Lower back pain, difficulty in movement, painful while breathing. History of UTI. Suggestions?
Patient: Hi, I have lower back pain on my right hand side. This is causing me problems with sitting standing sleeping. I had uti a while ago but I can't get rid of the pain. I get a ache all the time with a throbbing pain that comes and goes, if I sit down it hurts , I tend to find I get up from sitting down like an old person as I get stiff and can hardly move, warm baths don't seem to help. Sometimes in bed I found if very hard to sleep as I ache so much, I can no longer sleep on my front as its too painful, the best is on my back with my knees up. Even when I breathe in it hurts. I also feel cold and still pass water alot even though the last test was clear for uti.Any advice would be good.Thank you Doctor: Hi, You are having pain in the Lower back (throbbing in nature comes and goes) more on the right side, which does not allow you to sit, lye or stand. You are not able to sit erect and you have to sit like a old man bending your body. Even while in bed also the pain so much, that it disturbs your sleep. The pain does not allow you to sleep on your front as its too painful, the best is on your back with your knees up. Warm bath does not relieve you. You had once UTI which was treated and the recent investigations show NO UTI. Treatment: 1) A routine USG - to rule out any other cause other than spines. (kidney, ureter, bladder and appendix etc.,) 2) If USG is normal, straight away do MRI Lumbar spines with Lumbo Sacral joint. This will reveal any spinal pathology. 3) Routine blood test for WBC, DC, ESR, HB, MX, HIV, sugar, Urea and Creatinine, along with ECG, BP and Lipid profile if indicated. I think with this, the diagnosis will be very obvious. Treat the cause if any, You will be alright.  Best wishes