[51F] Experiencing severe lower back pain and pelvic cramping

Patient Description

A 51-year-old female presents with severe lower back pain radiating down to the right hip, described as a burning sensation that started suddenly a week ago. The pain is exacerbated at night and when lying down, with no alleviation reported. The patient has a history of microdiscectomy at L4 & L5 from the previous year. Additionally, she reports cramping in the left pelvic area, resembling menstrual cramps, despite having had a partial hysterectomy 20 years ago. There is no numbness or weakness in the legs, although the feet feel hot. No changes in bowel or bladder function have been noted. The patient has a family history of arthritis and is currently on Paxil 10mg for PTSD, depression, and anxiety, which she has been taking for four months. She reports allergies to erythromycin and versed. No other medications or chronic illnesses were reported.

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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:

  • Sciatica: This condition occurs when the sciatic nerve, which runs from your lower back down to your feet, is irritated or compressed. It can cause pain, burning, and discomfort in the lower back and hip, and can also cause sensations of heat in the feet. It could be related to your previous microdiscectomy surgery.

    • Treatment often involves physical therapy, pain relief medication, and in some cases, surgery.
  • Arthritis: Given your family history of arthritis, it's possible that you could be experiencing symptoms of this condition. Arthritis can cause pain and discomfort in various joints, including the back and hip.

    • Treatment often involves medication, physical therapy, and lifestyle changes such as exercise and diet.
  • Ovarian Cyst: The cramping in your pelvic area could be due to an ovarian cyst. These are fluid-filled sacs that can form in the ovaries. They can cause pain and discomfort in the pelvic area, similar to menstrual cramps.

    • Treatment can range from monitoring the cyst to surgical removal, depending on its size and whether it's causing symptoms.

What you can do

  1. Consult with a healthcare provider: Given the severity and duration of your symptoms, it's important to seek medical attention. Your healthcare provider can perform a physical examination and may order imaging tests to help determine the cause of your symptoms.

  2. Pain management: Over-the-counter pain relievers may help to manage your pain in the short term. However, it's important to use these as directed and not to rely on them for long-term pain management without consulting a healthcare provider.

  3. Physical therapy: Depending on the cause of your symptoms, physical therapy may be beneficial. A physical therapist can provide exercises and stretches that may help to alleviate your pain.

What you should look out for

Seek immediate medical attention if you experience any of the following:

  • Severe pain that doesn't improve with rest or over-the-counter pain relievers
  • Loss of bowel or bladder control
  • Numbness or weakness in your legs
  • Fever, chills, or unexplained weight loss

Remember, while I strive to provide accurate information, I'm not a doctor. It's important to consult with a healthcare provider for an accurate diagnosis and treatment.

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11 mo ago

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People Also Ask


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

Sciatica typically presents as pain that radiates from the lower back down through the hip and leg, often described as a burning or shooting pain. It can also cause numbness, tingling, or muscle weakness in the affected leg. Treatment may include physical therapy, pain relief medications, and in some cases, surgery to relieve pressure on the sciatic nerve.


Can arthritis cause lower back and hip pain, and what are the treatment options?

Yes, arthritis can cause pain and discomfort in the lower back and hip. It can lead to stiffness, swelling, and reduced range of motion in the affected joints. Treatment options include medications such as NSAIDs, physical therapy, lifestyle changes like exercise and weight management, and sometimes surgical interventions.


What are the symptoms of an ovarian cyst and how is it diagnosed?

An ovarian cyst may cause pelvic pain, bloating, and a feeling of fullness in the abdomen. Some women experience pain during intercourse or irregular menstrual cycles. Diagnosis typically involves a pelvic exam and imaging tests like an ultrasound. Treatment depends on the size and symptoms of the cyst and may range from monitoring to surgical removal.


How can physical therapy help with lower back pain?

Physical therapy can help alleviate lower back pain by strengthening the muscles that support the spine, improving flexibility, and promoting proper posture and body mechanics. A physical therapist can design a personalized exercise program to address specific pain issues and prevent future injuries.


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