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What causes persistant lower back pain for years?

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Orthopaedic Surgeon
Practicing since : 1998
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I have had lower back pain for years that doctors haven't been able to help me with. I wondering if the reason is because the focus has been on the spinal region. Ground zero is actually a few inches to the right. I always accepted that the most probable cause was a pinched nerve that causes pain to show up in expected locations. However, I have searched for a long time for a clear diagram of what I call the pelvis cradle (know that this isn't a professional term). I had always looked for alternate joints, but now think that it may be ligament or joint / ligament connection. I can place my finger on the location and feel movement that corresponds to pain (particularly going down stairs). If I return to a medical professional for further diagnosis, what do you suggest?
Posted Thu, 30 Jan 2014 in Back Pain
 
 
Answered by Dr. Vaibhav Gandhi 31 minutes later
Brief Answer: Due to compression of nerve root there is pain Detailed Answer: Hello, I have studied your case. Due to compression of this nerve root there is pain in your back. Due to diabetes there is degeneration and associated osteoporosis I will advise you to do MRI spine For these symptoms analgesic and neurotropic medication can be started. Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help. Physiotherapy like ultrasound and interferential therapy will give quick relief. I will advise to check your vit B12 and vit D3 level. Ultrasonography abdomen and pelvis will help to rule out other pathology leading to pain. So you should consult orthopaedic doctor. Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care
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Follow-up: What causes persistant lower back pain for years? 9 minutes later
ok, this is pretty much what I have been told by local doctors. I have had a spinal mri. While there is some narrowing involving L4 and L5, they did not think there was enough to warrant a surgerical solution. What's I wondering is, could the pain be from a non-nerve related issue, i.e, inflammation of ligament ,,,, other joint pain in pelvis reason. The pain location is very specific - a few inches to the right (assuming frontal view) of the spine at the belt level. I can put my finger on this location and feel movement that corresponds to pain. This is especially severe going down stairs or more specifically when the level of my pelvis from one side to the other becomes out of alignment.
 
 
Answered by Dr. Vaibhav Gandhi 17 hours later
Brief Answer: Hip ligament pathology leading to pain . Detailed Answer: Hello As per your symptom other than spine, there can be possibility of hip ligament [iliofemoral ,ischiofemoral ]pathology leading to pain while walking downstairs. In spinal canal stenosis due to ligament flavum hypertrophy these can be pain while walking downstairs. I will advise high frequency ultrasound hip and pelvis to look for any ligament or related pathology. Bone scan will also help to find any foci of lesion which may not be visible on MRI spine. Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Take care
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