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Two lumps on back, varied consistency - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Very Good Posted in: General Health
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2479 Questions
User :   I have two limpomas in my lower back, that are causing me a lot of pain. My PCP is sending me in for an ultrasound tomorrow. What are they looking for? And if they're causing me pain, can I get them removed?
Doctor :   hi
User :   Hi!
Doctor :  
ok
Doctor :  
since when have these been present?
User :   I was 14 when they appeared, and i'm 21 now.
User :   The pain has been so bad, he has me on vicodin
User :   he did xrays, and its not skeletal
Doctor :  
could you describe them to me in relation to their appearance and approximate size?
User :   if you were to put your thumbs in the middle of someone's love handles, they're there
User :   probably almost 2" in diameter each
Doctor :   ok
User :   and they're the same size on both sides
Doctor :   they are how many in number?
User :   just one on each side
User :   you cant' see them, you can only feel them when you press down
Doctor :  
how do they feel to touch? are they hard, soft or firm?
User :   all of the above
User :   haha
Doctor :  
are they raised from the surrounding skin surface?
User :   no
Doctor :  
are you able to move them in all directions?
User :   pretty much
Doctor :  
ok
Doctor :  
the ultrasound will probably be done to look for the extent of the tissues involved, and the origin of them in case there is any from the structures present in that area
Doctor :  
how is the mobility of lower back?are you able to flex and extend without pain?
User :   okay, so the ultrasound will show if they're messing with muscles, etc?
Doctor :  
are you able to turn sideways?
User :   no, unless i'm on the vicodin, it hurts to walk
User :   i can move all around, but it hurts.
Doctor :  
yes, it will try and figure out if they arise from muscle or nerve or fat tissues
Doctor :  
and to see if any vascular connections are there
User :   great
User :   so under what circumstances would they be causing me this much pain?
Doctor :  
if it is not vascular he may next ask for a biopsy to look for the kind of tissue involved
Doctor :  
and then treat you accordingly
Doctor :  
in case it involves nerves, then pain wil be intense, but muscle and fat involvement wil not cause very severe pain
Doctor :  
it wil be more like discomfort
Doctor :  
so wait for the ultrasound results
User :   what are the pros and cons of getting them taken out?
Doctor :  
and see what it turns out to be
Doctor :  
it will depend on the kind of tissue from which it is originating, and then it wil be decided whetherto remove it or first do a biopsy
Doctor :  
and then decide on removal
Doctor :   in case the nerve is involved, there might be some loss of sensation for sometime after operation
Doctor :  
but if muscle or fat is involved it wil not cause much after effects
Doctor :  
the biopsy will also tell whether there are chances that it will regrow depending on what tissue it is
Doctor :  
have you followed what i have said?
User :   yes definitely
Doctor :  
Is there any thing else I can help you with?
User :   so if its just fat tissue -- and its causing me discomfort - would you recommend getting them removed?
User :   like, is there a reason why they're acting up now? its a very dull dull dull pain, which is why i don't think its a nerve, its not sharp
Doctor :  
if its only fat tissue, then it wil be soft in consistency, but as per the history given by you, the consistency of the lesions vary
Doctor :  
so we cannot say that it is only fat tissue involved
Doctor :  
so a detailed investigation should be done especially since they were silent for a long time and now they are acting up
Doctor :   as there might have been some changes occurred in them which is leading to appearance of pain
User :   got it. so do the ultrasound, then a biopsy, and then discuss removal?
Doctor :   yes, very much, as these will show probable causes
Doctor :  
which will direct further line of treatment
Doctor :  
depending on the results
Doctor :  
Is there any thing else I can help you with?
User :   okay. i think my doc is really against getting them out. and i'm just in so much pain - i don't care what i have to do to stop it
User :   i'm only 21 and would rather have surgery now than later
Doctor :   yes, early treatment will help you have better outcome
Doctor :  
and once the tests are done
Doctor :  
you can discuss them with the concerned specialist
Doctor :  
and come to a conclusion whether to remove them
User :   who would the specialist be for this type of thing?
Doctor :  
or go for pain management
Doctor :  
first it should be a surgeon, and then if it directs to the type of the lesion based on the biopsy report
Doctor :  
it could also be a oncologist
Doctor :  
in case the biopsy report comes abnormal
Doctor :  
Is there any thing else I can help you with?
User :   one more thing..
Doctor :  
sure, please proceed
User :   my general doc is going to be the one looking at the ultrasound. is that okay?
Doctor :  
yes, he should be able to conclude based on ultrasound whether to treat you himself or refer you to surgeon or oncologist
User :   oh AND.. i'm building up a tolerance to the vicodin.. how many 5/500 pills is too much at once?
Doctor :  
you can also get back to us with your reports and take a second opinion from our panel specialists.
User :   okay
Doctor :   you should not take more than what is prescribed per day
Doctor :   it wil harm your liver and kidney metabolism and functions
User :   my doc said to just take them as needed and not exceed 4000mg of acetomenephen per day
User :   but we didn't discuss how many at once
Doctor :  
that would mean, not more than 8 pills per day
Doctor :  
but according to me at your age you should not cross taking more than 6 pills per day.
Doctor :   Is there any thing else you would like to ask me?
User :   is it bad to take 3 at once?
Doctor :   yes, it is bad to take 3 at once. you should be taking only one, and space out the time, like take it every 4 hours for pain relief
Doctor :  
not by taking more pills at one time
User :   it doesn't do anything if i only take one at a time
Doctor :  
then you should be discussing this with your treating doctor for possible change in medications
Doctor :  
to give you adequate pain relief
Doctor :  
rather than taking over dose of something that is not working effectively.
User :   what would be your recommendation for a different pain medicationt hen?
Doctor :  
i would recommend you a higher pain medication than vicodin, but it has narcotic properties and is a prescription medication.
User :   which medication is it?
Doctor :  
since I am not examining you personally, it would be unethical to prescribe prescription medicines
Doctor :  
and also it has abuse potential so it has to decided by your treating doctor about the dose and frequency of medication to be given to you.
User :   no i understand that, i was just curious which medication it was
Doctor :  
ok
Doctor :  
it is better discussed with your treating doctor, since I am not seeing you in person.
Doctor :  
is there anything else you would like to ask me?
User :   nope, thanks!
Doctor :  
Please fill the feedback form say done when done.
User :   done
Doctor :   Thanks for consulting HealthcareMagic. Bye for now. Please chat with our doctors 24/7 for medical queries. Please refer your friends to our service.
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