[43F] With lower back pain and bloating

Patient Description

A 43-year-old female presents with lower back pain on the right side, described as a dull pain with occasional spasms, for the past three days. The pain is located just above the buttock, more towards the hip, and is worse in the mornings when getting up and at night when trying to get into bed. Throughout the day, the pain is less severe, but mobility is limited, and certain movements trigger spasms. The patient has tried patches, icy hot, ibuprofen, and a muscle relaxer, which have provided some relief but not complete alleviation of the pain. Additionally, the patient reports feeling bloated and gassy for the same duration, with noticeable discomfort in the abdominal area. The bloating has not been linked to any specific foods. The patient also feels more tired than usual and has been taking more naps during the day. There are no reports of fever, chills, changes in bowel or bladder control, or numbness or tingling in the legs or groin area. The patient's medical history includes an appendectomy, arthroscopic surgery to check for endometriosis, a possible diagnosis of IBS, and anemia diagnosed during the first pregnancy in 1997. The patient takes daily gummy vitamins and ibuprofen for menstrual cramps but is not on any prescription medications. There are no known allergies or adverse reactions to 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:

  • Muscle Strain or Spasm: Your description of sudden onset lower back pain, especially with movement, and spasms suggests that you might have a muscle strain or spasm. This can occur from overuse, improper lifting, or even sleeping in an awkward position.

    • Treatment typically involves rest, ice or heat application, over-the-counter pain relievers like ibuprofen, and gentle stretching exercises.
  • Sciatica: The pain radiating from your lower back to your hip and buttock area could indicate sciatica, which is caused by irritation of the sciatic nerve. This can result in sharp pain, dull aches, and sometimes spasms.

    • Treatment may include physical therapy, pain relievers, and in some cases, corticosteroid injections.
  • Irritable Bowel Syndrome (IBS): Given your history of being told you might have IBS, the bloating and gassiness could be related to this condition. IBS can cause abdominal discomfort, bloating, and changes in bowel habits.

    • Management often involves dietary changes, stress management, and sometimes medications to relieve symptoms.
  • Kidney Issues: Pain in the lower back, especially on one side, can sometimes be related to kidney issues such as a kidney infection or kidney stones. However, these conditions are often accompanied by other symptoms like fever, chills, or changes in urination, which you do not have.

    • Diagnosis typically involves urine tests, blood tests, and imaging studies. Treatment depends on the specific condition but may include antibiotics for infections or pain management for stones.

What you can do

While waiting to see a healthcare professional, you can try the following to help alleviate your symptoms:

  1. Rest and Gentle Movement: Avoid activities that exacerbate your pain. Gentle stretching and walking can sometimes help relieve muscle tension.
  2. Heat and Ice Therapy: Apply a heating pad or ice pack to the affected area for 15-20 minutes several times a day.
  3. Over-the-Counter Pain Relief: Continue using ibuprofen or acetaminophen as directed for pain relief.
  4. Hydration and Diet: Drink plenty of water and eat a balanced diet rich in fiber to help with bloating and gas. Avoid foods that are known to cause gas, such as beans, carbonated drinks, and certain vegetables like broccoli and cabbage.
  5. Monitor Symptoms: Keep track of any changes in your symptoms, especially if they worsen or new symptoms develop.

What you should look out for

Seek medical attention more urgently if you experience any of the following:

  • Severe or worsening pain that does not improve with rest or over-the-counter medications
  • Difficulty controlling your bowel or bladder
  • Numbness or tingling in your legs or around your groin area
  • Fever, chills, or signs of infection
  • Blood in your urine or significant changes in urination

Remember, this information is not a substitute for professional medical advice. Please consult a healthcare provider for a formal diagnosis and appropriate treatment.

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6 mo ago


People Also Ask


What are common causes of lower back pain with spasms?

Common causes of lower back pain with spasms include muscle strain from overuse or improper lifting, poor posture, or sleeping in an awkward position. Other causes can include conditions like sciatica or kidney issues.


How can I differentiate between muscle strain and sciatica?

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


What dietary changes can help manage symptoms of IBS?

To manage IBS symptoms, consider increasing fiber intake gradually, avoiding trigger foods such as caffeine, alcohol, and fatty foods, and eating smaller, more frequent meals. Keeping a food diary can help identify specific triggers.


When should I seek medical attention for lower back pain?

Seek medical attention if you experience severe or worsening pain that doesn't improve with rest or over-the-counter medications, difficulty controlling bowel or bladder, numbness or tingling in the legs or groin, fever, chills, or signs of infection, or blood in your urine.

1 Comments


Leo#3962

6 mo ago

Did you have any twists or falls prior to this pain? The dependence on motions like getting in and out of bed does make it seem more like a muscle or ligament issue rather than something more serious. Seems most likely independent of your bloating and gassiness

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