[31F] With severe dull mid and low back pain and bladder changes

Patient Description

A 31-year-old female presents with severe dull mid and low back pain persisting for one month. The pain is located along the spine, worsens with sleep, and occurs daily, lasting a few hours. It is associated with stiffness and radiating pain in the legs. The patient reports that sitting upright, pain medication, and massage provide some relief. Additionally, she has experienced recent changes in bladder function, specifically urine incontinence, and attributes a back injury to overuse. The patient's medical history includes osteoarthritis, facet joint syndrome, and bladder incontinence. She denies the use of tobacco, alcohol, or recreational drugs. No numbness, tingling, or weakness in the legs is reported. The patient is not currently undergoing physical therapy or exercises for back pain. No recent changes in menstrual history are noted. Allergies include vancomycin, ciprofloxacin, Concerta, and Effexor. Current medications include Lyrica, Amrix, Tramadol, Fioricet, probiotics, multivitamin, and clindamycin gel.

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Arora's Assessment

What might be happening

Based on the information you've provided, Emily, your symptoms could be related to the following conditions:

  • Facet Joint Syndrome: This condition involves the small joints in the spine that can become inflamed or irritated, leading to back pain. Given your history, this could be a contributing factor to your current symptoms. Pain is often described as a dull ache and can be aggravated by certain positions, such as lying down.

  • Osteoarthritis: This is a degenerative joint disease that can affect the spine, causing pain and stiffness, especially after periods of inactivity like sleeping. Your history of osteoarthritis could be playing a role in your current back pain.

  • Herniated Disc: This occurs when the soft center of a spinal disc pushes through a crack in the tougher exterior casing, potentially pressing on nearby nerves. This could explain the radiating pain in your legs and changes in bladder function.

  • Spinal Stenosis: This condition involves the narrowing of the spaces within your spine, which can put pressure on the nerves. It often causes pain, numbness, or weakness in the legs, and can sometimes affect bladder control.

What you can do

  1. Consult a Healthcare Professional: It's important to seek medical attention to ensure a proper diagnosis and treatment plan. A healthcare provider can perform a physical examination and may suggest imaging studies, like an MRI, to get a clearer picture of what's happening in your spine.

  2. Symptom Management: Continue using pain medication as prescribed and consider physical therapy exercises to strengthen your back muscles and improve flexibility. Massage therapy may also provide relief.

  3. Lifestyle Adjustments: Pay attention to your posture, especially when sitting or sleeping. Using supportive pillows or cushions can help alleviate pressure on your spine.

  4. Track Your Symptoms: Use MDandMe to journal your symptoms, track your progress, and gain insights. This information can be valuable for your healthcare provider to understand your condition better.

What you should look out for

  • Worsening Symptoms: If your pain becomes more severe or persistent, or if you experience new symptoms such as numbness, tingling, or weakness in your legs, seek medical attention promptly.

  • Changes in Bladder or Bowel Function: Any further changes in bladder or bowel function should be evaluated by a healthcare professional as soon as possible.

  • Signs of Infection: If you develop a fever, chills, or any signs of infection, contact your healthcare provider immediately.

Remember, while this advice is based on the information provided, it's important to consult with a healthcare professional for a formal diagnosis and treatment plan. If you have any more questions or need further assistance, feel free to ask!

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20 d ago

People Also Ask


What is facet joint syndrome and how does it cause back pain?

Facet joint syndrome involves inflammation or irritation of the small joints in the spine, leading to back pain. The pain is often a dull ache and can be aggravated by certain positions, such as lying down.


How can osteoarthritis affect the spine and lead to back pain?

Osteoarthritis is a degenerative joint disease that can affect the spine, causing pain and stiffness, especially after periods of inactivity like sleeping. It results from the breakdown of cartilage in the joints, leading to discomfort and reduced mobility.


What are the symptoms of a herniated disc and how is it treated?

A herniated disc occurs when the soft center of a spinal disc pushes through a crack in the tougher exterior casing, potentially pressing on nearby nerves. Symptoms include radiating pain in the legs, numbness, or weakness. Treatment may involve physical therapy, medication, or in severe cases, surgery.


What is spinal stenosis and how does it impact bladder function?

Spinal stenosis is the narrowing of spaces within the spine, which can put pressure on the nerves. It often causes pain, numbness, or weakness in the legs, and can sometimes affect bladder control due to nerve compression.


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