[31M] With lower back pain and abdominal discomfort

Patient Description

A 31-year-old male presents with a three-day history of lower back pain, primarily located on the right side above the buttocks. The pain is described as tight and throbbing, particularly severe upon waking and gradually decreasing throughout the day. The patient reports significant stiffness and occasional muscle spasms in the back, along with slight leg pain and tingling, possibly related to work activities. The patient recalls walking up hills and having an 8-year-old walk on his back the day before symptoms began. Pain relief has been attempted with muscle relaxers, ibuprofen, and Tylenol. Additionally, the patient experiences a dull, constant abdominal pain rated at 2 out of 10 in severity, without associated nausea or significant changes in bowel habits. No recent injuries, fever, or chills reported. The patient denies any pre-existing conditions, allergies, or other medications.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

  • Muscle Strain: Given the sudden onset of your back pain after physical activity, it's possible you have a muscle strain. This can occur from overexertion, such as walking up hills or having someone walk on your back. Muscle strains often cause stiffness, spasms, and localized pain.

    • Treatment typically involves rest, ice or heat application, over-the-counter pain relievers like ibuprofen or Tylenol, and gentle stretching exercises.
  • Sciatica: The throbbing pain in your lower back and occasional tingling in your legs could suggest sciatica, which is irritation of the sciatic nerve. This can cause pain that radiates from the lower back down the leg.

    • Treatment may include physical therapy, pain relief medications, and exercises to improve flexibility and strength.
  • Kidney Issues: Although less likely, the location of your pain could also suggest a kidney issue, such as a kidney stone or infection, especially if accompanied by abdominal discomfort.

    • Diagnosis would typically involve urine tests and imaging studies. Treatment depends on the specific condition but may include hydration, pain management, or antibiotics.

What you can do

  1. Rest and Modify Activities: Avoid activities that worsen your pain. Gentle movements and avoiding heavy lifting can help.
  2. Apply Heat or Ice: Use a heating pad or ice pack on the affected area for 15-20 minutes several times a day to reduce pain and inflammation.
  3. Over-the-Counter Pain Relief: Continue using ibuprofen or Tylenol as directed to manage pain and inflammation.
  4. Gentle Stretching: Engage in gentle stretching exercises to improve flexibility and reduce stiffness. Consider yoga or specific back stretches.
  5. Symptom Tracking: Use MDandMe to journal your symptoms, track your progress, and share insights with your healthcare provider.

What you should look out for

Seek medical attention if you experience:

  • Severe or worsening pain that doesn't improve with self-care measures
  • Numbness or weakness in your legs
  • Difficulty controlling bowel or bladder function
  • Fever, chills, or other signs of infection
  • Persistent or severe abdominal pain

Remember, while these suggestions can help manage your symptoms, it's important to consult a healthcare professional for a formal diagnosis and appropriate treatment.

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2 mo ago

People Also Ask


What are the common causes of lower back pain?

Common causes of lower back pain include muscle strain, poor posture, herniated discs, sciatica, arthritis, and kidney issues. Physical activities, such as lifting heavy objects or sudden movements, can also lead to back pain.


How can I differentiate between muscle strain and sciatica?

Muscle strain typically presents as localized pain and stiffness in the back, often following physical exertion. Sciatica, on the other hand, involves pain that radiates from the lower back down the leg, often accompanied by tingling or numbness.


What are the signs that my back pain might be related to a kidney issue?

Signs that back pain might be related to a kidney issue include pain that is more to the side or back, accompanied by symptoms like fever, chills, nausea, or changes in urination. Persistent abdominal pain may also be a sign.


What are some effective home remedies for managing lower back pain?

Effective home remedies for managing lower back pain include rest, applying heat or ice to the affected area, taking over-the-counter pain relievers like ibuprofen or Tylenol, and performing gentle stretching exercises to improve flexibility and reduce stiffness.


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