Morning Lower Back Pain: Causes and Specialist Guidance

Regarding lower back pain issues?

Dear Vice Director,
I have been experiencing pain in the left lower back upon waking up in the morning for about three months.
Sometimes the pain is severe enough to wake me up, preventing me from continuing my sleep.
After getting up, the pain gradually subsides; when it is more severe, I typically feel no pain about three hours after rising, while in less severe cases, there is only mild discomfort that resolves shortly after getting up.

Initially, I suspected a kidney-related issue and visited Renai Hospital, where X-ray results showed normal kidney function.
However, the doctor noted spinal deformities, suggesting that they might be compressing nerves and causing the pain, and recommended that I see an orthopedic specialist.
I have since completed an orthopedic evaluation at Cathay General Hospital, which included X-rays and three blood tests (for ankylosing spondylitis, among others).
The orthopedic doctor found all examination results to be normal and suggested that I consult either a neurosurgeon or a rehabilitation specialist.
I would like to ask for your advice on which department I should visit for my current condition and what further examinations might be necessary.
Additionally, why might there be discrepancies in the test results between Renai and Cathay General Hospitals? I would greatly appreciate your assistance and suggestions.
Thank you very much.

Davis, 30~39 year old female. Ask Date: 2007/10/30

Dr. Shi Qiming reply Orthopedics

Dear Sir/Madam,
There are numerous causes of lower back pain, and when accompanied by stiffness and pain upon waking in the morning, rheumatoid arthritis and ankylosing spondylitis should be considered first.
If all tests return normal and neurological symptoms are significant, further imaging studies such as MRI or CT scans can be performed in orthopedics to accurately diagnose any nerve compression.
Sincerely,
Director Wang Zikang

Reply Date: 2007/10/30

More Info

Morning lower back pain can be a frustrating and debilitating issue, especially when it disrupts your sleep and daily activities. Based on your description, it seems that you have been experiencing pain in the left side of your lower back for about three months, which sometimes prevents you from sleeping and gradually improves after you get up. The fact that your X-rays showed normal kidney function but indicated spinal deformities suggests that the source of your pain may be related to your spine or the surrounding structures rather than your kidneys.

There are several potential causes for morning lower back pain, and understanding these can help guide your next steps in seeking treatment. Here are some common causes:
1. Muscle Strain: Poor sleeping positions or inadequate support from your mattress can lead to muscle strain. If your mattress is too soft or too firm, it may not provide the necessary support for your spine, leading to discomfort.

2. Spinal Issues: As noted in your X-ray results, spinal deformities can lead to nerve compression or irritation. Conditions such as herniated discs, spinal stenosis, or degenerative disc disease can cause pain that is exacerbated by certain positions during sleep.

3. Inflammatory Conditions: Conditions like ankylosing spondylitis or other forms of inflammatory arthritis can cause morning stiffness and pain, particularly in the lower back. These conditions often improve with movement throughout the day.

4. Nerve Compression: If there is any compression of the nerves in the lumbar region, it can lead to pain that may be felt in the lower back and potentially radiate down the legs.

5. Kidney Issues: While your kidney tests came back normal, it’s worth noting that kidney stones or infections can sometimes present as lower back pain. However, since your tests were normal, this is less likely to be the cause.

Given that you have already consulted both a nephrologist and an orthopedic specialist, and both have suggested further evaluation, it may be beneficial to see a neurologist or a rehabilitation specialist. A neurologist can assess for any nerve-related issues that may be contributing to your pain, while a rehabilitation specialist can provide insights into physical therapy options that may help alleviate your symptoms.

In terms of further testing, you might consider the following:
- MRI of the Spine: An MRI can provide a more detailed view of the soft tissues, including discs and nerves, and can help identify any herniations or other abnormalities that may not be visible on X-rays.

- CT Scan: This can also provide detailed images of the spine and may be useful if MRI is contraindicated.

- Electromyography (EMG): This test can assess the electrical activity of muscles and may help identify nerve compression or damage.

As for the differences in test results between hospitals, variations can occur due to differences in equipment, interpretation of results, or even the specific protocols used during imaging. It’s essential to communicate your concerns with your healthcare providers and ensure that they have all the necessary information to guide your treatment effectively.

In summary, your next steps should involve consulting a neurologist or rehabilitation specialist, considering further imaging studies, and discussing your symptoms in detail to pinpoint the underlying cause of your morning lower back pain. Early intervention and appropriate treatment can significantly improve your quality of life and help you manage your symptoms more effectively.

Similar Q&A

Understanding Morning Lower Back Pain: Causes and Specialist Guidance

Hello, doctor: I would like to ask, when I wake up in the morning, my entire lower back feels very sore. What could be the issues, and which specialty should I consult? Thank you.

Dr. Xiao Yongxun reply Internal Medicine
Hello: There are many causes of lower back pain, including localized injuries, lesions in the abdominal or pelvic cavities, spinal disorders, nerve root pathologies, fascial inflammation, or muscle spasms. While various conditions can lead to lower back pain, they may also presen...

Understanding Morning Lower Back Pain: Causes and Treatment Options

Hello, I've been experiencing pain on both sides of my lower back when I wake up in the past few days. The pain is not very noticeable when I'm standing or moving around, or when I press on my lower back. However, I do feel pain when I bend down to pick something up, an...

Dr. Lai Yanting reply Rehabilitation
Dear Allen: Your issue may be caused by a muscle strain (though further evaluation is needed to confirm this). Common causes include improper posture or overuse of the back muscles. It is advisable for you to consult a rehabilitation specialist for an examination to understand th...

Morning Back Pain: When to Seek Medical Attention?

Hello: Recently, I have been experiencing lower back pain almost every morning upon waking up, which lasts for about 30 minutes to 1 hour before easing or disappearing. However, there have been a few instances where the pain was severe enough to wake me up, making it difficult to...

Dr. Chen Taicheng reply Family Medicine
● Most cases of lower back pain are due to musculoskeletal issues; however, if the pain wakes you up at night or improves after getting up and moving, it may resemble morning stiffness. Conditions such as ankylosing spondylitis or rheumatoid arthritis should be prioritized for ex...

Morning Back Pain: Causes and When to See a Doctor

Hello Doctor: I would like to ask about a symptom I've been experiencing for the past month. Every morning when I wake up, I have significant back pain, but I can gradually stretch it out, and the pain slowly diminishes. After about 2-3 hours, the pain completely goes away. ...

Dr. Shi Guozheng reply Orthopedics
There are many causes of chronic lower back pain, which may include poor posture, overwork, prolonged standing, excessive sitting, or spinal deformities such as herniated discs. It is advisable to consult an orthopedic specialist for evaluation.