[31F] Experiencing lower back and pelvic pain with intermittent leg numbness

Patient Description

A 31-year-old female presents with lower left back pain described as a burning and pulsing sensation, rated 6/10 in severity, which started on Friday and has been worsening. The pain is localized above the buttocks, radiating upwards when lying down and into the hip, exacerbated by sitting and standing up. A heating pad provides some relief, but ibuprofen is ineffective. Additionally, the patient reports an achy and dull pelvic pain to the right of the pelvic bone, a recurrent symptom associated with her menstrual cycle, rated 4/10 in severity. This pelvic pain has been present on and off for a year. The patient also experiences intermittent numbness and tingling in the left leg, affecting the thighs and feet. Recently, the patient felt hot with chills, but this was a brief episode. There are no changes in bladder or bowel control, but the patient notes strong-smelling, yellow urine and general fatigue. The patient has a family history of endometriosis, with both her sister and mother diagnosed with the condition. She has a history of migraines, diagnosed last summer, and had an MRI to rule out MS. The patient occasionally uses ibuprofen or Tylenol but does not regularly take any medications and has no known drug allergies. The patient's medical history is otherwise unremarkable.

Arora's Assessment

What might be happening

Based on your symptoms, several conditions could be causing your discomfort:

Kidney Stones: These are hard deposits made of minerals and salts that form inside your kidneys. They can cause severe pain in the back and side, below the ribs, and can radiate to the lower abdomen and groin. The pain may come in waves and fluctuate in intensity. Other symptoms may include pink, red or brown urine, or foul-smelling urine.
- Treatment can include pain relievers and drinking lots of water to help pass the stone. Medical procedures may be required if the stone is too large.
Sciatica: This condition occurs when the sciatic nerve, which runs from your lower back through your hips and buttocks and down each leg, becomes pinched. This can cause inflammation, pain and often some numbness in the affected leg.
- Treatment typically includes physical therapy and pain relief medication. In severe cases, surgery may be needed.
Endometriosis: This is a disorder in which tissue similar to the tissue that forms the lining of your uterus grows outside of your uterine cavity. It can cause pain in the lower abdomen or lower back that can radiate to the pelvic area. The pain is usually worse during your period.
- Treatment often involves medication to manage pain and hormones to suppress endometriosis growth. In some cases, surgery may be needed.

What you can do

Make an appointment with your healthcare provider as soon as possible to discuss your symptoms. They may want to perform some tests to determine the cause of your pain.
In the meantime, continue using a heating pad and over-the-counter pain relievers as needed.
Stay hydrated and maintain a balanced diet. This is especially important if kidney stones are suspected, as drinking lots of fluids can help pass the stone.

What you should look out for

Contact your healthcare provider immediately or seek emergency medical attention if:

Your pain becomes severe or unbearable
You have blood in your urine or stool
You develop a fever or chills
You have difficulty urinating or have a significant decrease in the volume of your urine
You experience sudden or severe abdominal pain

Please remember that while I strive to provide accurate information, I am not a doctor. Always seek advice from a healthcare professional for a formal diagnosis and treatment.

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10 mo ago

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[31F] Experiencing lower back and pelvic pain with intermittent leg numbness

What might be happening

What you can do

What you should look out for

Experiencing symptoms?