Brief Answer:
Can be a back muscle strain.

Detailed Answer:
Hello,
Thanks for posting your query.
Back pain is quite COMMON among middle aged individuals. Back muscle strain is one of the MOST common causes of acute to severe lower back pain. Lifting a heavy object, twisting, or a sudden movement can cause muscles or ligaments stretch or develop microscopic tears.

Some other underlying causes like Sciatica, Spondylitis, Lumbar herniated disc, Degenerative disc disease, Isthmic spondylolisthesis etc should be ruled out through clinical examination and radiological investigation (like X- ray, CT scan, Myelogram, MRI etc). Kindly, consult with Orthopedic surgeon regarding this for proper management of the case.

TREATMENT: Some general guidelines can help you to reduce the back pain. These are as follows:

1) Take adequate bed REST with maintaining posture. Individuals who do not regularly exercise to build strength and flexibility are more likely to experience recurrent or prolonged back pain.

2) Alternate Hot water bottle or Ice pack can help to relieve most types of back pain by reducing inflammation.

3) Non-Steroid Anti-Inflammatory Drugs (NSAIDs) are quite useful to reduce inflammation and back pain. You need proper prescription from your doctor.

4) Exercise for Back Pain : It is a key element of almost any back pain treatment plan. You may contact with Physiotherapist regarding this.

It includes 3 components: aerobic conditioning, stretching, and strengthening. The exercises are done through a controlled, progressive program to build more strong and flexible spine.

5) Epidural Steroid Injections - deliver steroids directly into the painful area of the back to reduce inflammation. It doesn't heal the components of the back, but often provide enough pain relief to allow patients to move, exercise and heal.

I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal

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Brief Answer:
Coccydynia likely.

Detailed Answer:
Hello.
Thanks for writing again.
The pain on sitting on hard surfaces is likely to be due to coccydynia. Constipation further adds to the problem. Follow these measures for relief from the symptoms:

1) Avoid sitting down for long periods of time. When seated, do not sit on hard surfaces and do alternate sitting on each side of the buttocks. Also, lean forward and direct your weight away from the tailbone.

2) Take adequate rest and apply cold compresses, avoid any injury to the affected area and take some antiinflammatory and pain medications like ibuprofen(motrin) or diclofenac. Some severe cases with persistent coccydynia are treated with local cortisone injection and surgical resection of the coccyx.

3) You can also use a "doughnut" cushion or pillow to sit on. This cushion has a hole in the middle of it to prevent the tailbone from contacting the flat surface.

4) Also eat a high fiber diet foods to soften stools and avoid constipation.
It is best to get an MRI scan done for proper diagnosis. It will be more helpful than an X-ray.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.

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