Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For Burning Pain In Left Lower Back
Question: Hi,
I had a total hysterectomy (but kept my ovaries) done vaginally in July 2015. The surgery was conducted with me in stirrups to my understanding and when I woke up from the anaesthetic I had a burning pain in my left lower back. Over the next 3 days in hospital I was unable to lay flat and the pain in my back continued but was alleviated with heat packs and no doubt the pain killers that the nurses gave me. After returning home 4 days later I was unable to lay flat at all (nor lay on my side due to the surgery). The pain was intense but not when I was standing and walking around. I was unable to sit unless I sat on the sofa in a reclined position with pillows under my knees and supporting my lumbar area. That was 9 months ago and I have continued to suffer with lower back pain and still unable to sit for longer than 15 minutes without pain. I can't lay flat on my back without pillows under my knees and can only sleep side on with a pillow between by knees. Standing for long periods hurts also. I have had months of treatments with Pain Specialists, Physiotherapists and more recently a Muscular Skeletal Physcian. I have had 3 x MRI's done. The first in Sept 2015 said a minor protruding disc L5/S1 and some facet joint arthritis. The second one done in Oct 2015 somewhere different said everything was normal and at the time my Pain Specialist concluded it was "ligamentous" most likely and would settle down. Two physiotherapists after that diagnosed "sacroilitis" given a lot of my pain is in my Sacroiliac joint along with gluteal muscles spasms and aching hips and groin. More recently the Muscular skeletal physician diagnosed disc problems and disgarded the sacroilitis diagnosis as incorrect. He gave me a caudal epidural 3 weeks ago which in the first week increased my pain and has given me some side effects. My pain level is now the same as it was before the injection. My most recent MRI this week says everything is normal and no mention of disc protrusion.
Despite abiding by a stretching and walking routine my pain has got slightly worse over the past 9 months and moved around a bit. Mostly my pain is in the following areas:
1. Lower back around the sacrum and lower spine area
2. Lower back on the right side with some muscular discomfort higher up on the right side
3. Groin, hip area giving the feeling of things being very 'tight'
4. Gluteal area particularly in the medius and minimus areas
I have found it difficult despite my research and the several doctors and physiotherapist to know what to do to improve my back pain. I am reluctant to go back to any forms of exercise other than walking given the stretching and exercise routines prescribed for me have all increased my pain. Do you have any recommendations for what I should do next and what your thoughts are on what the likely problem could be?
Many thanks in advance for your time
XXXX
I had a total hysterectomy (but kept my ovaries) done vaginally in July 2015. The surgery was conducted with me in stirrups to my understanding and when I woke up from the anaesthetic I had a burning pain in my left lower back. Over the next 3 days in hospital I was unable to lay flat and the pain in my back continued but was alleviated with heat packs and no doubt the pain killers that the nurses gave me. After returning home 4 days later I was unable to lay flat at all (nor lay on my side due to the surgery). The pain was intense but not when I was standing and walking around. I was unable to sit unless I sat on the sofa in a reclined position with pillows under my knees and supporting my lumbar area. That was 9 months ago and I have continued to suffer with lower back pain and still unable to sit for longer than 15 minutes without pain. I can't lay flat on my back without pillows under my knees and can only sleep side on with a pillow between by knees. Standing for long periods hurts also. I have had months of treatments with Pain Specialists, Physiotherapists and more recently a Muscular Skeletal Physcian. I have had 3 x MRI's done. The first in Sept 2015 said a minor protruding disc L5/S1 and some facet joint arthritis. The second one done in Oct 2015 somewhere different said everything was normal and at the time my Pain Specialist concluded it was "ligamentous" most likely and would settle down. Two physiotherapists after that diagnosed "sacroilitis" given a lot of my pain is in my Sacroiliac joint along with gluteal muscles spasms and aching hips and groin. More recently the Muscular skeletal physician diagnosed disc problems and disgarded the sacroilitis diagnosis as incorrect. He gave me a caudal epidural 3 weeks ago which in the first week increased my pain and has given me some side effects. My pain level is now the same as it was before the injection. My most recent MRI this week says everything is normal and no mention of disc protrusion.
