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What Causes Lower Back Pain And Recurring Sacroiliac Pain?
Question: Hi there,
My poop occasionally smells like vomit. I get tired easily while normally in great shape. I have had lower back pain and sacroiliac pain on and off every 2 -3 month and lasting 1-2 months in duration for the past year. Back pain is preceded by crackling noises coming from my spine 1-2 weeks before. Feels like my connective tissue is loosening up causing my spine to misalign. It is strange because it is cyclic. This all Started following the flu last year with which was later followed by a rash on my abdomen lasting 3 months. Could this be a virus or bacteria causing this?
Any ideas?
My poop occasionally smells like vomit. I get tired easily while normally in great shape. I have had lower back pain and sacroiliac pain on and off every 2 -3 month and lasting 1-2 months in duration for the past year. Back pain is preceded by crackling noises coming from my spine 1-2 weeks before. Feels like my connective tissue is loosening up causing my spine to misalign. It is strange because it is cyclic. This all Started following the flu last year with which was later followed by a rash on my abdomen lasting 3 months. Could this be a virus or bacteria causing this?
Any ideas?
Brief Answer:
degenerative OA likely, investigate for infection
Detailed Answer:
Hello,
Lower back pain and sacro-ilitis pain recurrence is common with degenerative osteo arthritis and ankylosing spondilytis like conditions. Since you have cyclical symptoms along with stool problems, infections by bacteria and virus may be possible, but rarer in statistics unless proved by tests. Moreover endemicity of particular bacteria or virus may be prepondering factors; but immunity,good health of a person prevents it.
Considering these facts, I will encourage you to consult a spine/orthopedic surgeon. I would consider blood tests and stool tests to check for microbial infection and also look for orthopedic causes in spine by MRI, X Rays, serum test for HLA B27 and few other tests like CBC, CRP, RA factor, ESR, ASO titre. Physical therapy, back strengthening exercises, hot fomenataion, application of muscle relaxant gel/cream till the diagnosis is ascertained.
Best wishes,
degenerative OA likely, investigate for infection
Detailed Answer:
Hello,
Lower back pain and sacro-ilitis pain recurrence is common with degenerative osteo arthritis and ankylosing spondilytis like conditions. Since you have cyclical symptoms along with stool problems, infections by bacteria and virus may be possible, but rarer in statistics unless proved by tests. Moreover endemicity of particular bacteria or virus may be prepondering factors; but immunity,good health of a person prevents it.
Considering these facts, I will encourage you to consult a spine/orthopedic surgeon. I would consider blood tests and stool tests to check for microbial infection and also look for orthopedic causes in spine by MRI, X Rays, serum test for HLA B27 and few other tests like CBC, CRP, RA factor, ESR, ASO titre. Physical therapy, back strengthening exercises, hot fomenataion, application of muscle relaxant gel/cream till the diagnosis is ascertained.
Best wishes,
Above answer was peer-reviewed by :
Dr. Prasad
Thank you, Dr. XXXXXXX
You have given me more information than the 4 Dr's I have seen over the past year. The pain is incapacitating when it comes. I can barely walk, or sleep due to moving the wrong way causing excruciating pain. It really feels like I am being attacked by a micro organism as it was not precipitated by any physical action and it all began after having that terrible flu virus In XXXXXXX of 2014- totally out of the blue. The only warning Sign being the crackling noise coming from my spine without me even moving. I never had any crackling from any joints before-not even when I would try to crack a knuckle or my back - nothing. The crackling was just a noise with no associated pain. I have NEVER had any back pain previously in my life except for 2 days when I was pregnant in 2009. As of last year I was able to do a front handspring and am very strong. This doesn't make sense. Can OA attack so violently? I also have had 3 major attacks of terrible pain radiating from my gallbladder/ pancreas area. Dr.'s say all my bloodwork is normal and that I am completely healthy! All my blood tests and HLA -B27 came back normal/negative. I had a person living with me for a year that has Ankylosing spondylitis and also a major digestive problem due to having his gallbladder out and part of his pancreas. He is ridden with diarrhea explosions which I had to clean up. He was living with us for a year and shortly thereafter I started experiencing these symptoms. I read there is only a 5% chance that I could have Ankylosising Spond. without having the gene associated with it. Is there anyway I can tell if I have it(AS) other that waiting until I am crippled? I will ask for a stool sample. I heard that Klebsiella pneumoniae Abundance in the intestine is associated with the AS disease. Have you heard this?
Thanks Dr!
