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Suffering from back pain. Had constipation. Difficult to pass urine. Have inflammation in right leg. Something to panic?

Jul 2013
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Answered by

Orthopaedic Surgeon, Joint Replacement
Practicing since : 1996
Answered : 2148 Questions
My Uncle 59 yrs old had been sufferening from backpain in the lower back region quite a few days now. He had constipation and difficulty to pass urine for few days on the onset of the backpain, His BP and Sugar Levels are normal. He had inflammation in his right leg and the skin around the area do not seem to heal.

His ESR levels read 140 mm/hr. I have attached the xray, MRI and blood reports along with this email. The Xray report although says there is a disc slip, his ortho says this is part of ageing process.

Is there something to panic about? Doctor has advised him to undergo a surgery for the inflammation in the leg before which he is administered medicines for another 10 days to bring down the ESR levels.

We are really confused how to go about the treatment as we get to hear different opinions from different doctors, Do we need to go for further tests to confirm the exact cause? Please advise what we could suspect at this moment.

Iam unable to add reports due to the huge size of the files, Kindly drop your mail id so that I could send them via mail.

Thanks in Advance!
Posted Wed, 23 Oct 2013 in Bones, Muscles and Joints
Answered by Dr. K. Naga Ravi Prasad 20 hours later
Brief Answer:
He needs a better evaluation.

Detailed Answer:
Hi, thanks for writing to XXXXXXX

I have gone through all the attached scans & reports and nothing is found grossly abnormal in them.

There are numerous causes of low back pain. Most of the times, it is musculoskeletal in origin. But at times, Pain arising from other organs in the body is also felt in the back and is termed as "Referred pain". Many intraabdominal disorders like appendicitis, aneurysms,Pancreatic diseases, kidney diseases, bladder infections, pelvic infections can produce pain which is felt in the back. So, a thorough evaluation in the form of CT/MRI scan of the abdomen, clinical examination by a General surgeon and a Gastroenterologist will help in establishing the diagnosis.

As your uncle has constipation & difficulty in passing urine preceding the back pain, I suspect some problem either in the intestines or in the Genitourinary system. A "Colonoscopy" examination will rule out the intestinal causes and a "Cystoscopy" will show up any abnormalities in the urinary system.

The general treatment guidelines for Acute low back pain include -
- A short period of rest (e.g. one or two days) so as to allow the inflammed tissues to heal
- MOIST HEAT APPLICATION - Before activities, gentle heating can help loosen the muscle. Apply a heat pack to the groin prior to stretching or exercising. As a general rule of thumb, remember to heat before an activity and ice afterwards
- ICE PACKING - Apply ice to the painful area in the acute phase (first 48 hours after injury), and then after activities. Ice will help calm the inflammatory response and stimulate blood flow to the area
- PHYSICAL THERAPY - may speed up the recovery process. Therapeutic modalities such as Ultrasound, Massaging and specific exercises will be helpful.
- Appropriate medications for pain relief which include Analgesics and Muscle relaxants will reduce the pain & muscle spasm
- Gentle massage of the painful area with Analgesic/Muscle relaxants will have an immediate effect on pain relief.

Hope I have addressed your query. Happy to help further

Above answer was peer-reviewed by
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