Left Lower Abdomen and Back Pain: When to Seek Medical Help

There is pain in the lower left abdomen and left lower back when standing, and it becomes more painful when turning over in bed?

Hello Dr.
Chen, I have been suffering from pain in my left lower back and left lower abdomen recently, and I'm unsure which specialty I should consult.
Initially, I had persistent lower back pain and thought it would improve in a few days, so I didn't seek medical attention.
Later, I experienced constipation and went several days without a bowel movement.
After consulting both traditional and Western medicine, I took stool softeners and laxatives, but the stools were watery.
After a week of this treatment, I developed gastroesophageal reflux and stomach pain, characterized by a burning sensation in my upper back and epigastric area.
Now, I am experiencing significant pain in my left lower back and left lower abdomen while standing.
However, when I lie down, my lower abdomen feels very uncomfortable, and I have to bend my knees to alleviate the pain slightly.
But if I turn over, the pain in my left lower abdomen becomes unbearable.
I'm not sure what the cause is or which specialty I should see.
Thank you.

David, 50~59 year old female. Ask Date: 2017/03/21

Dr. Chen Taicheng reply Family Medicine

● There are many causes of lower back pain, with the majority being due to muscle strains in the lumbar region, followed by spinal issues.
If pain occurs during movement or stretching of the lower back, one should consider problems such as spinal joint degeneration, spondylolisthesis, or spinal stenosis.
Another possible cause is urinary system stones.
Given that you also experience pain in the lower abdomen, the likelihood of stones is higher.
● Other rare causes of lower abdominal pain and lower back pain include prostatitis, kidney inflammation, diverticulitis, retroperitoneal tumors, or other inflammatory infections.
● For reference, I previously addressed a similar issue regarding right-sided lower back pain (https://goo.gl/T5o3CR); for other back pain issues, please refer to these links (https://goo.gl/JQayrU)(https://goo.gl/XtzptG).
● Recommended specialties for consultation: Family Medicine or Urology (to rule out urinary system issues such as stones, kidney inflammation, or prostatitis) → Orthopedics (to rule out musculoskeletal and spinal issues) → Gastroenterology (to address gastroesophageal reflux and rule out diverticulitis or digestive system problems); if no results are found, consider consulting other relevant specialties to exclude rare causes.
Wishing you good health, Dr.
Chen Tai-Cheng from Taoyuan Hospital Family Medicine Department cares about you~

Reply Date: 2017/03/21

More Info

Dear Patient,
I understand that you are experiencing significant discomfort in your left lower abdomen and back, which has been compounded by constipation and gastroesophageal reflux symptoms. It’s important to address these issues comprehensively, as they may be interconnected.

Given your symptoms, it would be prudent to consult with a healthcare provider who specializes in gastroenterology for your gastrointestinal issues, particularly since you have experienced constipation and gastroesophageal reflux. A gastroenterologist can evaluate your digestive health, recommend appropriate imaging or tests, and provide treatment options for your constipation and reflux symptoms.

However, your left lower back and abdominal pain could also be related to musculoskeletal issues, such as a strain or injury to the muscles or ligaments in your back, or even a herniated disc affecting the nerves that supply the lower abdomen. In this case, an orthopedic specialist or a physical medicine and rehabilitation (PM&R) physician would be appropriate to consult. They can perform a thorough physical examination, assess your range of motion, and may recommend imaging studies such as X-rays or an MRI to rule out any structural issues.

The fact that your pain worsens with certain movements and positions, such as lying down or rolling over, suggests that there may be a mechanical component to your pain. This could be due to muscle spasms, inflammation, or even nerve involvement. Additionally, the discomfort you feel when standing could indicate that your posture or the way you are using your body is contributing to your pain.

It’s also worth noting that the connection between your gastrointestinal symptoms and back pain is not uncommon. Conditions such as irritable bowel syndrome (IBS) can manifest with abdominal pain that may radiate to the back. Furthermore, the stress and discomfort from your gastrointestinal issues can lead to muscle tension and pain in the back.

In summary, I recommend the following steps:
1. Consult a Gastroenterologist: To address your constipation and gastroesophageal reflux symptoms. They may suggest dietary changes, medications, or further testing to evaluate your digestive health.

2. Consult an Orthopedic Specialist or PM&R Physician: To evaluate your back pain. They can assess for any musculoskeletal issues and recommend appropriate treatment, which may include physical therapy, medications, or other interventions.

3. Consider Physical Therapy: If musculoskeletal issues are confirmed, a physical therapist can help you with exercises to strengthen your core and improve your posture, which may alleviate some of your pain.

4. Monitor Your Symptoms: Keep a diary of your symptoms, noting when they occur, their intensity, and any activities that exacerbate or relieve them. This information can be helpful for your healthcare providers.

5. Seek Immediate Care if Necessary: If you experience severe pain, fever, or any other concerning symptoms, do not hesitate to seek immediate medical attention.

Your health is important, and addressing these issues early can help prevent further complications. I hope this information helps you navigate your healthcare options effectively.

Best wishes for your recovery,
Doctor Q&A Teams

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