Despite abiding by a stretching and walking routine my pain has got slightly worse over the past 9 months and moved around a bit. Mostly my pain is in the following areas:
1. Lower back around the sacrum and lower spine area
2. Lower back on the right side with some muscular discomfort higher up on the right side
3. Groin, hip area giving the feeling of things being very 'tight'
4. Gluteal area particularly in the medius and minimus areas
I have found it difficult despite my research and the several doctors and physiotherapist to know what to do to improve my back pain. I am reluctant to go back to any forms of exercise other than walking given the stretching and exercise routines prescribed for me have all increased my pain. Do you have any recommendations for what I should do next and what your thoughts are on what the likely problem could be?
Many thanks in advance for your time
XXXX
Brief Answer:
Needs facetal joint injection, flexion and extension xrays
Detailed Answer:
Hi there.
Thanks for the query.
It appears that you have spasm of the adductor muscles causing tightness in the groin.
Since you have facetal arthritis, a steroid with local anaesthetic could be injected into the joint space and this shall offer good relief.
Also sometimes spinal instability can be associated with facetal joint arthritis so it is important to get some investigations done like Xray of the lumbosacral spine in flexion and extension views.
Applying hot packs shall also offer some relief at home.
Once I review the xrays as requested for, I can comment on any further management. As of now you can request a facetal joint injection from your Pain management specialist.
I hope I have answered your query.
I will be available to answer your follow up queries.
Regards,
Dr. Aashish Raghu
Needs facetal joint injection, flexion and extension xrays
Detailed Answer:
Hi there.
Thanks for the query.
It appears that you have spasm of the adductor muscles causing tightness in the groin.
Since you have facetal arthritis, a steroid with local anaesthetic could be injected into the joint space and this shall offer good relief.
Also sometimes spinal instability can be associated with facetal joint arthritis so it is important to get some investigations done like Xray of the lumbosacral spine in flexion and extension views.
Applying hot packs shall also offer some relief at home.
Once I review the xrays as requested for, I can comment on any further management. As of now you can request a facetal joint injection from your Pain management specialist.
I hope I have answered your query.
I will be available to answer your follow up queries.
Regards,
Dr. Aashish Raghu
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you Dr XXXXXXX for your reply. I recently had a caudal epidural but have had a bad reaction presumedly to the cortisone so am reluctant to have anymore cortisone injections. I am suffering from quite severe peripheral neuropathy. I also find ice is more effective for pain relief on my lower back.
You mention X-rays -would an MRI show more information?
Many thanks
XXXX
You mention X-rays -would an MRI show more information?
Many thanks
XXXX
Brief Answer:
Need to see if any abnormal motion of the spine relative to its position
Detailed Answer:
The MRI won't show if the spine has any abnormal motion relative to its position.
Xray in bending forward (flexion) and bending backwards (extension) is helpful to looking for abnormal motion of the spine, suggesting instability and the need for surgery if present.
Need to see if any abnormal motion of the spine relative to its position
Detailed Answer:
The MRI won't show if the spine has any abnormal motion relative to its position.
Xray in bending forward (flexion) and bending backwards (extension) is helpful to looking for abnormal motion of the spine, suggesting instability and the need for surgery if present.
Above answer was peer-reviewed by :
Dr. Yogesh D
Thank you Dr XXXXXXX No others doctors have suggested this yet so I will look into getting these X-rays done. You mention an abnormal motion of the spine? I had no back issues before my surgery last year and certainly not looking to blame any doctors but instead understand what could have caused this abnormality? Is it a trauma injury?
Brief Answer:
Trauma or even congenitally weak bones in that region
Detailed Answer:
This abnormal motion could be due to trauma such as a fall or it could be due to congenitally weak bones in that region which can cause the same.
Trauma or even congenitally weak bones in that region
Detailed Answer:
This abnormal motion could be due to trauma such as a fall or it could be due to congenitally weak bones in that region which can cause the same.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Yogesh D
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
