Left Lower Back Pain: Which Specialist to Consult?

Left lower back pain?

Hello Dr.
Yeh: I have read about all the lumbar issues that have similar symptoms to mine, and I would like to ask which specialty I should consult based on my symptoms.
A week ago, I started experiencing lower back pain, but I initially thought it was related to my menstrual cycle (although I have never had lower back pain associated with my period before).
I kept observing it, and later I began to feel sharp, intermittent pain on the left side of my lower back.
Now, after a week, I still have a dull ache in the left lower back, and sometimes I also feel numbness in the area above my left buttock and lower back.
A friend who previously had kidney stones suggested I tap on my lower back, and I found that the left side does hurt, while the right side does not hurt at all.
My urine appears normal and does not show any blood.
I wonder if walking helps distract me, as I feel more comfortable walking than sitting.
After researching online and asking friends, I have heard about neurosurgery, orthopedics, and urology, but I am unsure which specialty would be most appropriate for my symptoms.
Initially, I was thinking of seeing a nephrologist.
Thank you, doctor!

Emily, 20~29 year old female. Ask Date: 2019/12/31

Dr. Ye Qianyu reply Family Medicine

Hello! Based on your description, I recommend that you first visit an orthopedic specialist.
Please also try to recall if you had any significant movements, large-angle strains, or heavy lifting last week.
Have you noticed any rashes on your skin? Are you experiencing any numbness or pain in your lower limbs? This information will be helpful for the physician.
Thank you for your inquiry, and I wish you a speedy recovery!

Reply Date: 2019/12/31

More Info

Based on your description of left lower back pain, it is essential to approach this issue methodically to determine the most appropriate specialist for your condition. Given the symptoms you've outlined, including the pain localized to the left side of your lower back, occasional sharp pain, and numbness in the left buttock area, there are several potential causes that need to be considered.

1. Musculoskeletal Issues: The pain you are experiencing could be related to musculoskeletal problems, such as muscle strain, ligament sprain, or issues with the lumbar spine, including disc herniation or degenerative disc disease. These conditions are typically managed by an orthopedic specialist or a physiatrist (rehabilitation physician). They can perform a physical examination and may recommend imaging studies like X-rays or MRIs to assess the spine and surrounding structures.

2. Nerve Compression: Given the numbness you mentioned, there is a possibility of nerve involvement, such as sciatica, which can occur due to a herniated disc or spinal stenosis. In this case, a neurologist or a neurosurgeon would be appropriate to consult, especially if there are concerns about nerve compression that may require surgical intervention.

3. Urological Concerns: Although you have ruled out blood in your urine and have normal urinary function, the history of kidney stones in your friends raises a valid point. If there is any suspicion of kidney-related issues, such as stones or infections, a visit to a urologist would be warranted. They can conduct tests to ensure that your kidneys are functioning properly and that there are no obstructions.

4. Initial Steps: Given that your symptoms have persisted for over a week and are causing discomfort, it would be prudent to start with an orthopedic specialist or a physiatrist. They can evaluate your symptoms in the context of musculoskeletal health and determine if further imaging or referrals to other specialists are necessary.

5. Self-Care and Management: While waiting for your appointment, consider self-care measures such as applying heat or ice to the affected area, practicing gentle stretching exercises, and avoiding activities that exacerbate the pain. Over-the-counter anti-inflammatory medications, such as ibuprofen or naproxen, may help alleviate discomfort, but be sure to follow the recommended dosages and consult with a healthcare provider if you have any underlying health conditions.

In summary, based on your symptoms of left lower back pain, the best initial step would be to consult with an orthopedic specialist or a physiatrist. They can provide a thorough evaluation and guide you on the appropriate course of action, including potential referrals to a neurologist or urologist if necessary. It is essential to address these symptoms promptly to prevent any potential complications and to ensure a proper diagnosis and treatment plan.

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