[47F] Experiencing severe back pain and neurological symptoms

Patient Description

A 47-year-old female presents with a complex of symptoms including severe lower back pain described as 'locking up,' making movement difficult, and rated 8 out of 10 in severity. This pain has been persistent for a couple of weeks and intermittently present for about two months. The patient also reports a month-long history of pins and needles in the entire hand, worsening in the morning and associated with hand swelling. There is notable weakness in the hands, with an inability to grip objects for more than 5-10 seconds. Additionally, the patient experiences urgent urinary needs with little warning and a recent onset of diarrhea or loose stool. Past medical history includes diverticulitis and kidney stones, with noted allergies to penicillin and codeine-based pain medications. No current medications are being taken.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are a few possibilities:

  • Cervical Radiculopathy: This condition occurs when a nerve in your neck is irritated or compressed. It can cause pain that radiates into the shoulder and arm, as well as numbness or tingling in the hand or fingers. It's often caused by age-related changes that narrow the space where nerve roots exit the spine.

    • Treatment can include physical therapy, medications for pain relief, and in some cases, surgery.
  • Carpal Tunnel Syndrome: This condition is caused by pressure on the median nerve, which runs the length of the arm and goes through a passage in the wrist called the carpal tunnel. It can cause tingling and numbness in the hand and arm.

    • Treatment can include wrist splinting, medications, and surgery.
  • Lumbar Spinal Stenosis: This condition occurs when the spinal canal in your lower back narrows, which can put pressure on the nerves that travel through the lower back and down to your legs. It can cause back pain and numbness or weakness in one or both legs.

    • Treatment can include physical therapy, medications, and surgery.

Please note that these are just possibilities and not a definitive diagnosis. It's important to consult with a healthcare professional who can evaluate your symptoms and medical history to provide an accurate diagnosis.

What you can do

Here are some steps you can take to manage your symptoms:

  1. Over-the-counter pain relievers: Non-prescription medications like ibuprofen or acetaminophen can help reduce pain and inflammation.
  2. Heat or cold therapy: Applying a heat pack or cold pack to the affected area can help relieve symptoms.
  3. Physical activity: Regular exercise can help maintain flexibility and strength in your muscles, which can relieve pressure on your nerves.
  4. Rest: Avoid activities that worsen your symptoms, and take breaks to rest when needed.

What you should look out for

Please seek immediate medical attention if you experience:

  • Severe pain that doesn't improve with rest or over-the-counter medications
  • Loss of bladder or bowel control
  • Sudden or severe weakness in your arms or legs

Remember, this advice is intended to be general in nature, and specific causes may need different management. Always consult with a healthcare professional for accurate information.

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10 mo ago

People Also Ask


What are the common causes of severe lower back pain that feels like it's 'locking up'?

Severe lower back pain that feels like it's 'locking up' can be caused by conditions such as lumbar spinal stenosis, herniated discs, or muscle spasms. These conditions can lead to nerve compression or inflammation, resulting in significant pain and restricted movement.


What could cause pins and needles sensation in the hands, especially in the morning?

Pins and needles sensation in the hands, particularly in the morning, can be caused by carpal tunnel syndrome, where the median nerve is compressed at the wrist. It can also be due to cervical radiculopathy, where nerves in the neck are compressed, leading to symptoms in the hands.


How can urgent urinary needs and recent diarrhea be related to back pain?

Urgent urinary needs and recent diarrhea can sometimes be related to nerve compression in the lower back, such as in lumbar spinal stenosis. This can affect the nerves that control bladder and bowel function, leading to these symptoms.


What are the treatment options for cervical radiculopathy and carpal tunnel syndrome?

Treatment options for cervical radiculopathy include physical therapy, pain relief medications, and possibly surgery if conservative treatments fail. For carpal tunnel syndrome, treatments include wrist splinting, anti-inflammatory medications, and surgery to relieve pressure on the median nerve.


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