[40F] Experiencing severe lower left back pain with difficulty breathing

Patient Description

A 40-year-old female has been experiencing severe pain in the lower left back area for about a week. The pain is described as very painful, tender, and warm to the touch, radiating up to the left shoulder and making it difficult to sit, stand, lay down, sleep, or drive. Additionally, the patient reports difficulty taking deep breaths. The pain starts in the middle of the back and works its way to the side. The patient has had a few instances of fever or chills in the past two weeks but no blood in urine or recent weight loss. The patient recently recovered from sepsis with pneumonia two weeks ago and has a history of an enlarged heart diagnosed three years ago, and a thyroid condition diagnosed 20 years ago. Currently, the patient is not on any medications and has no known drug allergies.

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Arora's Assessment

What might be happening

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

  • Musculoskeletal pain: This is a common cause of back pain. It can be due to muscle strain, sprains, or other injuries. It can also be due to chronic conditions like arthritis. The pain is usually localized to the area of damage but can radiate to other areas. It can be exacerbated by physical activity and relieved by rest.

  • Pneumonia or Pleurisy: Given your recent history of pneumonia and sepsis, it's possible that your current symptoms are a continuation or recurrence of these conditions. Pneumonia can cause chest pain that radiates to the back, difficulty breathing, and fever. Pleurisy, inflammation of the lining of the lungs, can also cause similar symptoms and can occur after an episode of pneumonia.

  • Kidney Infection or Stones: These conditions can cause severe pain in the lower back, side, or abdomen, fever, and other symptoms. The pain can be severe and can radiate to different areas.

  • Heart conditions: Given your history of an enlarged heart, it's important to consider conditions like heart disease or heart failure. These can cause a variety of symptoms including back pain and difficulty breathing.

What you can do

Given the severity of your symptoms and your recent medical history, it's important that you seek medical attention as soon as possible.

In the meantime, try to rest and stay hydrated. Over-the-counter pain relievers may help alleviate your pain, but it's important to check with a healthcare provider before starting any new medication.

What you should look out for

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

  • Severe chest pain
  • Difficulty breathing
  • Confusion or difficulty staying awake
  • Blood in your urine
  • Fever that's not improving or is getting worse

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 appropriate examination, testing, and care.

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9 mo ago

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People Also Ask


What are the common causes of severe lower back pain that radiates to the shoulder?

Common causes of severe lower back pain that radiates to the shoulder include musculoskeletal issues such as muscle strain or sprains, as well as more serious conditions like kidney infections or stones, and heart-related issues. It's important to consult a healthcare provider for an accurate diagnosis.


Can pneumonia or pleurisy cause back pain and difficulty breathing?

Yes, pneumonia and pleurisy can cause back pain and difficulty breathing. Pneumonia can lead to chest pain that radiates to the back, while pleurisy, which is inflammation of the lung lining, can cause sharp pain that worsens with breathing.


What symptoms indicate a kidney infection or kidney stones?

Symptoms of a kidney infection or kidney stones include severe pain in the lower back, side, or abdomen, fever, chills, nausea, and sometimes blood in the urine. It's important to seek medical attention if these symptoms occur.


How can an enlarged heart affect back pain and breathing?

An enlarged heart can lead to conditions like heart disease or heart failure, which may cause symptoms such as back pain and difficulty breathing. These symptoms occur due to the heart's reduced ability to pump blood effectively, leading to fluid buildup and pressure in the chest and back.


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