Is the "lower back pain" originating from the kidneys or the muscles and nerves?
I am a 20-year-old female student.
I have been experiencing lower back pain for two years, located just below the 12th rib, around the first and second lumbar vertebrae.
Sometimes the pain feels like a "throbbing pain," but at other times, I do not feel any discomfort.
The pain comes and goes rather than being constant throughout the day.
I sometimes have difficulty standing.
Interestingly, when I feel the urge to pass gas or have a bowel movement, the back pain becomes more severe.
When the pain occurs, I prefer to have someone "press and step" on my back, as it helps alleviate the discomfort.
I have seen doctors in the past; one mentioned "hydronephrosis," while another suggested it might just be muscle tension.
However, my urinalysis results were normal.
I would like to know what kind of condition I might have and which specialty I should consult for treatment.
Please help me, as I am really suffering...
Ms. Zhou, 20~29 year old female. Ask Date: 2008/11/10
Dr. Zheng Zhong reply Neurosurgery
It is recommended that you first visit the neurosurgery outpatient clinic to rule out any spinal pathology.
Reply Date: 2008/11/10
More Info
Lower back pain can be a complex issue, especially when it presents with varying symptoms like the ones you described. Given your age and the nature of your symptoms, it’s essential to consider both musculoskeletal and potential kidney-related issues.
Understanding Your Symptoms
1. Location and Nature of Pain: You mentioned that the pain is located just below the 12th rib, which corresponds to the lower thoracic and upper lumbar region of the spine. The "knocking pain" you experience could indicate irritation of the muscles, ligaments, or nerves in that area. The intermittent nature of your pain suggests that it may not be solely due to a structural issue but could also be influenced by muscle tension or spasms.
2. Association with Bowel Movements: The increase in pain when you feel the urge to pass gas or have a bowel movement could suggest a connection between your gastrointestinal system and your lower back pain. This could be due to increased intra-abdominal pressure during these activities, which may exacerbate any underlying muscle tension or spinal issues.
3. Previous Medical Opinions: You mentioned being told you might have "water kidney" (likely referring to a condition like hydronephrosis) or simply muscle tightness. Normal urine tests are a good sign, as they often rule out significant kidney issues. However, kidney problems can sometimes present with referred pain to the back, so it’s essential to keep this in mind.
Recommended Actions
1. Consult a Specialist: Given the complexity of your symptoms, it would be wise to consult both a physiatrist (a specialist in physical medicine and rehabilitation) and a urologist. The physiatrist can evaluate your musculoskeletal system, while the urologist can further assess any potential kidney issues.
2. Physical Therapy: Engaging in physical therapy could be beneficial. A physical therapist can help you with exercises to strengthen your core and back muscles, improve flexibility, and reduce muscle tension. They may also teach you proper body mechanics to avoid exacerbating your pain.
3. Pain Management Techniques: Techniques such as heat therapy, gentle stretching, and relaxation exercises (like yoga or Pilates) can help alleviate muscle tension. Additionally, if you find that pressure on your back provides relief, this could be a sign that muscle tightness is a significant contributor to your pain.
4. Lifestyle Modifications: Pay attention to your posture, especially when sitting for long periods as a student. Ergonomic adjustments to your study area can help reduce strain on your back. Regular breaks to stand, stretch, and move around can also be beneficial.
5. Further Investigations: If your symptoms persist, further imaging studies like an MRI or CT scan may be warranted to rule out any structural abnormalities in the spine, such as herniated discs or other degenerative changes.
Conclusion
While it’s challenging to pinpoint the exact cause of your lower back pain without a thorough examination, the combination of muscle tension and potential kidney-related issues could be at play. By consulting the appropriate specialists and engaging in a comprehensive treatment plan that includes physical therapy and lifestyle modifications, you can work towards alleviating your symptoms and improving your quality of life. Remember to communicate openly with your healthcare providers about your symptoms and any changes you experience.
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