Your Symptoms: Lower Back Pain, Numbness, and Neck Issues - Neurology

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Based on your symptoms and history, it sounds like you are experiencing a combination of musculoskeletal issues, likely exacerbated by prolonged sitting and poor posture, which is common among office workers. Let's break down your symptoms and discuss the potential underlying causes, as well as recommendations for management and when to seek medical attention.


Lower Back Pain
Your lower back pain, which began two years ago, could be attributed to several factors, including muscle strain, ligament sprain, or even issues related to the lumbar spine such as disc degeneration or herniation. The fact that the pain is intermittent and localized to a specific area suggests that it may be muscular in nature, particularly if it improves with movement or stretching. However, the tenderness you describe when pressing on your spine could indicate a more serious issue, such as a facet joint problem or even a nerve root irritation.


Numbness and Tingling
The numbness and tingling in your left leg and arm are concerning, especially since they have progressed over time. This could be indicative of nerve compression, possibly due to a herniated disc in the lumbar or cervical spine, or it could be related to peripheral neuropathy. The fact that these sensations improve with movement suggests that they may be related to postural changes or nerve entrapment due to prolonged sitting.


Neck Pain and Swelling
The pain in your neck and the recent development of a lump could be related to muscle tension or a more significant issue such as a cervical spine problem or even a lymphatic issue. The lump you describe could be a muscle knot or a swollen lymph node, and its fluctuation in size could indicate that it is related to muscle tension rather than a more serious condition.


Recommendations
1. Posture and Ergonomics: Given that you are a desk worker, it is crucial to assess your workstation ergonomics. Ensure that your chair, desk, and computer are set up to promote good posture. Consider using a chair with lumbar support and take regular breaks to stand, stretch, and move around.

2. Physical Activity: Incorporate regular physical activity into your routine. This could include stretching exercises, strengthening exercises for your core and back, and cardiovascular activities. Yoga and Pilates can be particularly beneficial for improving flexibility and core strength.

3. Self-Care: For immediate relief, you can apply heat or cold to the affected areas. Gentle stretching and self-massage can also help alleviate muscle tension.

4. Monitor Symptoms: Keep track of your symptoms. If the numbness and tingling worsen, or if you experience weakness, loss of bladder or bowel control, or severe pain that does not improve with self-care, it is important to seek medical attention promptly.

5. Consult a Healthcare Professional: Given the complexity of your symptoms, it would be wise to consult a healthcare professional. A physical therapist can provide a tailored exercise program and manual therapy to address your specific issues. If necessary, a physician may recommend imaging studies, such as an MRI, to evaluate for any underlying structural problems in your spine.


When to Seek Medical Attention
You should consider seeing a doctor if:
- The pain persists or worsens despite self-care measures.

- You experience significant weakness in your limbs.

- The numbness spreads or becomes more frequent.

- You notice any changes in bowel or bladder function.

- The lump in your neck does not resolve or continues to grow.

In conclusion, while some of your symptoms may be manageable with lifestyle changes and self-care, the progression of numbness and the presence of a lump warrant further evaluation by a healthcare professional. Early intervention can help prevent more serious complications and improve your quality of life.