • Peripheral Neuropathy: This condition results from damage to the peripheral nerves, often causing weakness, numbness, and pain, usually in your hands and feet. It can be associated with a number of medical conditions, including diabetes.

    • Treatment typically involves managing the condition causing the neuropathy. Pain and physical therapy may also be recommended.
  • Gastroesophageal Reflux Disease (GERD): This is a chronic condition where stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus, causing heartburn.

    • Treatment typically involves lifestyle changes and over-the-counter medications. In severe cases, prescription medication or surgery may be needed.

What you can do

  1. For your back pain, consider over-the-counter pain relievers, heat or cold packs, and gentle exercises or stretching. Avoid heavy lifting and prolonged sitting when possible.
  2. For the tingling and numbness in your hands and feet, try to maintain good control of underlying conditions such as diabetes, if applicable. Regular exercise and a healthy diet can also help.
  3. For your heartburn, try to avoid foods that trigger your symptoms. Over-the-counter antacids may also provide temporary relief.

Remember, it's important to consult with a healthcare provider for a formal diagnosis and treatment plan.

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 weakness in your legs.
  • The tingling and numbness in your hands and feet worsen, or if you experience muscle weakness or difficulty walking.
  • Your heartburn is severe, occurs frequently, or is accompanied by difficulty swallowing, weight loss, or vomiting.

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11 mo ago

People Also Ask


What are some common causes of chronic lower back and hip pain?

Chronic lower back and hip pain can be caused by a variety of factors including muscle strain, herniated discs, arthritis, or other degenerative conditions. Poor posture, obesity, and lack of exercise can also contribute to chronic pain.


How can peripheral neuropathy be managed or treated?

Peripheral neuropathy management typically involves addressing the underlying cause, such as controlling blood sugar levels in diabetes. Pain management may include medications, physical therapy, and lifestyle changes like regular exercise and a healthy diet.


What lifestyle changes can help alleviate symptoms of GERD?

Lifestyle changes to alleviate GERD symptoms include avoiding trigger foods (such as spicy or acidic foods), eating smaller meals, not lying down immediately after eating, maintaining a healthy weight, and avoiding smoking and alcohol.


When should I seek medical attention for heartburn or acid reflux?

You should seek medical attention for heartburn if it is severe, occurs frequently, or is accompanied by symptoms such as difficulty swallowing, unexplained weight loss, or vomiting, as these could indicate a more serious condition.


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