[38F] Experiencing back pain and persistent cough

Patient Description

A 38-year-old female presents with a one-week history of lower to mid back pain described as constant with episodes of sharp pain, rated 6/10 in severity, exacerbated by standing and bending over. Additionally, she reports a month-long history of a productive cough that worsens in cold weather, causing breathlessness and nausea during coughing fits. Urine leakage has been occurring for a week, coinciding with the cough. The patient has a history of an unspecified hernia found on a CAT scan of the stomach two years prior. She has an NSAID allergy 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, possible explanations for your symptoms include:

  • Bronchitis: This is an inflammation of the bronchial tubes, the airways that carry air to your lungs. It causes a cough that often brings up mucus, as well as shortness of breath, wheezing, and chest tightness. The cough can last for several weeks and the constant coughing can lead to muscle strain, including in your back, which may explain your back pain.

    • Treatment typically involves rest, fluids, and over-the-counter pain relievers and cough suppressants. Antibiotics may be necessary if the bronchitis is caused by bacteria.
  • Urinary Incontinence: This is a common condition characterized by the loss of bladder control. The coughing fits you've been experiencing could be causing stress incontinence, where pressure on the bladder from coughing or sneezing causes urine leakage.

    • Treatment can involve pelvic floor exercises, bladder training, medications, or in some cases, surgery.
  • Hiatal Hernia: This occurs when part of your stomach pushes upward through your diaphragm. Your diaphragm normally has a small opening (hiatus) that allows your food tube (esophagus) to pass on its way to connect to your stomach. The stomach can push up through this opening and cause a hiatal hernia. This could potentially explain the discomfort in your naval area.

    • Treatment typically involves medications to manage symptoms, and in severe cases, surgery.

Please note that these are possible explanations and not a definitive diagnosis. It's important to consult with a healthcare provider for an accurate diagnosis and treatment.

What you can do

  1. Rest and stay hydrated: This can help your body recover if you're dealing with bronchitis.
  2. Over-the-counter medication: Over-the-counter pain relievers can help manage your back pain, and cough suppressants can help with your cough.
  3. Pelvic floor exercises: These can help strengthen your pelvic muscles and improve bladder control.
  4. Avoid lifting heavy objects: This can put strain on a hernia and potentially make it worse.

What you should look out for

Reasons to seek immediate medical attention:

  • If your cough or shortness of breath worsens
  • If you start coughing up blood
  • If your back pain becomes severe or is accompanied by other symptoms like fever or loss of bladder control
  • If you notice a bulge or lump in your abdominal area, or if your hernia symptoms worsen

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for accurate information.

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11 mo ago

People Also Ask


What are the common symptoms of bronchitis and how is it treated?

Bronchitis is characterized by inflammation of the bronchial tubes, leading to symptoms such as a persistent cough that produces mucus, shortness of breath, wheezing, and chest tightness. Treatment often includes rest, staying hydrated, and using over-the-counter pain relievers and cough suppressants. If the bronchitis is bacterial, antibiotics may be prescribed.


What is stress urinary incontinence and how can it be managed?

Stress urinary incontinence is a condition where physical activities such as coughing, sneezing, or exercising cause urine leakage due to pressure on the bladder. Management strategies include pelvic floor exercises to strengthen the pelvic muscles, bladder training, medications, and in some cases, surgical interventions.


How can a hiatal hernia affect my health and what are the treatment options?

A hiatal hernia occurs when part of the stomach pushes through the diaphragm into the chest cavity, which can cause symptoms like heartburn, chest pain, and discomfort. Treatment options include lifestyle changes, medications to reduce stomach acid, and in severe cases, surgery to repair the hernia.


What are some non-NSAID options for managing back pain?

For managing back pain without NSAIDs, options include acetaminophen for pain relief, physical therapy, applying heat or cold packs, gentle stretching exercises, and in some cases, prescription medications or alternative therapies like acupuncture or chiropractic care.


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