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Nadim Al-Mubarak
Nadim Al-Mubarak, Doctor
Category: Medical
Satisfied Customers: 379
Experience:  MD at University Hospital Case Medical Center
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I have suffered with a pain in my lower back and hips for

Customer Question

I have suffered with a pain in my lower back and hips for over 8 months that is becoming almost debilitating. I am a professional 62 years old woman with an typical Type A personality and who does no drugs, other than blood pressure and Premarin. My profession keeps me either behind a computer or under the wheel of a car. Doctors have diagnosed me with Fibromyalgia and Irritable Bowel over the last 20 years all of which I've learned to realize the pain associated with these issues. However, this is neither of those pains. In October 2015 I was admitted to the hospital with severe diarrhea and vomiting and released five days later with a diagnosis of some type of "super bug" invasion. In December I started having back pain- but not muscle pain - more like I was out of alignment as the pain traveled from hip to hip, sometimes pelvic area and across the lower back. My family was worried this was an after math of my "super bug" problem in December. However at first I associated this with some hard bowel movements and feared I had pulled something in my colon. My Bowel movements can sometimes be as painful as childbirth and I often have joked that my bladder resided near my knees in the aftermath of these situations. In Jan. the back pain started interrupting my sleep and in Feb. I was rushed to the emergency room because the pain was so bad I could hardly get out of bed and couldn't stand. XRays, Therapy, Ultra Sounds and tons of doctor visits later, including Orthopedic and Urologist, the pain is increasing and no one can find anything. One doctor suggested a parasite since I've vacationed out of the country recently, another suggested my spine might be out of alignment, but no one sees anything in all the tests other than a large 3" Cyst on my kidneys. The Urologist informed me today that these Simple Cysts are normal and isn't causing this extreme pain. I'm devastated as the pain is now interfering with my normal life. I've thought of going to Vanderbilt or the Mayo Clinic and just admitting myself for not mentally or physically being able to cope any longer. As a last ditch effort I reaching out to the web to ask for suggestions. Any ideas of where I may be able to get answers would be greatly appreciated.
Submitted: 12 months ago.
Category: Medical
Expert:  DrRussMD replied 12 months ago.


I am a double board certified US doctor and quite familiar with this situation.

The x rays do not show if you have disc problems, which is what this sounds like as far as the back pain.

You need an MRI of the lower spine.

I suggest you see an MD specialist of physical medicine and rehabitation.

They are medical doctors who would instantly understand what type of structural problem this is, and order the MRI.

They will then give you the correct therapies to straighten it out.

OK, so you might have more questions or want to give me more information: Please use reply to expert if you have further questions.

Also, please click a positive rating [hopefully excellent (5)—that’s how we are paid, per rating]. If you forgot something, just use reply and come back. I am here

Expert:  Nadim Al-Mubarak replied 12 months ago.


  • Thank you for the detailed history. You seem to have gone through extensive evaluation and have seen a number of physicians. It would be hard to believe that no one would have thought of ordering an MRI of the spine ?
  • Even if the X-rays or MRI of the spine are normal, it could still be in the spine and/or the nerves originating from the spine. It just sound like it. I would recommend that you see a Neurologist to start with, if you have not already done so. If you have already seen one, it would be a good idea to see another Neurologist for a second opinion (not discounting the first one)
  • In the mean time, you may also seek the help of pain management specialist for temporary, possibly long-term pain relieve, pending further investigation to get to the roots of the the problem

Best wishes

Expert:  DrRussMD replied 12 months ago.


A pain management specialist is not the first doctor to go to.

And they are not for temporary relieve.

They are for long term pain management.

As I said, at least in the US, the PM&R doctor is THE specialist in physical medicine.

You did not state that an MRI was ordered, and as I first recommended, this would be definitive along with an EMG/NCS .

In fact, a neurologist is not indicated for a structural problem, and is not going to see you without a referral for a neurological problem.

That is basically how the system works, and would be an initial waste of your time if this is not strictly a neurological problem.

Spinal problems with discs are typically handled by a spinal orthopedist or a PM&R doctor.

This is the original expert. I am a double board certified US doctor.

Find me by request in medical any time. For Dr. Thomas only.

Expert:  Nadim Al-Mubarak replied 12 months ago.
  • The lady has already seen numerous doctors and had extensive testing. Pain management would not be the "first doctor to be go to" in this case, When the pain is LIFE STYLE DISABLING, pain management can offer temporary and potentially long-term relieve
  • My recommendation is very clear. At this stage, this is a primary Neurologist domain. From the information provided, physical medicine and rehabilitation has no place in this case. The root of the problem has not been found. It needs to be found and it does not appear to be skeletal