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Suggest Treatment For Pain In Lower Back

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Posted on Wed, 14 Jan 2015
Question: Hello, about a week ago I noticed a a pain in my lower back towards my tail bone. I was developing a pimple and that's why it felt so sore. Well I kept picking at it and the next day it had swelled. I noticed the pain got worse so I looked in the mirror and noticed the spot where I was aching had turned into a purple/dark purple color about the width of a dime. I went to the ER last night and was diagnosed with Cellulitis. I've been taking the antibiotics prescribed since last night but I noticed today that the skin around one of my butcheecks is turning pink. I know this is due to the cellulitis but I'm very concerned. What does the spread of the pink skin indicate and is it normal to have purpleish skin (small in width) with cellulitis? Are there any other remedies I can try as well? I am currently on clindamycin.
doctor
Answered by Dr. T Chandrakant (34 minutes later)
Brief Answer:
Abscess - treatment as per the cause - additional Ibuprofen

Detailed Answer:
Hi.
Thanks for your query and an elucidate history.

To recapitulate in a nutshell:
Young 20/F - pain 2 week -towards tail bone - sore pimple - picked - got swollen - pain worsened - purple - ER diagnosis of cellulitis- taking Clindamycin- 1 day- skin on one butt-cheek turned pink - took home remedies of garlic paste - Neosporin locally and Sitz bath twice daily - now concerned > why pink / why purplish > any other remedies you can try....

The spread of the pink skin indicates increased vascularity due to infection , this being a normal reaction of the body.
It is definitely normal to have purplish skin with cellulitis. This is due to the clogging of the tissues with venous blood added on with the bacterial action.

After re-reading of the history you have provided, I am of the opinion that you need to continue with Clindamycin / Sitz bath.

I would advise the following things::
-Apply liquid Povidone Iodine locally and widely to make the area sterile.
-Take an anti-inflammatory like Ibuprofen if this suits you at 8 hourly interval after food with Ranitidine.
-Second opinion of a Surgeon for direct examination so that the cause can be diagnosed and the possible future course of such a disease can be predicted and treatment planned accordingly.

This is important , as we have to decide the ''why'', meaning the actual cause of this cellulitis:
Whether this is a pilonidal sinus appearing for the first time / fistula in ano / just a boil caused by breaking of the skin be scratching. Although the initial treatment is same for all, the later treatment for a cure is totally based on the proper diagnosis.

If the pain is for about a week, it is possible that the abscess may open on its own and if not it is wise to have a definitive surgery of incision and drainage /
Excision of the tract or at least laying it open for a few reasons ::
-To get the pus drained out and to get a relief as antibiotics will help more if the pus is let out.
-Understand whether this is just a boil / pilonidal sinus or fistula or so.
The ultimate aim has to have a ''cure'', and not the temporary relief.

I hope this answer helps you to get a proper diagnosis, and get a proper further treatment. Please feel free to ask for more or if you need further clarifications if you feel there is a gap of communication.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. T Chandrakant (37 hours later)
Since i started taking the clindamycin (thursday morning) my cellulitis has spread from the tip of my tail bone to both my buttcheeks. The color gradually changed from pink to a dark purple. The pain is minimal to nothing. If anything it only feels sore. I continue to have no other side effects such as fever or chills. But the appearance of my tail bone and bottom look a bit alarming. I have attatched a picture of how it looks now. I know ive only been on antibiotics for two days, but the rate of the cellulitis spread has quadripled from my tail bone to my bottom.

Please let me know if i should seek a further appointment with my doctor because i see no improvement. Also there are these ringlets or sore looking thing on my left cheek that i thought looked weird.
doctor
Answered by Dr. T Chandrakant (54 minutes later)
Brief Answer:
Yes, seek further appointment.

Detailed Answer:
Hi.
Thanks for your feedback and the pictures.
This looks like a cutaneous infection like that of erysipelas.
I think you should seek a further appointment with your Doctor as there is progression of the problem and you may need an additional / change of antibiotic.

You may stop Sitz bath as it may cause soddening of the area.
Apply spirit or Liquid Povidone Iodine.

Keep the area aerated, dry and do not apply any ointment.

Note: For further inquiries on surgery procedure and its risks or complications book an appointment now

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
Answered by
Dr.
Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 19777 Questions

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Suggest Treatment For Pain In Lower Back

Brief Answer: Abscess - treatment as per the cause - additional Ibuprofen Detailed Answer: Hi. Thanks for your query and an elucidate history. To recapitulate in a nutshell: Young 20/F - pain 2 week -towards tail bone - sore pimple - picked - got swollen - pain worsened - purple - ER diagnosis of cellulitis- taking Clindamycin- 1 day- skin on one butt-cheek turned pink - took home remedies of garlic paste - Neosporin locally and Sitz bath twice daily - now concerned > why pink / why purplish > any other remedies you can try.... The spread of the pink skin indicates increased vascularity due to infection , this being a normal reaction of the body. It is definitely normal to have purplish skin with cellulitis. This is due to the clogging of the tissues with venous blood added on with the bacterial action. After re-reading of the history you have provided, I am of the opinion that you need to continue with Clindamycin / Sitz bath. I would advise the following things:: -Apply liquid Povidone Iodine locally and widely to make the area sterile. -Take an anti-inflammatory like Ibuprofen if this suits you at 8 hourly interval after food with Ranitidine. -Second opinion of a Surgeon for direct examination so that the cause can be diagnosed and the possible future course of such a disease can be predicted and treatment planned accordingly. This is important , as we have to decide the ''why'', meaning the actual cause of this cellulitis: Whether this is a pilonidal sinus appearing for the first time / fistula in ano / just a boil caused by breaking of the skin be scratching. Although the initial treatment is same for all, the later treatment for a cure is totally based on the proper diagnosis. If the pain is for about a week, it is possible that the abscess may open on its own and if not it is wise to have a definitive surgery of incision and drainage / Excision of the tract or at least laying it open for a few reasons :: -To get the pus drained out and to get a relief as antibiotics will help more if the pus is let out. -Understand whether this is just a boil / pilonidal sinus or fistula or so. The ultimate aim has to have a ''cure'', and not the temporary relief. I hope this answer helps you to get a proper diagnosis, and get a proper further treatment. Please feel free to ask for more or if you need further clarifications if you feel there is a gap of communication.