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28 year old with severe back and hip pain due to strain. Blood test done. Calcium deficiency detected. Advised for bone mineral density test.

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Patient's height: 160 cm
Weight: 51Kg
Age: 28yrs
Sex: Female
I am married for 10 months now.I am having regular and normal menstrual cycle.

I used to get back pain sometimes during past 3 years.I was working as a software professional then.Now I am not working but physically active. From past 8 months if I walk for sometime or if I stand continuously for 1hr or more, I am getting pain in the heel which leads to severe hip pain . This pain won't get reduced by any pain killers or pain balms and remains atleast for a day.

Now from past 20 days I am having severe back pain continuosly.It is only on right side of the back and below the shoulder.This pain is continuous i.e even if I am in resting position or sleeping it is not getting reduced at all.It is sort of pricking in nature.There is no effect of pain killers and balms.

I had consulted Doctor(orthopedic). He had told me it might be happening due to calcium deficiency. He asked me to get the following tests done:

urea,creatinine,uric acid,
Rh factor

Medication given by doctor:
Tab Pantodac DSR
Tab Nucoxia
Oint Nizer

I have got all the tests done except BMD.Reports yet to come. Is it necessary to get the BMD done?
I want to know what may be the reason for this continuos pain? Am I going through right medication?Please guide me.

Posted Wed, 18 Apr 2012 in Back Pain
Answered by Dr. Rajinder Bajoria 24 hours later
Thanks for nice query.
In a young female ,constant pain in the back without any menstrual problem, not relived by analgesic or medication suggest compression of some nerve or nerve entrapment.
As you are suffering from pain for the last three years or it is getting worse for the last few months disturbing your professional life & even sleep.

In such case detailed investigation can only point the exact cause.

Calcium deficiency can cause backache, but not so severe in intensity.

One thing I would like to know whether the straight leg raising test is positive or not. If positive it points towards herniation of inter-vertebral disc.

Have you got the X-Ray spine AP or lateral view or MRI.

These days the best investigation to find the exact cause or pathology is MRI

So it is worth going straight for MRI if straight leg raising test is positive.

Bone mineral density( BMD) is a medical term referring to the amount of matter per cubic centimeter of bones. It is used in clinical medicine as an indirect indicator of osteoporosis and fracture risk.It may help in reaching diagnosis in some patient.

Back pain is generally classified as
1.Mechanical or nonspecific back pain
2.Secondary back pain.

1.Approximately 98% of back pain are nonspecific back pain which has no serious underlying pathology.

2.Secondary back pain which is caused by an underlying pathology accounts for approximately 2% of the cases.

Underlying pathology in these cases may include
Prolapsed inter-vertebral disc most common cause
Spinal osteomyelitis
Epidural abscess
Tuberculosis of spine is also very common in India leading khyphosis or scoliosis and persistent backache.

Herniated disc(PIVD) is the most common neurologic impairment which is associated with this condition,.

In your case it appears to be a case of herniation of disc.

As your sign & symptoms are increasing & not response to analgesic & medication

Let the report of all the test advised by your orthopedic come, hope it may help to some extent.

Hope I have answered your query, I will be available to answer your follow up queries.

Wish you Good Health and trouble free speedy recovery.

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