Morning Lower Back Pain: Is It Orthopedic or Urological?

Q: Morning Lower Back Pain: Is It Orthopedic or Urological?

Hello： Based on your age and work conditions, the likelihood of significant spinal pathology is low. <br>It is more likely that you are experiencing stiffness in the back muscle groups, which can be alleviated with some activity. <br>You may start with muscle training, heat thera

In the morning, I often experience soreness in my left lower back, but it goes away after using the restroom?

Hello Doctor, recently I have been waking up every morning with lower back pain, especially when I need to use the restroom.
The painful area is on the left side near the pelvis (but it feels better when I turn to the right).
When I turn to the other side to sleep, I experience a "pop" sound, as if I have strained my back, but this symptom disappears after I use the restroom.
I work in an office, so I sit for almost 8 hours a day.
I previously visited a rehabilitation specialist for tight muscles in my lower back, but I didn't experience morning pain at that time.
I would like to ask if I should see an orthopedic doctor or a urologist for these symptoms.
Thank you.

Ms. Li, 20~29 year old female. Ask Date: 2016/01/08

Dr. Wang Shouji reply Orthopedics

Hello: Based on your age and work conditions, the likelihood of significant spinal pathology is low.
It is more likely that you are experiencing stiffness in the back muscle groups, which can be alleviated with some activity.
You may start with muscle training, heat therapy, and flexibility exercises.
If symptoms persist, please visit an orthopedic clinic for an X-ray and further evaluation.
Thank you!

Reply Date: 2016/01/08

More Info

Morning lower back pain can be a common issue, especially for individuals who spend long hours sitting, such as office workers. Your description of the pain being localized to the left side near the pelvis and the sensation of a "pop" when turning suggests that there could be multiple factors at play, potentially involving both orthopedic and urological aspects.

Possible Causes of Morning Lower Back Pain
1. Musculoskeletal Issues: Given your history of tight muscles and previous visits to a rehabilitation specialist, it is possible that your lower back pain is related to musculoskeletal problems. Prolonged sitting can lead to muscle stiffness, particularly in the lower back and pelvic region. This stiffness can cause discomfort upon waking, especially if your sleeping position does not support proper spinal alignment. The "pop" sound you hear when turning could indicate a muscle or ligament strain or a minor joint issue.

2. Nerve Compression: If there is any nerve compression in the lumbar region, it could lead to pain that radiates to specific areas, including the pelvis. Conditions such as a herniated disc or spinal stenosis can cause localized pain that may be exacerbated by certain movements or positions.

3. Urological Factors: The fact that your pain seems to resolve after using the restroom raises the possibility of a urological issue. Conditions such as urinary tract infections (UTIs) or bladder issues can sometimes present with referred pain in the lower back or pelvic region. If you experience any additional symptoms such as changes in urination, frequency, or discomfort while urinating, it would be wise to consult a urologist.

4. Referred Pain: Sometimes, pain in the lower back can be referred from other areas, such as the kidneys or reproductive organs. If there are underlying issues in these areas, they may manifest as back pain.

Recommendations
1. Consultation with Specialists: Given the dual nature of your symptoms, it would be beneficial to consult both an orthopedic specialist and a urologist. An orthopedic doctor can assess your musculoskeletal health, including any potential issues with your spine or muscles. A urologist can rule out any urinary tract or bladder-related issues that might be contributing to your symptoms.

2. Physical Therapy: If your pain is primarily musculoskeletal, physical therapy may be beneficial. A physical therapist can provide exercises to strengthen your core and back muscles, improve flexibility, and teach you proper ergonomics for sitting and sleeping.

3. Posture and Ergonomics: Since you spend a significant amount of time sitting, ensure that your workstation is ergonomically designed. Your chair should support your lower back, and your feet should rest flat on the ground. Taking regular breaks to stand, stretch, and walk around can also help alleviate stiffness.

4. Sleep Position: Evaluate your sleeping position. Using a supportive mattress and pillow can help maintain spinal alignment. If you sleep on your side, placing a pillow between your knees can help reduce strain on your lower back.

5. Hydration and Diet: Ensure you are well-hydrated and maintain a balanced diet. Dehydration can sometimes lead to muscle cramps and discomfort.

6. Monitoring Symptoms: Keep track of your symptoms, including when they occur, their intensity, and any associated activities. This information will be valuable for your healthcare providers in diagnosing and treating your condition.

In conclusion, your morning lower back pain could stem from a combination of orthopedic and urological factors. It is essential to seek evaluations from both specialists to determine the underlying cause and appropriate treatment. Early intervention can help prevent the progression of any potential issues and improve your overall quality of life.

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