[32F] Experiencing middle back pain, sore throat, and fatigue

Patient Description

A 32-year-old female presents with a one-day history of severe middle back pain described as a sensation of being hit horizontally with a bat, rated 7/10 in intensity. The pain is exacerbated by bending, sitting up, and twisting, but is alleviated when laying down or sitting. Additionally, the patient reports a 10-day history of a sore throat, characterized by a dull ache and raw feeling, located low below the larynx. The patient also experiences fatigue but denies fever or chills. There is no recent history of injury or trauma to the back. The patient's medical history is significant for myoclonus dystonia diagnosed in 2009 and deep brain stimulation (DBS) therapy initiated in 2022. The patient reports an allergy to sulpha drugs but is not currently on any medications.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possible explanations for your symptoms:

  • Musculoskeletal Strain: Your middle back pain, which is worsened by bending, sitting up, and twisting, could be due to a strain or sprain of the muscles or ligaments in your back. This is a common cause of back pain and can occur without a specific injury.

    • Treatment typically involves rest, over-the-counter pain relievers, and physical therapy exercises.
  • Viral Infection: Your sore throat and fatigue, especially if they started around the same time, could be due to a common viral infection like the flu or mononucleosis. These infections can also cause body aches that might explain your back pain.

    • Treatment for viral infections usually involves rest, hydration, and over-the-counter remedies to manage symptoms. Antibiotics are not effective against viruses.
  • Myoclonus Dystonia: This is a movement disorder that can cause muscle contractions and other symptoms. While it typically affects the arms, neck, and torso, it's possible that it could be contributing to your back pain or fatigue.

    • Treatment usually involves medications, but as you're not currently taking any, it would be worth discussing this with your doctor.

Please note that these are possible explanations based on the information you've provided, but only a healthcare professional can provide a definitive diagnosis.

What you can do

  1. Rest and avoid activities that worsen your back pain. Over-the-counter pain relievers may also help.
  2. Stay hydrated and get plenty of sleep to help your body fight off any potential infection.
  3. Schedule an appointment with your healthcare provider to discuss your symptoms. They may want to perform tests to rule out certain conditions or adjust your treatment plan for myoclonus dystonia.

What you should look out for

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

  • Severe pain or pain that doesn't improve with rest and over-the-counter pain relievers
  • Difficulty breathing or shortness of breath
  • Fever, chills, or other signs of a severe infection
  • New or worsening symptoms

Remember, this advice is intended to be general in nature, and specific causes may not apply to your personal circumstances. Always consult with a healthcare provider for appropriate examination, testing, and care.

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11 mo ago

People Also Ask


What are common causes of middle back pain without a recent injury?

Common causes of middle back pain without a recent injury include muscle strain, poor posture, or overuse. It can also be due to conditions like arthritis or a herniated disc. Stress and tension can also contribute to back pain.


How can a viral infection lead to both a sore throat and back pain?

A viral infection can cause systemic symptoms like fatigue and body aches, which may include back pain. The immune response to the virus can lead to inflammation and discomfort in various parts of the body, including the throat and back.


What is myoclonus dystonia and how might it affect back pain?

Myoclonus dystonia is a movement disorder characterized by involuntary muscle contractions and jerking movements. It primarily affects the arms, neck, and torso, but can also cause muscle tension and discomfort in other areas, potentially contributing to back pain.


What are the potential side effects or considerations of deep brain stimulation therapy?

Deep brain stimulation (DBS) therapy involves implanting electrodes in the brain to help control movement disorders. Potential side effects include infection, bleeding, or hardware complications. It may also cause changes in mood or cognition, and adjustments to the device settings may be needed to optimize benefits and minimize side effects.


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