Patient: Hi I have pain in my lower right side of my back when I bend or sit or get up after sitting a while. There seems to be a little ball which isn’t on the other side which hurts when touched. I was just wondering what this could be?
Doctor: Mechanical low back pain (LBP) is the second most common reason for seeing a physician in the United States. Of the US p opulation, 85% will experience an episode of mechanical LBP at some point during their lifetime. Fortunately, the LBP resolves for the vast majority within 2-4 weeks. Sometimes it may complicate with a persistent muscle contracture and/or a sciatic nerve inflammation and the healing process takes a little longer. Possibly the “little ball” that you mention is a localized muscle contracture, tender to the touch. The suggested conservative treatment would be: a physical therapy program aimed to: control the pain and the inflammatory process, relative rest, flexion and extension exercises of the spine to reduce the nerve tension, exercises that improve the muscular strength and endurance of lumbar muscles. You can also try anti-inflammatory drugs (“Aleve”).Try avoiding all the activities that produce pain or discomfort, such as weight lifting, keep a good posture at all times and sleeping with a pillow between the knees while lying on one side may increase comfort. Some doctors recommend lying on your back with a pillow under your knees. Try a local cold pack to see if it helps to ease the pain. If you don’t have a cold pack, use a large bag of frozen vegetables; it makes a good first aid cold pack. Or have someone close to you massage you in a triangular pattern with an ice cube over the sore areas, no more than 15-20 minutes at the time. After the cold massages, try alternating with heat from an electric heating pad to see if it helps the pain. If you don’t have an electric heating pad, put a hand towel under hot water, wring it out, and place it on your back. Sometimes the moist heat penetrates more deeply and gives better relief of pain. You may feel better lying on your back on a firm surface with a pillow under your knees.
Comments / Follow Ups
Guest: I’m in 90 percent pain ,from toes to thigh,had 2 back surgerys,l4l5,l5s1.