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Suggest Treatment For Lower Back Pain In An Elderly Person
Question: I have been experiencing lower back and groin pain, with lower leg and foot pain. Also, my hands and feet itch quite a bit. I also have a great deal of pain after an ejaculation. I am a 70 year old male.
Thanks
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Brief Answer:
need more information
Detailed Answer:
Hi xxxxxxxx, thanks for asking from HCM.
I can understand your concern. You mentioned that you are having back pain, groin pain and painful ejaculation. The pain in back and groin at 70 years age can be due to various causes like
- Lumbar disc disease
- Lumbar spondylolisthesis
- Renal stone disease
- Musculoskeletal disorder
- Prostatitis - It can cause painful ejaculation also
- Cystitis
To reach at some conclusion, I need more information about
- Back pain site? Is it in centre or right/left? what is the exact site - lumbar or tail bone region?
- Is there any burning micturition, pain radiation from back to groin?
- Is there any history of restlessness, vomiting, nausea along with pain?
- What is the character of pain? sharp/dull, radiating/non radiating, current like!
Answers of these questions will help in reaching at some conclusion. Based on that, investigations can be advised like
- MRI lumbosacral spine
- Ultrasound of kidney/urinary bladder
- Semen analysis
- CT abdomen
For relief, you can
- apply painkiller gel like diclofenac gel at local site
- Take painkiller like Tylenol after prescription
- Avoid exertion and weight lifting
- Hot fomentation will help in back pain.
Hope you got my point. If any doubt, do let me know.
Thanks. Take care.
need more information
Detailed Answer:
Hi xxxxxxxx, thanks for asking from HCM.
I can understand your concern. You mentioned that you are having back pain, groin pain and painful ejaculation. The pain in back and groin at 70 years age can be due to various causes like
- Lumbar disc disease
- Lumbar spondylolisthesis
- Renal stone disease
- Musculoskeletal disorder
- Prostatitis - It can cause painful ejaculation also
- Cystitis
To reach at some conclusion, I need more information about
- Back pain site? Is it in centre or right/left? what is the exact site - lumbar or tail bone region?
- Is there any burning micturition, pain radiation from back to groin?
- Is there any history of restlessness, vomiting, nausea along with pain?
- What is the character of pain? sharp/dull, radiating/non radiating, current like!
Answers of these questions will help in reaching at some conclusion. Based on that, investigations can be advised like
- MRI lumbosacral spine
- Ultrasound of kidney/urinary bladder
- Semen analysis
- CT abdomen
For relief, you can
- apply painkiller gel like diclofenac gel at local site
- Take painkiller like Tylenol after prescription
- Avoid exertion and weight lifting
- Hot fomentation will help in back pain.
Hope you got my point. If any doubt, do let me know.
Thanks. Take care.
Above answer was peer-reviewed by :
Dr. Yogesh D
Back Pain site - Mostly right side of spine and often in my right quadrant. Sometimes on the left side and always in the lower back.
Pain radiation to groin - yes there is pain radiation to the groin and often have some degree of pain in and around my right testicle. Pain is also in my legs, mostly lower and mostly on the right, but sometimes on the left as well. Pain feels like a very strong ache and not a sharp nerve type pain.
Also my feet have a great deal of pain and I feel like I am losing the senses in my feet and especially my toes. However, if I stub my toe there is horrific pain that last quite a while.
I have tried a heat compress on my back over night and there has been some relief in my back, but my legs and feet have had no relief and seem to hurt more this morning.
I have tried over the counter pain medications and nothing has worked,. My Dr. is not in favor of opioids and I am not either unless absolutely needed.
I am scheduled to see chiropractor on Monday, but don' t think he will be of any help.
Pain radiation to groin - yes there is pain radiation to the groin and often have some degree of pain in and around my right testicle. Pain is also in my legs, mostly lower and mostly on the right, but sometimes on the left as well. Pain feels like a very strong ache and not a sharp nerve type pain.
Also my feet have a great deal of pain and I feel like I am losing the senses in my feet and especially my toes. However, if I stub my toe there is horrific pain that last quite a while.
I have tried a heat compress on my back over night and there has been some relief in my back, but my legs and feet have had no relief and seem to hurt more this morning.
I have tried over the counter pain medications and nothing has worked,. My Dr. is not in favor of opioids and I am not either unless absolutely needed.
I am scheduled to see chiropractor on Monday, but don' t think he will be of any help.
Brief Answer:
History analysis suggest multiple pathologies
Detailed Answer:
Hu xxxxxxxx, welcome back.
Thanks for providing me your detailed history. Your pain in right quadrant, radiation to groin and right testicle, pain after ejaculation and pain in tail bone region suggest
- Genitourinary pathology like lower ureter stone/right side seminal vesicle inflammation/prostatitis. To confirm, we need ultrasound of genitourinary system, per rectal examination, semen analysis and urine microscopy.
Your second complaint - pain in legs, numbness like feeling in toes and feet, pain on left side back suggest
- Sensory neuropathy or lumbar spondylosis. I am suspecting sensory neuropathy more, because you don't have radiculopathy. Another possibility is origin of these systemic signs due to genitourinary disease. Still we should rule out neuropathy. To know more, please ask your doctor to check your all sensations like pain, touch, temperature, vibration and proprioception in lower limbs. If there is some finding, nerve conduction velocity will be needed to confirm the level.
Till your full evaluation, you should
- Take neutron specific vitamin like B12, folic acid, pyridoxine, pantothenic acid.
- Eat green leafy vegetables, fruits, drink lemon water and keep yourself well hydrated.
- Avoid wearing tight shoes/socks, walking bare foot. Maintain hygiene of feet and regularly check your feet for any cuts. It is to prevent any painless wound/cut.
- Do calf massage daily or take help. It will relieve some pain. Stretching of calves will also help.
- Apply painkiler gel like diclofenac gel over calves.
Hope it will help. Please let me know your reports after evaluation. I will guide you further.
Thanks. Take care.
History analysis suggest multiple pathologies
Detailed Answer:
Hu xxxxxxxx, welcome back.
Thanks for providing me your detailed history. Your pain in right quadrant, radiation to groin and right testicle, pain after ejaculation and pain in tail bone region suggest
- Genitourinary pathology like lower ureter stone/right side seminal vesicle inflammation/prostatitis. To confirm, we need ultrasound of genitourinary system, per rectal examination, semen analysis and urine microscopy.
Your second complaint - pain in legs, numbness like feeling in toes and feet, pain on left side back suggest
- Sensory neuropathy or lumbar spondylosis. I am suspecting sensory neuropathy more, because you don't have radiculopathy. Another possibility is origin of these systemic signs due to genitourinary disease. Still we should rule out neuropathy. To know more, please ask your doctor to check your all sensations like pain, touch, temperature, vibration and proprioception in lower limbs. If there is some finding, nerve conduction velocity will be needed to confirm the level.
Till your full evaluation, you should
- Take neutron specific vitamin like B12, folic acid, pyridoxine, pantothenic acid.
- Eat green leafy vegetables, fruits, drink lemon water and keep yourself well hydrated.
- Avoid wearing tight shoes/socks, walking bare foot. Maintain hygiene of feet and regularly check your feet for any cuts. It is to prevent any painless wound/cut.
- Do calf massage daily or take help. It will relieve some pain. Stretching of calves will also help.
- Apply painkiler gel like diclofenac gel over calves.
Hope it will help. Please let me know your reports after evaluation. I will guide you further.
Thanks. Take care.
Above answer was peer-reviewed by :
Dr. Raju A.T
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