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What could be the reason for a lump in my back?

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Internal Medicine Specialist
Practicing since : 1998
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I'm a 35 y/o male, 6'6" 265lbs. I noticed a quarter sized lump on the left side of my back next to my shoulder blade after about a month of discomfort, now the discomfort has gone to pain just above the lump, I am also experiencing pain on the left side of my neck under the jaw, and under my left pectoral muscle, especially when I put pressure on the lump, now I'm getting burning pains that run down my left arm to the middle of my wrist, I have seen my pcp, he said its a tense muscle or a fatty deposit, I've been put on muscle relaxers for two weeks which had no effect, and received a shot which I believe was cortizone, which also did nothing. There are times when just above the lump it feels like something is crawling on me which causes me to itch that area, there has also been a few nights where I've had night sweats, I've also had chronic epididymitis for the past four months and not sure if thats related, should I start seeing another doctor? I'm just not sure what to do.
Posted Wed, 25 Apr 2012 in Bones, Muscles and Joints
Answered by Dr. Jasvinder Singh 42 minutes later

Thanks for posting your query.

From the symptoms that you have mentioned four important possibilities are coming to my mind which need to be evaluated:

1)     Firstly this swollen lump which is causing radiating pain can be a swollen lymph node in relation to the epididymitis infection that you had recently. Lymphadenopathy (swollen lymph nodes) is usually caused by a viral or bacterial infection. Other causes include allergic reactions or some malignancy.

2)     Second possibility is of any cyst which is a small cystic swelling filled with a soft, whitish brown material called sebum that sometimes oozes out onto the skin's surface. It can regress in size when the sebum decreases.

3)     Third possibility is of a benign skin growth or a boil/ abscess which is causing localized pain as well as radiating pain due to compression of the underlying nerves and spinal nerves. This compression of nerves may cause referred pain in neck, arms, wrists etc which are supplied by the spinal nerves.

You need to get a MRI scan and a FNAC (fine needle aspiration cytology) of the lump. FNAC is aspiration of the material of the glands which is done by a fine gauge needle (22 or 25 gauge) and a syringe. MRI scan is the best test for detecting the cause of any both these tests need to be done soon. Hence please get this lump evaluated from a surgeon.

Till then, apply warm compresses on the area and take some over the counter anti-inflammatory pain killer after consulting your doctor. You can also take some vitamin B12 like Neurobion supplements for the nerve pain after consulting your 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.
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