Unexplained Lower Back Pain: Possible Causes and Solutions

Unexplained low back pain?

Hello Doctor: When I bend to the left or right, I experience pain on the left side of my lower back and back.
Even when I'm not bending, it feels uncomfortable.
Bending to the left feels restricted, as if there is a ball preventing me from bending down.
Sometimes, when I bend to the left, I also feel a heavy and uncomfortable sensation in my chest.
Additionally, when I bend my neck to the left, it also hurts.
I'm unsure if the neck and lower back pain are related.
I have previously consulted with orthopedic, internal medicine, and cardiology specialists.
I underwent X-rays of my spine, an ultrasound near my kidneys, and an electrocardiogram, all of which came back normal.
This condition has persisted for about 1 to 2 years.
Could you please advise me on what the issue might be?

Mr. Huang, 10~19 year old female. Ask Date: 2018/11/06

Dr. Wang Zhaomin reply Rehabilitation

There are many causes of shoulder, neck, and lower back pain.
If initial examinations are normal, it may also be related to psychological stress or generalized muscle tension.
It is advisable to avoid maintaining the same posture for extended periods, such as when using a computer, playing on a mobile device, or studying.
Taking breaks to relax and stretch the muscles can help improve the condition.
It is recommended to continue seeking medical attention, as a professional physician can provide an on-site assessment, which is more likely to identify the underlying cause.

Reply Date: 2018/11/06

More Info

Understanding unexplained lower back pain can be a complex issue, particularly when it involves multiple areas of discomfort, such as the back, neck, and even sensations related to the heart. Based on your description, it seems that you are experiencing pain on the left side of your lower back and neck, which worsens with certain movements, particularly bending to the left. Additionally, you mentioned feeling a sensation of heaviness or discomfort in your chest when bending, which can understandably be concerning.

Firstly, it is important to recognize that lower back pain can arise from various sources, including muscular, skeletal, and even neurological issues. Given that you have already undergone several diagnostic tests, including X-rays, ultrasounds, and an electrocardiogram (ECG), and all results came back normal, it suggests that there may not be any significant structural abnormalities in your spine or organs that could explain your symptoms.

1. Muscle Strain or Sprain: One of the most common causes of lower back pain is muscle strain or sprain. This can occur due to overuse, improper lifting techniques, or even prolonged poor posture. The sensation of a "ball" preventing you from bending could be related to muscle tightness or spasms in the muscles surrounding your spine. Stretching and strengthening exercises, along with physical therapy, can be beneficial in alleviating these symptoms.

2. Myofascial Pain Syndrome: This condition involves pain in the muscles and surrounding connective tissues (fascia). Trigger points, or knots in the muscles, can refer pain to other areas, which might explain the discomfort in your neck and chest. Treatment often includes physical therapy, massage, and sometimes injections to relieve pain.

3. Nerve Compression: Although your imaging studies did not show any significant issues, sometimes nerve compression can occur without clear imaging findings. This can lead to referred pain in different areas of the body. If there is any nerve involvement, it may be worthwhile to consult with a neurologist for further evaluation.

4. Postural Issues: Poor posture, especially if you spend long hours sitting or in a position that strains your back and neck, can lead to discomfort. Ergonomic adjustments to your workspace and regular breaks to stretch can help mitigate these issues.

5. Psychosomatic Factors: Chronic pain can sometimes be exacerbated by stress or anxiety. If you find that your pain worsens during stressful times, it may be beneficial to explore stress management techniques, such as mindfulness or cognitive behavioral therapy.

6. Heart-Related Concerns: While your heart tests have come back normal, it is essential to remain vigilant about any chest discomfort. If you experience significant changes in your symptoms, such as increased severity or new symptoms, it would be prudent to seek immediate medical attention.

In terms of management, consider the following strategies:
- Physical Therapy: A physical therapist can provide a tailored exercise program to strengthen your back and neck muscles, improve flexibility, and address any postural issues.

- Pain Management: Over-the-counter anti-inflammatory medications may help reduce pain and inflammation. However, consult with your healthcare provider before starting any new medication.

- Regular Exercise: Engaging in low-impact activities such as swimming, walking, or yoga can help maintain mobility and reduce pain.

- Heat and Cold Therapy: Applying heat can help relax tense muscles, while cold therapy can reduce inflammation.

In conclusion, while your symptoms are concerning, they may not necessarily indicate a severe underlying condition, especially given the normal results from your tests. However, persistent pain should not be ignored. If your symptoms continue or worsen, consider seeking a second opinion or further evaluation from a specialist, such as a pain management physician or a rheumatologist, who can provide additional insights into your condition.

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