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Suffering from back pain and getting whitish blotches on tongue. Proper diagnosis?

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General & Family Physician
Practicing since : 2005
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I have been experiencing lower back nerve problems for many years and doctors cannot pinpoint the nerve pinching problem. It comes on several times a year, causes my lower back muscles to stiffen which just makes the problem worse and usually lasts 3-5 days. This problem is always accompanied by my tongue breaking out in whitish blotches which go away when the back nerve problem stops. I've had this problem for about 25 years and doctors have not been able to diagnose it.
Posted Wed, 19 Dec 2012 in Back Pain
Answered by Dr. Prasad 11 hours later

Thanks for the query.

Back pain is a chronic condition and as recurrence is very common it does affect normal function and activities. Multifactorial associations make back pain a chronic and recurring condition, therefore many-a-time physicians and orthopedic surgeons are unable to thoroughly identify and treat all the factors as to cure the pain.

With an opportunity to examine you, I shall provide you the possibilities which I feel you can take forward/discuss with your treating doctor.

1. The first among the list is vertebral disc problems with nerve compressions. The short nature of symptoms does not favour the diagnosis of disc problems.
2. Spine pathology such as spondylosis, osteoarthritis and autoimmune associated arthritis are again persisting complaints which lead to progressive worsening.
3. Chronic medical illness such as tuberculosis, multiple myeloma, hematological cancers and metastatic illness are accompanied by other systemic complaints.
4. Muscular aches resulting from trauma, spasms, localized inflammation (infection) can cause acute symptoms such as yours; but is less likely to be present at similar locations.
5. Back pain can also occur from systemic illness such as anemia, viral infections, renal disease (stones), urinary tract infections and others.

The usual set of investigations that includes complete hemogram; markers of inflammation; radiological tests like X-ray/CT/MRI scan and nerve conduction test/electromyelogram (EMG) are enough to identify the pathology. If all of these tests are normal, muscular aches or systemic disease can be pointed as the cause. I am sure your doctors in the last 25 years have done these tests though you did not report of the tests in your presentation.

Therefore, the fact that ‘white spots on the tongue are always associated with back ache’ indicates strongly that the episodes of back ache could be related to "systemic viral illness". And hence improving your calcium and vitamin D intake (either through diet or supplements) may reduce the frequency and intensity of back aches.

I hope you find this reply detailed and understandable. Let me know if you have any doubts.

Best wishes
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