[48F] Experiencing severe back pain, fever, and excessive sweating

Patient Description

A 48-year-old female presents with a history of severe lower back pain rated 9/10, which radiates down the leg and has been persistent for over 5 years. The pain worsens with walking and standing for extended periods and is somewhat alleviated by sitting and taking Tylenol. The patient also reports a constant low-grade fever, a knot on the back of the neck, hip pain, and a knot in the stomach. Excessive sweating has been an issue for more than 10 years, occurring all over the body, even in cold weather. The patient has a history of being hit by a car 3 years ago, but back pain was present prior to this accident. There are also changes in bowel or bladder function and increased lower back pain with coughing or sneezing. The patient's medical history includes a mental health condition diagnosed 15 years ago. Current medications include Suboxone 8mg film strips and Cymbalta. The patient has an allergy to pain killers. No other medications or known drug allergies are reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Sciatica: This condition is characterized by pain that radiates along the path of the sciatic nerve, which branches from your lower back through your hips and buttocks and down each leg. It typically affects only one side of your body and is often caused by a herniated disk or bone spur in the spine that presses on the nerve. The pain can be severe and can cause numbness, tingling, or muscle weakness in the affected leg.

    • Treatment options include over-the-counter pain relievers, physical therapy, and in severe cases, surgery.
  • Lumbar spinal stenosis: This is a narrowing of the spinal canal in your lower back that puts pressure on your spinal cord and the nerves that travel through the spine. Symptoms can include back pain, numbness or weakness in a foot or leg, and problems with bladder or bowel function.

    • Treatment options include physical therapy, medications to relieve pain and inflammation, and in severe cases, surgery.
  • Fever of unknown origin: This is a persistent fever that remains unexplained after initial medical evaluation. It could be caused by a variety of conditions, including infections, cancers, and autoimmune diseases.

    • Treatment of the fever depends on the underlying cause, which may require further testing to determine.
  • Hyperhidrosis: This is a condition characterized by excessive sweating that's not necessarily related to heat or exercise. You might sweat so much that it soaks through your clothes or drips off your hands.

    • Treatment options include prescription antiperspirants, nerve-blocking medications, and in severe cases, surgery.

Please note that these are potential explanations for your symptoms, but they may not be the actual cause. It's important to consult with a healthcare professional for an accurate diagnosis.

What you can do

In the meantime, here are some things you can do to manage your symptoms:

  1. Continue taking over-the-counter pain relievers as needed for your back pain, but be sure not to exceed the recommended dosage.
  2. Try to stay as active as possible. Regular, gentle exercise can help reduce back pain and keep your back strong.
  3. Stay hydrated and eat a balanced diet to help manage your fever.
  4. Wear light, loose clothing to help manage your excessive sweating.

What you should look out for

You should seek immediate medical attention if:

  • Your back pain is severe or doesn't improve with rest.
  • You have sudden, severe back pain after a fall or injury.
  • Your back pain is accompanied by unexplained weight loss.
  • You have difficulty controlling your bowels or bladder.
  • Your fever persists or gets higher.
  • You have night sweats or unexplained weight loss along with your fever.

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 recommendations.

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1 yr ago

People Also Ask


What are the common causes of sciatica and how is it treated?

Sciatica is often caused by a herniated disk or bone spur that compresses the sciatic nerve. Treatment includes pain relievers, physical therapy, and possibly surgery if severe.


What is lumbar spinal stenosis and what symptoms should I watch for?

Lumbar spinal stenosis is a narrowing of the spinal canal in the lower back, causing pressure on the spinal cord and nerves. Symptoms include back pain, leg numbness or weakness, and bladder or bowel issues. Treatment may involve physical therapy, medications, or surgery.


What could be causing a persistent low-grade fever?

A persistent low-grade fever can be due to infections, autoimmune diseases, or even cancers. Further medical evaluation is needed to determine the cause.


How can hyperhidrosis be managed effectively?

Hyperhidrosis can be managed with prescription antiperspirants, nerve-blocking medications, and in severe cases, surgery. Wearing light clothing and staying hydrated can also help.


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