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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Chronic Excruciating Back Pain

I am a massage therapist. I ve had excruciating back pain that comes on after exercise (mainly abdominal exercise) and remains for weeks at a constant pain level (8), it wakes me at night when I move in my sleep. No amount of changing position eleviates the pain and it is constant as long as I continue to exercise. I am unable to lessen the pain with medication, and frequent massage (weekly) and chiropractic did not help at all. The pain seems to be internal to me, as psoas, erector and QL work have not elicited any direct pain. I am unable to specifically locate the pain. I have seen a physical therapist, per my MD, and she determined that it is caused by something internal. I also have had itchy palms for the past few months, quite severe. I have experienced weight gain, although I have been on a strict diet and exercise program and have seen a dietician. This is frustrating because I have never had any trouble losing or maintaining my weight before and I follow a mayo clinic diet and I was working out 3 times a week for an hour each and I walk 4 miles a day and belly dance 2 times a week. I have had to stop all but the walking due to pain. I keep a food journal and when I planned my vacation, I adjusted my caloric intake to 1000-1200 calories, and have only gained weight in the last 2 months. I have a great deal of pain on palpation of the lower abdominal region and behind the navel area. I have had some bile in my mouth when I burp and often feel as though I need to be careful or I could easily vomit, only some upset stomach though. No nausea. My stool is very loose, a light tan color with a strange odor, this is unusual. I have developed a fissure on the anus due to this stool issue. I have some pressure pain under my lower left ribcage on the posterior side, much like a waist band is cutting into me. I know I have other symptoms that may help to steer me in the right direction, but I cant think of them right now. My MD is not very helpful in this matter.
Tue, 18 Apr 2023
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General & Family Physician 's  Response
Hi,

Chronic back pain can be a complex issue and may have several underlying causes. It is important to consult with a healthcare professional who can conduct a thorough examination and recommend appropriate tests to determine the cause of the pain.

Based on the symptoms you have described, you may be experiencing gastrointestinal issues such as inflammation of the digestive tract, gallbladder issues, or pancreatitis. Loose stool with an unusual odor, bile in your mouth, and a fissure on the anus are all indicative of digestive issues. The pain on palpation in the lower abdominal region and behind the navel area could be related to inflammation of the digestive tract or the presence of gallstones. Pain stemming from under the lower left ribcage may be a sign of pancreatitis.

It is important to note that back pain may also be related to issues with the spine such as herniated discs, spinal stenosis, or degenerative disc disease. However, given the symptoms you have described, it is advisable to address the potential gastrointestinal issues first.

To determine the underlying cause of your symptoms, you may need to undergo some tests such as blood work, imaging tests, stool tests, or a colonoscopy. Your healthcare provider may also refer you to a gastroenterologist or a specialist in digestive health.

In the meantime, it may be helpful to modify your exercise routine to avoid exercises that aggravate your pain. Gentle stretches and low-impact exercises such as swimming or walking may be beneficial. Pain management techniques such as hot or cold therapy, massage, and relaxation exercises may also help to alleviate symptoms.

It is important to continue working with your healthcare provider to find a diagnosis and develop an appropriate treatment plan to manage your symptoms and improve your quality of life.

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Priyanka, General & Family Physician
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Suggest Treatment For Chronic Excruciating Back Pain

Hi, Chronic back pain can be a complex issue and may have several underlying causes. It is important to consult with a healthcare professional who can conduct a thorough examination and recommend appropriate tests to determine the cause of the pain. Based on the symptoms you have described, you may be experiencing gastrointestinal issues such as inflammation of the digestive tract, gallbladder issues, or pancreatitis. Loose stool with an unusual odor, bile in your mouth, and a fissure on the anus are all indicative of digestive issues. The pain on palpation in the lower abdominal region and behind the navel area could be related to inflammation of the digestive tract or the presence of gallstones. Pain stemming from under the lower left ribcage may be a sign of pancreatitis. It is important to note that back pain may also be related to issues with the spine such as herniated discs, spinal stenosis, or degenerative disc disease. However, given the symptoms you have described, it is advisable to address the potential gastrointestinal issues first. To determine the underlying cause of your symptoms, you may need to undergo some tests such as blood work, imaging tests, stool tests, or a colonoscopy. Your healthcare provider may also refer you to a gastroenterologist or a specialist in digestive health. In the meantime, it may be helpful to modify your exercise routine to avoid exercises that aggravate your pain. Gentle stretches and low-impact exercises such as swimming or walking may be beneficial. Pain management techniques such as hot or cold therapy, massage, and relaxation exercises may also help to alleviate symptoms. It is important to continue working with your healthcare provider to find a diagnosis and develop an appropriate treatment plan to manage your symptoms and improve your quality of life. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Priyanka, General & Family Physician