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Lower back pain and recurring UTI/epididymitis
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timng posted:
I'm male, 33y. I've these symptoms for about 2 years. I've lower back pain, mostly at the center (lumbar spine) towards the right side, though sometimes on the left too. Normally it's not painful but only discomfort; however when I bend my lower back backward (or try to sit very straight) then there is pain, which feels like muscle or spine pain. When I walk, I've a feeling that my body is unbalanced and a bit tilted to the right. Also, occasionally I have UTI symptoms (urinate frequently, burning pain in the penis and pelvic/bladder area after urinating which lasts 3-10 minutes). Each period of the "UTI symptoms" lasts from 1 day to 1 week. Recently in the past 4 months, I also have recurring episodes of epididymitis on the right side (sometimes coincides with UTI symptoms) with swollen right epididymis and discomfort in the scrotum & right pelvic side. I also have slight discomfort in the right thigh, especially when the UTI/epididymitis happens.

I've seen 1 family doctor (my previous PCP), 1 internist (my current PCP), and 2 urologists in the past 9 months. I've taken tests: many urine tests, several blood tests, 2 scrotum ultrasounds, 1 bladder ultrasound, 1 kidney ultrasound, STD tests, HIV test, etc. All came back normal/negative, except the right epididymis was enlarged when it's swollen, of course, but still in "acceptable" range. My prostate was physically examined 2 months ago and its size was normal. No kidney stone, no bacteria found, no lump, kidneys and livers function normally, etc. All the doctors had no idea what's wrong with me; and they kept saying I'm fine because I'm young and healthy. They only prescribed Cipro whenever I had UTI symptoms or epididymitis, which I didn't know would help or not because the symptoms would subside even without any treatment.

These symptoms are not life-threatening nor extremely painful, but severely affecting my life. My quality of life (work, personal, sex) has been going downhill because of them. I really really want to find out what the root causes are and how to cure them for good.

So my questions are:
1) What could be wrong with me? What could be the root causes of these problems?

2) I've been reading a lot, and I have 2 theories (which I haven't discussed with my doctors). I'm no medical doctor, so I'd like to know if my theories make sense.

2a) Perhaps my immune system is weak, which makes me vulnerable to recurring infections (UTI and epididymitis), e.g. diabetes. My doctors didn't think so because I'm "young and healthy."

2b) Perhaps the root cause is a structural problem of my lumbar spine. For the last 8 years, my work involved using the computer many hours/day, and my posture was not always good. Not only the spine but also the muscles in my lower back have issues. This causes my lower back pain/discomfort. And because the lumbar spine is tightly connected with the pelvis and abdomen, the weak spine and muscles cause other problems.

I hope that someone here can shed some light on my problems. Thank you very much!
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counterso responded:
You don't have a UTI. Taking repeated antibiotics has only weakened your immune system, especially if you have done nothing to rebuild it after the antibiotics.

Your doctors are clearly dismissive, even though they have given you a battery of tests.

It is possible that there is a persistent epididymitis condition that has never been fully resolved, and this could be a large part of what's occurring.

You might also just have some kind of nerve impingement as you have suggested, either from posture, or a bad structural alignment. There are good and bad chiropractors, but certainly worth a visit to find out, especially going when you feel the discomfort. A good chiropractor will probably tell you it will take 1-3 visits to fix. A bad one will give you a frequent visitor card.

Anyway, men only get UTIs for one of three reasons, none of which I expect apply to you. You should NEVER take an antibiotic unless you have been specifically tested and found to have an actual infection.

You should not have to suffer. Discuss your thoughts with your doctor. Experiment with the chiropractor if you want to. Don't let it just get you down.
 
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timng replied to counterso's response:
Hi counterso. Thank you very much for your answer. I also suspect that there is a root cause (even some causes) of my problems, that either causes UTI-like symptoms or makes me vulnerable to recurrent infections. I will see my doctor soon and will discuss this with him. Thanks again!
 
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counterso replied to timng's response:
Unresolved epididymitis is much more likely a recurrent symptom-causing situation. It can be challengin to fully treat, and really needs to be resolved to prevent scar tissue from forming.

UTIs only occur in men for one of three reasons, as I mentioned, and those are:
1) sticking something in your urethra
2) poor hygiene (incontinence)
3) physical abnormality

For number 3, you would have had UTIs your whole life if that were the case.

