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Dr. D.
Dr. D., Doctor (MD)
Category: Health
Satisfied Customers: 4
Experience:  Family Medicine, outpatient and inpatient
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I have pain on the right side on my back about waist high.

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I have pain on the right side of my back about waist high. Can not find a sore spot, but it kind of hurt when I walk. Some times I get sharp pains. I thought it was spinal related, but it hurts only on one side and it aches when I am waking up in the mornings. It some times makes me pull my back down and to the right when I walk.

Hello,

I'm sorry your back has been bothering you. The back is one of the most common places I treat people for chronic and acute pain (also the knee, head, shoulder, and wrist). However, we could probably narrow down the possibilities a bit with a few questions to rule out serious conditions and perhaps make the treatment more effective.

Back pain from things other than the back:
1. If it burns when you urinate or you feel a sense of urgency or have pressure over your bladder near the same time as when you had the back pain, you could be having a kidney infection (a worsened bladder infection). Unfortunately, this can't be handled over the internet--you would need a urinalysis (and preferably a urine culture) and antibiotics at the minimum.

2. Kidney stones that are passing can sometimes feel like back pain, but pain radiating into the groin is more common (and it is excruciating).

3. Problems with the internal abdominal organs and structures can sometimes come on like this, especially if you are having abdominal discomfort, bloody or black stools, diarrhea, etc.

4. Abscesses can come on like this, but most folks will see a red warm spot and maybe have fever or chills or night sweats.

Back pain du-jour:
1. Sacro-iliac joint--common place for chronic back pain, especially after a strain or long time of overuse. Press around about 3 inches to either side of the tailbone area about at the level of where the buttocks separate into cheeks--is it tender? This can be helped by physical therapy and medicines like aleve or ibuprofen. Ibuprofen should be taken with food and usually prescription doses are needed to help with the inflammation, under the direction of a physician.

2. piriformis problems--if you're having problems turning your foot and knee outward. Also, you can sometimes get pain by pushing your hand into the buttock.

3. Paraspinal muscles--they running parallel to your spine, along either side. Bend over forward and touch your toes. Then have a friend come up behind you and look straight over the curve of your back--is there a noticeable hump on one side? Try pressing on it--is it tender?

4. Low back pain is common in fibromyalgia, but that involves a bunch of tender points and usually can be brought on by pressing on certain "trigger points"--doesn't sound like that's you.

5. rarely, rheumatoid arthritis can start by affecting the lower limbs or back and is associated with stiffness in the morning. However, that is very rare and usually affects the wrists and hands first.

6. Ankylosing spondylitis is a kind of arthritis that affects young people and results in "freezing up" of the spine-hip area so that you start not being able to bend over as easily. This can only by diagnosed with a doctor's physical, lab tests, and x-rays. (And is exceedingly rare)

If at any time, you start getting bladder or bowel incontinence or are having weakness or numbness in a leg or foot, please see a doctor right away for a physical exam--the nerves to the bladder and legs/feet come out around that area.

The like diagnosis depends on:
-how long have you have it?
-how bad is the pain?
-what makes it worse; what makes it better?
-is the range of motion in your spine and hips normal?
-age, other medical problems, past surgeries, occupation, previous injuries, medications you are taking

Just let me know these things and we'll see if we can't narrow down the possibilities.

In general, in people without medical problems, it is also safe to take acetaminophen (Tylenol) in addition to aleve or ibuprofen. The published maximum safe dose can be found most places on the internet, but I recommend 3000mg a day if you are taking it for several days or more. Tylenol can be taken every 4-6 hours. This gives you a safety net since other things you take may have some Tylenol in it and some people may have liver disease that they don't know about.

Customer: replied 11 years ago.

I still need help.
I am a heart patient with a quadruple by pass. I take Zocor, Hyzaar, Atenalol. I also had some arthritis in my hands and I take Piroxicam for that. Calcium, Centrum Silver vitamins and Prilosec for recurring ulcers.
Aspirin daily also.
Have had upper back ache between my shoulder blades for about 5 years and is as of yet it is not diagosed either. This lower mid back pain is different and more sharp pains.

While musculoskeletal pain can be quite common even in patients with coronary artery disease and gastric ulcers, given your history, you need to schedule a visit with your regular doctor (or available physician) for a face to face visit. Sooner is better even though you've had the upper back pain for 5 years and an ER visit if it gets really bad quickly is never a bad idea.

The reasons you need to get a face-to-face are:
-a doctor's physical exam
-possible blood tests (especially since you are on zocor)
-possible imaging studies like x-rays and cat scans/MRI

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