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Suggest Treatment For Low Back Pain

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Posted on Wed, 25 Oct 2017
Question: I have moderate to severe low back pain and feel like I need to defecate but dont. Pain aching and shooting down towards tail bone and not siatic. pain worse arching back, not so much bending forward as it is backward when hips move forward. history of lumbar surgery about 7 years ago.


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Answered by Dr. Ishu Bishnoi (1 hour later)
Brief Answer:
Probable differential diagnosis as mentioned below

Detailed Answer:
Hi xxxxx33, thanks for asking from HealthcareMagic.


I can understand your concern. Your pain is mainly in the lower back, radiating till tailbone, more on the extension at spine and giving feeling to defecate. Such kind of pain cannot occur in lumbar disc or lumbar spine disease.

The probable differential diagnosis in such kind of pain -

- Anal fissure pain - Anal fissure is a tear in anal opening reaching up to anal sphincter. It generates severe spasmodic pain at anus which can reach till lower back, may give a feeling of defecation, severe pain.

To know about this, you need to consult proctologist. S/he will examine anal opening to make a diagnosis.

- Rectal mass - Lower intestine mass in rectum or anus can cause similar kind of pain. If it is involving sacral nerves, it can cause severe pain.
The diagnosis can be confirmed after per rectal examination and CT-scan abdomen. You should consult proctologist for it.

- Coccydynia - Coccygeal bone is the tailbone. Its inflammation or damage can cause "Coccydynia'. It can cause pain at the tailbone. more pain during sitting and some relief in standing position. Your pain is not resembling much to it, but still, it can be a possibility.

- Rare chance of sacral mass or sacral nerve compression. It can cause pain in lower back, feeling of defecation, more pain on moving hip. It can be confirmed by MRI sacral spine and examination by a neurologist.

My advice is first to consult a Proctologist only to rule out common anal pathology. You can send me your reports. I will help you in understanding the disease.

If any doubt, do let me know.
Thanks. Take care.


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
Answered by
Dr.
Dr. Ishu Bishnoi

Neurologist, Surgical

Practicing since :2007

Answered : 901 Questions

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Suggest Treatment For Low Back Pain

Brief Answer: Probable differential diagnosis as mentioned below Detailed Answer: Hi xxxxx33, thanks for asking from HealthcareMagic. I can understand your concern. Your pain is mainly in the lower back, radiating till tailbone, more on the extension at spine and giving feeling to defecate. Such kind of pain cannot occur in lumbar disc or lumbar spine disease. The probable differential diagnosis in such kind of pain - - Anal fissure pain - Anal fissure is a tear in anal opening reaching up to anal sphincter. It generates severe spasmodic pain at anus which can reach till lower back, may give a feeling of defecation, severe pain. To know about this, you need to consult proctologist. S/he will examine anal opening to make a diagnosis. - Rectal mass - Lower intestine mass in rectum or anus can cause similar kind of pain. If it is involving sacral nerves, it can cause severe pain. The diagnosis can be confirmed after per rectal examination and CT-scan abdomen. You should consult proctologist for it. - Coccydynia - Coccygeal bone is the tailbone. Its inflammation or damage can cause "Coccydynia'. It can cause pain at the tailbone. more pain during sitting and some relief in standing position. Your pain is not resembling much to it, but still, it can be a possibility. - Rare chance of sacral mass or sacral nerve compression. It can cause pain in lower back, feeling of defecation, more pain on moving hip. It can be confirmed by MRI sacral spine and examination by a neurologist. My advice is first to consult a Proctologist only to rule out common anal pathology. You can send me your reports. I will help you in understanding the disease. If any doubt, do let me know. Thanks. Take care.