Expert: Dr. Timothy K. Durnin - 6/27/2007

Question
I woke up the other morning with a pain in my left lower quadrant that felt like the onset of menstrual cramps.  I am not menstruating and don't expect to be for another week or so. I also am not pregnant and not able to be, so there is no question of that.

The pain was mild, but as the day went on, worsened to the point of immobility.  It started like menstrual cramps and ended up feeling like LABOR.  It was excruciating.  I tried to remain active most of the day until I could not any longer.  I lied in bed with a small pillow supporting the natural arch of my lower back with a heating pad over it.  Lying flat was not an option, nor was on my side or stomach.  I took ibuprofen.  The pain subsided after about 30 minutes of the heat and IBs, but came back after being up and mobile again for just a few minutes.  I repeated the heat and IBs some 4 hours later.  

The pain radiates from my lower left quadrant to my abdomen.  Again, it feels like cramps/contractions.  Other than difficulty passing stool because of the pain, there are seemingly no GI issues.  No blood, no black and tarry, and I am regular.  But any pressure hurts, so I have to let it come "naturally," as it were.  Also, there is no numbness in my extremities.  Hands, feet, legs are fine.

The pain has returned this morning.  So far, relatively mild, but like yesterday, I expect it to become debilitating later.  

Ideas what may cause this?  I've not been able to find anything that describes pain similar to this.

Thanks so much!

Answer
Hi DJ,

Your pain sounds classic for ovarian cyst rupture or endometriosis, putting heat on it may feel good temporarily but will only aggravate the inflammation. Use a warm moist towel over the LLQ with an ice pack in it/15 minutes. Repeat every hour. Make an appointment with an OBGYN for an abdominal ultrasound and Gyny work-up.

If it is negative, follow up with a lumbar MRI.

If you have any trouble with any of the above, feel free to follow up for additional advice.

Hope this helps,
Dr. Timothy K. Durnin
drs.chiroweb.com