Sincere appreciation,
XXXXXX
You have given me more information than the 4 Dr's I have seen over the past year. The pain is incapacitating when it comes. I can barely walk, or sleep due to moving the wrong way causing excruciating pain. It really feels like I am being attacked by a micro organism as it was not precipitated by any physical action and it all began after having that terrible flu virus In XXXXXXX of 2014- totally out of the blue. The only warning Sign being the crackling noise coming from my spine without me even moving. I never had any crackling from any joints before-not even when I would try to crack a knuckle or my back - nothing. The crackling was just a noise with no associated pain. I have NEVER had any back pain previously in my life except for 2 days when I was pregnant in 2009. As of last year I was able to do a front handspring and am very strong. This doesn't make sense. Can OA attack so violently? I also have had 3 major attacks of terrible pain radiating from my gallbladder/ pancreas area. Dr.'s say all my bloodwork is normal and that I am completely healthy! All my blood tests and HLA -B27 came back normal/negative. I had a person living with me for a year that has Ankylosing spondylitis and also a major digestive problem due to having his gallbladder out and part of his pancreas. He is ridden with diarrhea explosions which I had to clean up. He was living with us for a year and shortly thereafter I started experiencing these symptoms. I read there is only a 5% chance that I could have Ankylosising Spond. without having the gene associated with it. Is there anyway I can tell if I have it(AS) other that waiting until I am crippled? I will ask for a stool sample. I heard that Klebsiella pneumoniae Abundance in the intestine is associated with the AS disease. Have you heard this?
Thanks Dr!
Sincere appreciation,
XXXXXX
Brief Answer:
K.pneumonie is not directly causing AS,chance finding with HLA 27positive
Detailed Answer:
Thank you XXXXXXX for the query
In your case since you are HLA-B27 negative chances for akylosing is remote.If stool culture is done and klebsiela is not found it would be surer
What I read was klebsiella pneumoniie if present in HLA_B27 positive patients chances for ankylosing spondilytis are higher and not that the bacteria directly influence any gene or cause ankylosing spondylitis
Besides, your x ray would show typical appearance of "bamboo spine" - a finding which is characterised by radiologists.sacro-iliac joints show very diminished space
Perhaps your doctors have seen the images and there is nothing yet to show in x rays also besides HLA-B27
You may consult a spine specialist also
Best wishes,regards,
Dr XXXXXXX
K.pneumonie is not directly causing AS,chance finding with HLA 27positive
Detailed Answer:
Thank you XXXXXXX for the query
In your case since you are HLA-B27 negative chances for akylosing is remote.If stool culture is done and klebsiela is not found it would be surer
What I read was klebsiella pneumoniie if present in HLA_B27 positive patients chances for ankylosing spondilytis are higher and not that the bacteria directly influence any gene or cause ankylosing spondylitis
Besides, your x ray would show typical appearance of "bamboo spine" - a finding which is characterised by radiologists.sacro-iliac joints show very diminished space
Perhaps your doctors have seen the images and there is nothing yet to show in x rays also besides HLA-B27
You may consult a spine specialist also
Best wishes,regards,
Dr XXXXXXX
Above answer was peer-reviewed by :
Dr. Raju A.T
Thank you Dr XXXXXXX
Last questions are, would the Radiologist see bamboo spine/ diminished sacroilliac space after 1 year of symptoms? How long does it normally take to manifest on X-rays? Can I take an antibiotic to help my immune system fight this attack? If so which one is best?
Are there any other tests to determine that it is Ank Spond for sure, or definitely not Ank Spond?
Thank you,
XXXXXX
Last questions are, would the Radiologist see bamboo spine/ diminished sacroilliac space after 1 year of symptoms? How long does it normally take to manifest on X-rays? Can I take an antibiotic to help my immune system fight this attack? If so which one is best?
Are there any other tests to determine that it is Ank Spond for sure, or definitely not Ank Spond?
Thank you,
XXXXXX
Brief Answer:
radio logical findings take long to come
Detailed Answer:
Thank you for the query.HlaB27 if negative then remote chance of as.
Stool and blood culture may be done to rule out infection
AS sometimes takes long periods to give classical features on x ray and depends on rapidity of process and host immunity and strength sometimes few years
Treatment is by cortisone and nsaid antiinflammatory
Chance infections have to be dealt with culture and sensitivity reports
In absence of HLAB27, but positive klebsiela or any bacteria is a chance infection due to other causes and instead of producing AS may spread hematogeniously to cause infection of spine in some, but is rare.AS is not a infective disease but due to immune factors
Regards
radio logical findings take long to come
Detailed Answer:
Thank you for the query.HlaB27 if negative then remote chance of as.
Stool and blood culture may be done to rule out infection
AS sometimes takes long periods to give classical features on x ray and depends on rapidity of process and host immunity and strength sometimes few years
Treatment is by cortisone and nsaid antiinflammatory
Chance infections have to be dealt with culture and sensitivity reports
In absence of HLAB27, but positive klebsiela or any bacteria is a chance infection due to other causes and instead of producing AS may spread hematogeniously to cause infection of spine in some, but is rare.AS is not a infective disease but due to immune factors
Regards
Above answer was peer-reviewed by :
Dr. Prasad
It is funny I have to go to XXXXXXX to find out what's wrong with me when we live in the US and are supposed to have one of the best healthcare around. None of my Dr.'s have given me half of the information you have. Thank you, again. I really appreciate your help. You are great!
Take care,
XXXXXXX
Take care,
XXXXXXX
Brief Answer:
thank you
Detailed Answer:
Thank you XXXXXXX for considering our answers worthy
Wish you good health,
Regards,
Sunil
thank you
Detailed Answer:
Thank you XXXXXXX for considering our answers worthy
Wish you good health,
Regards,
Sunil
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Above answer was peer-reviewed by :
Dr. Pradeep Vitta
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