I would still go with the more likely scenario that you're having some nerve impingement and check that out first before looking for additional internal medicine diagnostics.
 
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kds4433 responded:
Dude. I wish we could talk. I've been fighting almost the exact same symptoms for over four years now. I, too, have visited a urologist, who prescribed doxazosin, a prostate medication, which did nothing for me. And I've been to the emergency room-- twice-- with excruciating pain in my testicles.

Like you, I am otherwise a picture of perfect health. One of the emergency room doctors prescribed antibiotics for me "just in case" it was an infection, and I took all of them to no effect (that was two years ago). While in the emergency room I had an x-ray and ultrasound done which revealed only slight swelling in the testes, nothing else (no varicoceles, no lumps, no kidney stones). I have been tested for and shown no sexually transmitted infections, am HIV-, age 44, not overweight, no known "structural abnormalities", but my epididymides regularly lock up on me and all I can do then is lie down and wait it out for few hours. This past week it has been daily. One of those days the attack lasted for almost six hours.

So far I have figured out this: whatever is causing the pain in my epididymides is connected very closely to the muscles along the spine in my middle/lower back region. I have a massage tool that I sometimes use to try to relieve the pain, and I use it like a big thumb to push extremely hard against the muscles in this region-- I can actually feel the tool sliding over a severely cramped muscle in there on both sides, and I get at least temporary relief from this routine. I have also found that if I stretch my lower back by stretching out my legs, grabbing my feet, and using my toes and forearms to pull gently but firmly for a solid 60-90 seconds, I can also get temporary relief. I also think that if I do this at the onset of an attack, the attack seems to last shorter and to be less intense than if I wait awhile and only do it once the pain gets bad.

I have also noticed this: if I watch my scrotum during an attack, the testes will be slowly moved up and down by some muscle over which I have no control (all the research I can find suggests this is the cremaster muscle, but it is not working like that muscle). The more dramatic the movement, the more intense the flash of pain that will accompany it. I have so far found no way of preventing this testicular "churning" from happening: a hot water bottle has done nothing, a bag of ice, nothing, alternating a hot water bottle with a bag of ice (imagine how much fun THAT was!), nothing.

You have figured out by now that there is a nerve that connects the testes to the spinal column somewhere around the place where the 12th rib joins the spine, which is right where that muscle in my back (the spinalis dorsi or longissimus dorsi) is cramping up. My guess is that the muscle cramps are constricting these nerves on both sides, causing pain. I also suspect that the cramping is causing signals to be sent to the muscles in the scrotum that are making the testes churn uncontrollably/ excruciatingly. Stretching and massage have been at least one source of relief for me so far. I only noticed/ discovered the connection to my back about a year ago (long after the visits to the emergency room). I talked about this with my urologist, but although he was familiar with the co-occurrence of back pain with epididymitis, he just wrote me a new script for doxazosin and sent me on my merry way.

I think what I may need is some kind of muscle relaxant, something to reverse the cramping in the spinal muscles. Or a chiropractor, which I have not yet tried to see for this problem. What is your own update? I will be checking back here regularly to see if you respond. Thanks for writing about this. The misery is shared.
 
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kds4433 replied to kds4433's response:
So even as I am writing this, I am having one of these attacks. After I posted the above, I went to stretch my back again, for the third time this morning: I began with a firm pull using my hands and the soles of my feet. About 3 seconds into the stretch, the entire erector spinae muscle on my left side contracted like I'd been stabbed, which has never happened before. I jolted myself upright, and then lay back down in a whirlwind of pain. Guess there will be no more back stretching for a few days. So much for that idea.
 
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counterso replied to kds4433's response:
kds4433,

I do not recommend that you press randomly on the nerve bundles and muscles as you have described. You're not a massage therapist or physical therapist, and the muscles in this area are quite tricky, as well as can be bruised by strong pressure, causing other problems.

It sounds like you may have some kind of pelvic floor dysfunction and may need to see a specialist who knows how to treat such things. You may benefit from a book called "A headache in my pelvis" and also seeking someone to check your situation for pelvic floor dysfunction. There are a few very specially trained physical therapists who know how to address the condition.

Stop causing yourself more pain, and get professional assistance with this one please.


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