Which Specialist Should I See for Lower Back and Rectal Pain?

Which specialty should I see?

I often experience soreness from my lower back to the anal area, whether standing or sitting, and it feels similar to pressure on the sacral vertebrae.
I previously visited a rehabilitation specialist and had X-rays taken, but the doctor said there were no issues with my spine.
I wonder if this could be due to frequent constipation, which might be causing pressure on the nerves from the colon and rectum, leading to the pain.
Recently, I've also felt nerve pain in the left side of my pelvis.
I'm unsure if this is related to my colon.
Could you please advise me on which specialist I should see or if further explanation is needed? Thank you.

Xiao Xin, 20~29 year old female. Ask Date: 2001/04/10

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, based on your description, pelvic issues may be related to local tissues and organs, including gynecological, colorectal, and neuromuscular factors.
You might want to start by examining gastrointestinal aspects.
Wishing you well!

Reply Date: 2001/04/10

More Info

Based on your symptoms of lower back and rectal pain, as well as your history of constipation, it is important to approach this issue from multiple angles. Given the complexity of your symptoms, I would recommend consulting with a few different specialists to get a comprehensive evaluation.

1. Orthopedic Specialist or Neurosurgeon: Since you mentioned that you have experienced pain that feels like it could be related to nerve compression in the sacral area, it would be prudent to see an orthopedic specialist or a neurosurgeon. They can perform a thorough examination and may recommend imaging studies such as an MRI to assess for any potential issues with the spine, including herniated discs or spinal stenosis that could be contributing to your pain.

2. Gastroenterologist: Given your history of constipation, it may also be beneficial to consult with a gastroenterologist. Chronic constipation can lead to increased pressure in the abdominal and pelvic regions, which might contribute to discomfort in the lower back and rectal area. The gastroenterologist can evaluate your bowel habits, dietary habits, and may suggest treatments or lifestyle changes to alleviate constipation.

3. Pain Management Specialist: If your pain persists despite seeing the above specialists, a pain management specialist could provide additional options for managing your symptoms. They may offer treatments such as nerve blocks, physical therapy, or other interventions that can help alleviate pain.

4. Physical Therapist: Since you have already seen a rehabilitation specialist, continuing with physical therapy might be beneficial. A physical therapist can work with you on exercises that strengthen the muscles around your lower back and pelvis, which may help alleviate some of the discomfort you are experiencing.

5. Colorectal Surgeon: If the gastroenterologist suspects that there may be an issue with the colon or rectum that is contributing to your pain, they may refer you to a colorectal surgeon for further evaluation.

In summary, I recommend starting with an orthopedic specialist or neurosurgeon to rule out any structural issues in your spine. Following that, a consultation with a gastroenterologist to address your constipation may provide insights into your symptoms. If necessary, consider seeing a pain management specialist for further options. Lastly, continuing physical therapy can help strengthen your back and pelvic muscles, potentially alleviating some of the pain.
It is essential to communicate all your symptoms clearly to each specialist, including the nature of your pain, any changes in bowel habits, and how these symptoms affect your daily life. This comprehensive approach will help ensure that you receive the most effective treatment for your condition.

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