[52F] With acute pelvic and back pain

Patient Description

A 52-year-old female presents with a primary complaint of pelvic pain, described as stabbing, with a severity of 8 out of 10. The pain started gradually 2 days ago. Additionally, she reports numbness in the pubic area, which began 1 day ago. There are no recent injuries or accidents, and no factors have been identified that make the pain better or worse. She denies fever, chills, changes in urinary or bowel habits, radiating pain down the legs, or leg weakness. The patient is postmenopausal and has not had a period in months. She has no history of gynecological conditions but has a history of bulging discs in the lower back from years ago. She does not use tobacco, alcohol, or recreational drugs, and there have been no recent changes in her diet or nutrition. There have been no recent exposures to infections or sexually transmitted diseases, and she has not traveled recently. Medications include Flexeril and Ketorolac, both at 10 mg three times a day, prescribed at the ER two days ago when the symptoms first appeared. She has no known drug allergies.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for your symptoms:

  • Pelvic Inflammatory Disease (PID): This is an infection of the female reproductive organs. It can cause pelvic pain and may lead to numbness or tingling if there is significant inflammation. Treatment typically involves antibiotics.

  • Ovarian Cyst: A fluid-filled sac on an ovary can cause pelvic pain, especially if it ruptures or causes the ovary to twist (torsion). Treatment may include pain management and, in some cases, surgery.

  • Sciatica: Given your history of bulging discs, it's possible that nerve compression in your lower back is causing referred pain to your pelvic area and numbness. Treatment often includes physical therapy, pain management, and sometimes surgical intervention.

  • Urinary Tract Infection (UTI): Although you haven't reported changes in urinary habits, some UTIs can present with pelvic pain. Treatment typically involves antibiotics.

  • Musculoskeletal Issues: Strain or injury to muscles, ligaments, or joints in the pelvic or lower back area can cause pain and numbness. Treatment often includes rest, physical therapy, and pain management.

What you can do

While it's important to consult a healthcare provider for a formal diagnosis and treatment plan, here are some steps you can take to manage your symptoms:

  1. Pain Management: Continue taking the prescribed Flexeril and Ketorolac as directed by your healthcare provider. These medications can help manage pain and muscle spasms.
  2. Rest: Avoid activities that may exacerbate your pain. Gentle stretching and light activities may help, but avoid heavy lifting or strenuous exercise.
  3. Heat Therapy: Applying a warm compress or heating pad to the affected area can help alleviate pain and muscle tension.
  4. Hydration and Nutrition: Ensure you stay hydrated and maintain a balanced diet to support overall health and recovery.
  5. Symptom Tracking: Use MDandMe to journal your symptoms, track your progress, and get insights. This information can be valuable for your healthcare provider.

What you should look out for

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

  • Severe or worsening pain: If your pain becomes unbearable or significantly worsens.
  • Fever or chills: These could indicate an infection that requires prompt treatment.
  • Changes in urinary or bowel habits: Painful urination, blood in urine, constipation, or diarrhea.
  • Weakness or numbness in legs: This could indicate nerve involvement that needs immediate attention.
  • Unexplained vaginal bleeding: Any unusual bleeding should be evaluated by a healthcare provider.

Remember, while I can provide information and suggestions, it's crucial to consult a healthcare professional for a formal diagnosis and appropriate treatment. If you have any further questions or need additional support, feel free to reach out.

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6 mo ago

People Also Ask


What are the common causes of pelvic pain in postmenopausal women?

Common causes of pelvic pain in postmenopausal women include ovarian cysts, pelvic inflammatory disease, musculoskeletal issues, and sometimes urinary tract infections. It's important to consult a healthcare provider for an accurate diagnosis.


How can a history of bulging discs affect pelvic pain?

A history of bulging discs can lead to nerve compression, which may cause referred pain to the pelvic area. This condition, known as sciatica, can also result in numbness or tingling sensations.


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

Symptoms of an ovarian cyst can include pelvic pain, bloating, and sometimes changes in menstrual cycles. If a cyst ruptures or causes torsion, it can lead to severe pain. Treatment may involve pain management, hormonal therapy, or surgery, depending on the severity.


Can pelvic pain be a sign of a urinary tract infection even without urinary symptoms?

Yes, pelvic pain can be a sign of a urinary tract infection even if there are no changes in urinary habits. Some UTIs present primarily with pelvic discomfort, and a healthcare provider can confirm the diagnosis with a urine test.


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