Persistent Mid Back Pain

Patient

Q: I am a 25 year old female. I have been having back pain for going on 13 weeks now. I do not recall injuring my back at any time. The pain is constant and is around the same area in the middle of my back, but hurts worse on the left or right side. Some days it hurts worse on the right than the left and visa versa. It hurts when I cough. It hurts the most when I am bending over and if I try to bend over and lift my left leg especially (trying to put pants on) the pain is unbearable. The pain has not subsided at all since the day I woke up with it. I am a medicaid patient, and have been to the doctor 4 times. The first time I saw a doctor he did an X-ray and saw nothing. Each and every time the doctor tells me it is muscle strain with no additional testing. I would like to know what is wrong with my back, and if you have any idea where I can seek help from anyone that will actually listen to me??

Doctor

A:    According to your description of the pain, no antecedent of trauma, worsens with coughing, duration 13 months, you definitely would benefit of a doctor (Orthopedic Surgeon) evaluation including a comprehensive physical examination and imaging studies (MRI) to rule out maybe an intercostal neuritis or  possible structural spinal causes for the pain. The conservative treatment of the upper back pain is basically relative rest of the spinal segment involved, avoiding all the activities that produce pain or discomfort, such as weight lifting. Also very important is the  reeducation to keep a good posture at all times. Control of the pain and inflammation with Ice, transcutaneous electrical nerve stimulation (TENS), and anti-inflammatory medication (such as “Motrin”, “aleve”). Keep a consistent exercise routine with stretching and extension-flexion which may reduce tension and stress to the spinal joints.

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