Abdominal Pain and Lower Back Discomfort: Causes and Solutions

Q: Abdominal Pain and Lower Back Discomfort: Causes and Solutions

Dear Miss Troubles：<br>There are many common causes of lower abdominal pain, including acute appendicitis, ectopic pregnancy, hernia, hip joint diseases, inflammatory bowel disease, ischemic bowel disease, mesenteric lymphadenitis, terminal ileitis, ovarian torsion, diverticuliti

Abdominal pain and lower back pain?

Hello, doctor! Recently, I have been experiencing abdominal pain that feels like nerve pain for two consecutive weeks, and my lower back is extremely sore.
At first, during the first week, I thought it was a strain from exercising and stretching, so I went to see a doctor.
However, the doctor only prescribed muscle relaxants and pain relievers.
By the second week, the pain persisted, and I also experienced cramping pain in the lower abdomen.
What could be the issue? I tend to be an anxious person, and I wonder if there is any connection.

Fanrao Xiaojie, 20~29 year old female. Ask Date: 2017/09/12

Dr. Xiao Yongxun reply Internal Medicine

Dear Miss Troubles:
There are many common causes of lower abdominal pain, including acute appendicitis, ectopic pregnancy, hernia, hip joint diseases, inflammatory bowel disease, ischemic bowel disease, mesenteric lymphadenitis, terminal ileitis, ovarian torsion, diverticulitis, and more.
Similarly, there are numerous common causes of lower back pain, such as muscle strains or sprains, tendon injuries, urinary tract infections, pelvic inflammatory disease, urinary stones, degenerative arthritis, herniated discs, spondylolysis, disc displacement, osteoporosis, tumors, ankylosing spondylitis, abscesses, arachnoiditis, discitis, psoriatic arthropathy, and fibromyalgia, among others.
During the initial outpatient visit, if the symptoms are not too pronounced or severe, analgesics and anti-inflammatory medications, along with muscle relaxants, are often the first-line treatment options.
This is particularly true for young women, as muscle and tendon injuries are common.
However, since there has been no significant improvement, please discuss further evaluation and examination with your attending physician to patiently seek the underlying cause.
Mental health factors such as depression, anxiety, back pain, and cognitive impairment can certainly be associated with pain; however, clinical practitioners generally prioritize the consideration of organic diseases first.

Reply Date: 2017/09/12

More Info

Abdominal pain and lower back discomfort can arise from a multitude of causes, and understanding these can be crucial for effective treatment. Given your symptoms of abdominal pain resembling nerve pain and significant lower back discomfort persisting for two weeks, it is essential to consider both musculoskeletal and visceral origins of pain.

Possible Causes of Your Symptoms
1. Musculoskeletal Issues: Since you initially thought your pain was due to a muscle strain from exercise, it is possible that you may have sustained a soft tissue injury. Muscle strains, ligament sprains, or even conditions like sciatica can lead to referred pain in the abdomen and lower back. The fact that you were prescribed muscle relaxants and pain relievers suggests that your doctor was considering a musculoskeletal origin.

2. Visceral Pain: Abdominal pain can also stem from internal organs. Conditions such as appendicitis, ovarian cysts, or gastrointestinal issues like irritable bowel syndrome (IBS) can manifest as abdominal discomfort. The cramping sensation you described could indicate gastrointestinal distress, which may be exacerbated by anxiety.

3. Nerve-Related Pain: Given your description of the pain as "nerve-like," it’s worth considering neuropathic pain, which can occur due to nerve irritation or compression. Conditions like herniated discs in the lumbar spine can lead to nerve compression, resulting in pain that radiates to the abdomen and lower back.

4. Psychological Factors: Anxiety can significantly influence physical health. It can lead to muscle tension, which may exacerbate pain perception. Additionally, anxiety can contribute to gastrointestinal symptoms, potentially leading to a cycle of discomfort that can be challenging to break. Stress and anxiety can also manifest as physical symptoms, including abdominal pain and back discomfort.

Recommendations for Management
1. Follow-Up with Your Doctor: Since your symptoms have persisted despite initial treatment, it is crucial to follow up with your healthcare provider. They may recommend further diagnostic tests such as imaging studies (like an MRI or CT scan) to rule out structural issues or more serious conditions.

2. Physical Therapy: Engaging in physical therapy can help address musculoskeletal pain. A physical therapist can provide targeted exercises to strengthen the core and back muscles, improve flexibility, and reduce pain.

3. Stress Management Techniques: Since you mentioned being prone to anxiety, incorporating stress management techniques such as mindfulness, yoga, or cognitive-behavioral therapy (CBT) may help alleviate both your anxiety and physical symptoms.

4. Medication Review: If you are still experiencing significant pain, discussing your medication regimen with your doctor may be beneficial. They might consider adjusting your pain management plan or exploring other options, such as nerve pain medications if neuropathic pain is suspected.

5. Lifestyle Modifications: Regular exercise, a balanced diet, and adequate hydration can improve overall health and potentially reduce abdominal and back pain. Avoiding activities that exacerbate your symptoms is also advisable.

Conclusion
In summary, your symptoms of abdominal pain and lower back discomfort could stem from a variety of causes, including musculoskeletal injuries, visceral issues, nerve-related pain, and psychological factors. It is essential to maintain open communication with your healthcare provider to explore these possibilities and develop a comprehensive treatment plan. By addressing both the physical and psychological aspects of your pain, you can work towards achieving relief and improving your quality of life.

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