Expert: Dr. J. Shawn Leatherman - 11/5/2007

Question

Hello,

My name is Laura and I'll be nineteen in less than two weeks.  About a month ago, I started having severe lower back pain that sometimes radiates down to my hips.  It came out of nowhere.  I did not injure myself, or do any sort of physical activity that could cause this.  The pain is still here and it's so uncomfortable, I can't even sit for very long.  It hurts the worst when I'm sitting, but when I stand, it still hurts, and is often accompanied by sharp shooting pains in my hips.  It almost brings tears to my eyes.

I don't have any serious medical conditions.  In fact, I just recently (this year) had a sonogram of my internal organs after complaining of sharp, upper abdominal pain.  Everything was normal, though.  They checked my liver, kidneys, stomach, etc.  I also just recently (a few months ago) had a blood test, which checked various things.  About two years ago, my triglycerides were high because I used to eat really horribly (fast food all the time).  In the passed year, I've taken on a vegan diet and I've been really health conscious.  Needless to say, I lost 50+ pounds, and based on the blood test a few months ago, my cholesterol is perfect.  My bad cholesterol lowered immensely and is now in perfect range, and my good cholesterol, which was too low before, is now higher and in normal range.

My point is, my doctor also tested my liver and kidney function, and other things, through the blood test I had recently.  Alas, I don't think my back pain is caused by a problem with an internal organ, but what do I know?  I just know that I'm otherwise healthy and in a LOT of pain.

I know you cannot diagnose me, but any advice or information you have of what it COULD be would be greatly appreciated.  I do plan on seeing my doctor about this, but in the mean time, what should I do to try and relieve the pain?  Are there any exercises I can do, or stretches?  Or would that potentially make it worse since I don't know what it is?

Please note that this isn't your typical "sore muscles" type of pain.  This is severe, like nothing I've ever experienced and I really hate it.  In fact, my back is starting to ache horribly right now, just from sitting to type this.

Thank you so much for listening.
I'll appreciate anything you have to say!

In pain,
Laura

Answer
Dear Laura,

At your age, you do not fit any profile for back pain other than acute injury, which you deny, so this sounds very perplexing.  I have to ask, have any x-rays been taken, or an MRI. These imaging techniques are the best tools for evaluation of the spinal/skeletal structure of the low back in relation to your complaints.

Now, as far as your symptoms are concerned, the pain patterns you have described can be from the joints in the pelvis called the sacroiliac joints, the nerve roots in the low back, of the disk material.  Anytime you have pain that radiates down the leg, hip, or buttock, the cause is usually in the low back anatomy somewhere near the beltline.  Functional orthopedic tests are a great way to evaluate those structures, but these are not often performed by family doctors.  Range of motion restrictions or limitations are also important to help understand the anatomical production of pain.  If you have not been tested this way, then you need to.

Musculoskeletal pain issues are frequently mis-diagnosed or not diagnoses at all by family practitioners, because their training is geared more towards pathological conditions and illness that shows up with traditional blood work and vital signs.  These will not be helpful with a musckuloskeletal case unless there is an underlying physiological pathology.

I would suggest that you seek out the care of a good chiropractic physician in your area.  Chiropractors are experts in dysfunction and pain generated by the musculoskeletal system, and it seems as though all other forms of internal pathology have been eliminated thus far.  Spinal manipulation is often a very easy solution to structural/anatomical pain generating structures of the low back, and research has proven its safety and efficacy.

More information on the anatomy of the low back, pain generating structures, and research on the effectiveness of chiropractic care for low back pain can easily be accessed on my website:  www.suncoasthealthcare.net.

Good Luck Laura.
Respectfully,
Dr. J. Shawn Leatherman