Lumbar Pain: Causes, Symptoms, and Specialist Guidance

Lumbar pain

Around the end of October 2011, I sprained my ankle while playing basketball at noon.
However, when I went to play again in the afternoon, the pain that was originally located below my spine seemed to have disappeared.
But at the moment I stepped out with my right foot, the pain spread to both legs, making it impossible for me to take another step.
After resting for about 5 to 10 minutes, the discomfort subsided.
However, in the following years, I experienced sudden episodes of pain in my lower back, even while lying down, side-lying, or bending over to pick something up.
I would like to know what conditions my symptoms might indicate and which specialty I should consult.

Lan, 10~19 year old female. Ask Date: 2016/01/26

Dr. Jiang Junyi reply Neurology

Hello, based on your description, your symptoms are more indicative of a lumbar disc herniation, where the intervertebral disc compresses one of the two nerve roots at each level.
Patients typically complain of pain radiating down one leg, while simultaneous radiation to both legs is rare.
The L4-L5 and L5-S1 segments are the most mobile joints in the lumbar spine, and greater mobility increases the risk of injury.
Common symptoms include lower back pain that worsens with sneezing, coughing, or bending, and pain radiating to the legs and feet.

It is important to pay attention to health: when lifting heavy objects, it is best to do so in stages.
When placing heavy items at a higher position or dealing with tasks at a lower level, try to lower your body to avoid bending.
Avoid maintaining the same posture or movement for extended periods; take breaks to stand and move around.
Reduce prolonged exposure to damp and cold environments, and be mindful of keeping warm.

I recommend consulting with a rehabilitation specialist or a neurologist/neurosurgeon to discuss examination and treatment options.
Wishing you good health and peace.
Dr.
Tao, Neurology, cares about you.

Reply Date: 2016/01/26

More Info

Understanding lumbar pain can be quite complex, as it can stem from various causes and manifest in different ways. Based on your description, it seems that your lumbar pain began after a basketball injury in 2011, which may have led to a series of complications over the years. Here’s a breakdown of potential causes, symptoms, and guidance on which specialists to consult.

Potential Causes of Lumbar Pain
1. Muscle Strain or Ligament Sprain: The initial injury during basketball could have strained the muscles or ligaments in your lower back. Even if the pain seemed to subside, it might have led to chronic issues if not properly rehabilitated.

2. Herniated Disc: A herniated disc occurs when the soft material inside the disc pushes out, potentially pressing on nearby nerves. This can cause pain that radiates down the legs, known as sciatica.

3. Degenerative Disc Disease: Over time, the discs in the spine can degenerate, leading to pain and reduced mobility. This condition is often age-related but can be accelerated by previous injuries.

4. Spinal Stenosis: This condition involves the narrowing of the spinal canal, which can put pressure on the spinal cord and nerves, leading to pain, numbness, or weakness in the legs.

5. Sacroiliac Joint Dysfunction: The sacroiliac joint connects the lower spine to the pelvis. Dysfunction in this joint can lead to pain in the lower back and buttocks, which may worsen with certain movements.

6. Facet Joint Syndrome: The facet joints in the spine can become inflamed or degenerated, leading to localized pain that may radiate to other areas.

Symptoms to Monitor
- Pain Intensity: Note if the pain is sharp, dull, or throbbing, and whether it radiates to the legs.

- Mobility Limitations: Difficulty bending, lifting, or performing daily activities can indicate a more serious underlying issue.

- Numbness or Tingling: If you experience these sensations in your legs or feet, it may suggest nerve involvement.

- Pain Patterns: Observe if the pain worsens with certain activities or positions, such as sitting, standing, or lying down.

Recommended Specialists
Given the complexity of your symptoms, it would be prudent to consult the following specialists:
1. Orthopedic Surgeon: They specialize in musculoskeletal issues and can evaluate your spine and joints for any structural problems.

2. Neurologist: If nerve involvement is suspected, a neurologist can assess for conditions like herniated discs or spinal stenosis.

3. Physical Medicine and Rehabilitation (PM&R) Specialist: Also known as physiatrists, they focus on rehabilitation and can create a tailored exercise program to strengthen your back and improve mobility.

4. Chiropractor: They can provide spinal manipulation and other therapies to alleviate pain and improve function.

5. Pain Management Specialist: If the pain is chronic and debilitating, a pain management specialist can offer various treatments, including medications, injections, or alternative therapies.

Next Steps
1. Diagnostic Imaging: Consider getting an MRI or CT scan to visualize the structures of your spine and identify any herniated discs, stenosis, or other abnormalities.

2. Physical Therapy: Engaging in physical therapy can help strengthen the muscles supporting your spine and improve flexibility, which may alleviate pain.

3. Lifestyle Modifications: Incorporate low-impact exercises, maintain a healthy weight, and practice good posture to reduce strain on your back.

4. Pain Management: Discuss pain relief options with your healthcare provider, which may include medications, injections, or alternative therapies like acupuncture.

In conclusion, lumbar pain can arise from various conditions, and understanding the underlying cause is crucial for effective treatment. Consulting with the appropriate specialists and undergoing diagnostic evaluations will help you find the right path to recovery. Remember, it’s essential to address these symptoms early to prevent further complications and improve your quality of life.

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