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Experiencing Severe Lower Back Pain
SariJin posted:

I am 22 years old, female, generally healthy besides my back issue. I've been having severe lower back pain for the past couple of months. No accidents or injuries that I can recall that can explain this problem. I used to have on and off again lower back pain when I was a teenager but it didn't bother me enough to seek help. Now as time goes on, I have an increasing intensity of pain in lower lumbar area, and at times, in the upper gluteal area. It is very hard for me to stand or walk short or long distances, and I have difficulty bending. When my back hurts, I can't take full steps; I kinda hobble along with my eyes closed, wincing through the pain. The only way that I can describe it, is as severe tightening; it's almost vice grip like in sensation. Even standing too long while getting dressed for work leaves me in pain and breathing shallow. Walking leaves me weakened and I feel numb in the lower back & legs and like I want to fall. I also have swelling behind my left knee, which often causes tingling and numbness (especially at night). I believe that this is from my back because I tend to stand improperly to ease some of pressure off my back. The doctor did bilateral X-rays on the knee and ankles, which came back normal, then a MRI on the left knee which reported fluid around the knee--whatever that means, because he does not explain crap. He prescribed me Naprosyn 500, which did nothing for me, and then Motrin 800 ( still does nothing for me) for the knee. For my back, He finally sent me to an orthopedist, who did another X-ray on the back (sigh), declared it normal, prescribed me Naprosyn 500 AGAIN (double sigh), and wants me to stretch for a month. I keep begging my primary for a MRI but he keeps changing the subject to my knee and other stuff. After visiting my doctor dozens of times in 1 1/2 month period, a definite first for me, I still don't know what's wrong me.

Can someone help me make sense of this? Have you ever experienced something like this, and what was the outcome like? Am I right to badger the doctor for a MRI, or are the X-rays good enough?

Many Thanks....
Ari Ben-Yishay, MD responded:
After "many months" of low back pain you should certainly push to at least get an x-ray of your lumbar spine. An MRI is needed if you have specific symptoms or warning signs your doctor would be looking for. If you dont improve with exercise and physical therapy, then an MRI would absolutely be appropriate . You need to get evaluated to get your questions answered.
pjwilmnc responded:
You are absolutely right to question your care, your doc sounds like he's not listening to you because this is a serious pain issue which motrin is like giving you a tictac. Explain how severe it is just like you did here and ask for a referral to a pain mgt doc if he won't write you a rx for a strong pain med. Pain is subjective and just because the MRI was normal does not mean you don't have pain! Switch drs and leave him in the dust if he blows you off again. You're only 22, I'm 53 and have been dealing with back pain issues for a long time until I'm getting help now but still you have to tell them what you need and what doesn't work in no uncertain terms. I think the knee is unrelated to the back and the pain is the #1 issue bt far. Good luck to you.

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