Severe Pain In The Middle Of Back. Done With X Rays, Blood And Urine Tests. Chronic Inflammation And Pain. Could I Ask A Doctor?

Posted on Wed, 13 Nov 2013

Question: The first week of SEP, while on a business trip in the United Arab Emirates, I woke up in the middle of the night with severe pain in the middle of my back. This continued every night for three weeks and the pain and inflammation eventually spread to knees, hips, lower back, wrists, hands, and neck. The condition has lasted seven weeks now and includes night. Soon as I returned to the US on 26 SEP, I went to the ER, followed by my Family Doctor, and referrals to Infectious Disease, Rheumatology, and Urology Specialists each with another round of X-rays, blood and urine tests. So far the only diagnosis has been a PSA level of 4.6 and I am scheduled for a biopsy mid NOV and an unknown infection that is causing chronic inflammation and pain. My condition is slowly getting worse and still no answers. I am a 56 year old white male that exercised regularly before the first attack. The Doctors I have seen so far have been unable to diagnose the cause. The pain medication has helped. The medication for inflammation has only helped a little. I am exhausted from dealing with this for two months. The most significant pain is the back and neck. Where do I go from here?

Answered by Dr. Het Ram Bishnoi (14 hours later)

Brief Answer:
Complex back pain & its causes

Detailed Answer:
Hello, XXXXXXX ,hatcher.
Thanks for the query to H.C.M. Forum.
If I were your treating doctor for this case of severe pain in the back & neck region ,I would come up with these possibilities , these includes.
1 Vertebral osteomyelitis is usually caused by staphylococci ( you might got this infection in UAE), but other bacteria may be responsible . This pain exacerbated by motion and unrelieved by rest. Diagnosis can be confirmed by spine tenderness over involved area and elevated erythrocyte sedimentation rate ( E S R ) as these two findings are suggestive of this disease.MRI & CT are sensitive & specific for osteomyelitis.
2 Spondylosis or osteoarthritic spine disease , typically occurs in middle age group . This disease involves the cervical & lumbosacral spine.Diagnosis can be confirmed by hypertrophied facets & osteophytes.
3 Cancer of prostate may cause metastasis in vertebral . Diagnosis can be confirmed by evaluation of prostate specific antigen ( as this is already high 4.6 ng/dl normal less than 4) and biopsy .
4 Lumbar adhesive arachnoiditis with reticulopathy is due to fibrosis caused by inflammation within the subarachnoid space.Diagnosis can be confirmed by M R I by contrast.
In my opinion consult a orthopedic surgeon and get his opinion .
Hope I have answered your question .If further any question I will help.
Good luck. Dr. HET

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Shanthi.E