[50M] Experiencing back pain, tingling, and abdominal issues

Patient Description

A 50-year-old male presents with a 3-year history of sharp back pain rated 8/10, particularly in the lower middle back, right hip, and right leg, which worsens upon sleeping or lying down. The pain radiates down to the foot and is alleviated by walking, swaying knees side to side, and pulling knees to chest. The patient also reports a month-long history of cramping and bloating in the abdomen, with bloating present in both the upper and lower abdomen. Additionally, the patient experiences tingling sensations described as pins and needles, sometimes resulting in numbness in the hands and feet, also persisting for a month. The patient has a medical history of high blood pressure diagnosed three years ago and elevated sugar levels diagnosed a month ago. Current medications include Losartan, Hydrochlorothiazide, Rosuvastatin, Naproxen, and supplements such as Fish oil, Coenzyme Q-10, Ashwagandha, and Flonase. The patient has allergies to Demerol and Penicillin.

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Arora's Assessment

What might be happening

Based on the information you have provided, possible diagnoses include:

  • Lumbar Radiculopathy (Sciatica): This condition is caused by compression or irritation of the nerve roots that emerge from the lumbar spine. It can cause sharp pain in the lower back, hip, and leg, as well as tingling and numbness in the leg and foot.

    • Treatment typically involves physical therapy, pain management (like the Naproxen you're already taking), and sometimes surgery in severe cases.
  • Lumbar Spinal Stenosis: This is a narrowing of the spinal canal in the lower back that can put pressure on the spinal cord and nerves, causing back pain and numbness or weakness in one or both legs.

    • Treatment can include physical therapy, medications to relieve pain and inflammation, and in some cases, surgery.
  • Peripheral Neuropathy: This is a result of damage to your peripheral nerves, often causing weakness, numbness and pain, usually in your hands and feet. It can also affect other areas of your body. Your elevated blood sugar levels could be a possible cause.

    • Treatment typically involves managing the condition causing the neuropathy. Pain relief and other treatments to reduce symptoms can be helpful.
  • Irritable Bowel Syndrome (IBS): This is a common disorder that affects the large intestine and can cause cramping, abdominal pain, bloating, gas, and diarrhea or constipation.

    • Treatment focuses on long-term management of the condition, and can include changes in diet, medication, and stress management.

Please note that these are potential explanations for your symptoms, but there may be other causes. It's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

  1. Continue taking your prescribed medications as directed by your doctor.
  2. Maintain a healthy diet and regular exercise routine. This can help manage your high blood pressure and elevated sugar levels, and may also help with your back pain.
  3. Try to identify any triggers for your abdominal pain and bloating. This could be certain foods or stress. Avoiding these triggers can help manage your symptoms.
  4. Consider over-the-counter pain relievers for your back pain, but always check with a healthcare provider before starting any new medication.

What you should look out for

Please seek immediate medical attention if you experience:

  • Severe pain that doesn't improve with rest
  • Pain after a fall or an injury
  • Weakness, numbness, or tingling in your legs
  • Changes in bowel or bladder control
  • Unexplained weight loss
  • Fever

Remember, while I strive to provide accurate information, I'm not a doctor and this advice should not replace a consultation with a healthcare provider.

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11 mo ago

People Also Ask


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

Lumbar radiculopathy, often referred to as sciatica, is commonly caused by a herniated disc, bone spurs, or spinal stenosis that compresses the nerve roots in the lumbar spine. Treatment typically includes physical therapy, pain management with medications like NSAIDs, and in severe cases, surgery may be considered.


How does lumbar spinal stenosis differ from other back pain conditions?

Lumbar spinal stenosis is characterized by the narrowing of the spinal canal in the lower back, which can compress the spinal cord and nerves, leading to pain, numbness, or weakness in the legs. It differs from other back pain conditions in that it often causes symptoms that worsen with standing or walking and improve with sitting or bending forward.


What lifestyle changes can help manage peripheral neuropathy symptoms?

Managing peripheral neuropathy often involves controlling the underlying condition, such as diabetes, through diet and exercise. Lifestyle changes like maintaining a healthy weight, avoiding alcohol, and ensuring proper foot care can also help manage symptoms. Pain relief can be achieved through medications, physical therapy, and sometimes alternative therapies like acupuncture.


What dietary changes can help alleviate symptoms of irritable bowel syndrome (IBS)?

For IBS, dietary changes can include increasing fiber intake, avoiding trigger foods such as caffeine, alcohol, and fatty foods, and eating smaller, more frequent meals. Some patients find relief by following a low FODMAP diet, which involves reducing certain carbohydrates that are difficult to digest. It's also important to stay hydrated and manage stress.


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