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What causes back pain with history of disc bulge at L4-L5 and L5-S1 level?

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Posted on Wed, 11 May 2016
Question: I have had back pain many years. The pain is usually been along spine or just outside spine on the sides. Its most painful along spine but i noticed a soreness along bottom of ribs a few months ago. Its seemed to go away for a bit but came back.
I have had multiple work ups over the last 6 months to check kidneys as I have always been concerned because of having to take meds for acid reflux and back pain( no NSAID's because they irritate my stomach).
Anyway, I went back to doctor again due to back pain feeling different and again, all tests and labs were normal.
my last check was a little over a month ago and it consisted of bloodwork, urinalysis, scans.
All local doctors have assured me its likely back muscles likely from disc issues but did say watch for kidney stones which confused me because they said they saw none?
I am guilty of not drinking much water and I do drink more sodas than I should.

My history and most recent results of blood work and tests are below

41 y/o Ex- fireman and current construction company owner( early work was very physical had a few back injuries like sprains and pulls).
My weight is 208, height 5'8"(muscular)
I have 10 year old diagnosis of L4-L5 & L5-S1 disc bulges as well as a slight thorasic bulges and a cervical herniation. Back was evaluated by neuro a few years back with no significant changes.

Have had chronic minor to moderate back pain for around 15 years.

TESTS and LABS - from last check up, 30 days ago

creatine was 1.1

BUN - 12

GFR - normal

Glucose 112



URINALYSIS & B/P

Protein - neg

glucose - neg

blood - neg

Leuk - neg

urinalysis all negative

B/P 127/88

scans all normal

i've been without insurance for a month, so Ive written on here quite a bit.
I even bought medical urine test strips from a medical supplier that check for protein, blood, and sugar...( regent strips).
Ive been testing with the strips the last several days and the strips are always negative for everything.
so,
My guess has always been that this might be due to me sleeping on the couch. This morning however while using a public restroom I noticed my urine was cloudy.
I talked to my brother on the phone shortly after and I explained what just happened and to my XXXXXXX he said "oh, it's kidney stones, Ive gotten them off and on for the last 10 years". He said he would notice back soreness for a while and then after he passed the cloudy urine he began feeling better. He said he's had tons of work ups including seeing all kinds of specialists doctors.
He said his scans were normal as well and his doctor told him he was passing little tiny crystals. He also said his doctor told him he neded to consistantly drink enough water or those little crystals can form into a big stone and he wouldnt want that.
I left the coversation confused. First, I never knew anyone in my family got these and 2nd, this confused me as I always thought people pased stones not cloudy urine or crystals. He said his doctor told him that dehydration plays a big role in this and to just drink a healthy amount of water each day, for a while consistantly and it usually gets you back on track and he has and he has been fine.
Thats the only time i've ever had cloudy urine in the last few months.
Given all my testing is that what this is?
doctor
Answered by Dr. Indu Kumar (2 hours later)
Brief Answer:
Hypothyroidism,arthritis,low calcium,low vitD etc should also be ruled out.

Detailed Answer:
Hello
Thanks for writing to HCM

Only disc bulge at L4-5 and L5-S1 level is not expected to cause back pain unless there is nerve root compression.
Other causes like hypothyroidism,arthritis,low calcium,low vitamin D level etc should also be ruled out as these conditions may also cause back pain.

Cloudy urine is most likely due to dehydration as urine examination is normal.
It is not a very serious issue.
It is good that other investigations are also normal.

You may need few more blood test like thyroid profile,HsCRP,serum calcium,vitamin D level etc.You may also need X-rays of both hand,SI joint etc.

Get well soon.
Hope I have answered your query.
Further queries are most welcome.

Take Care
Dr. Indu XXXXXXX

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Indu Kumar (1 hour later)
Thyroid tests were fine as well. Vitamin D is a bit low confirmed by my doctor(think around 23).
What about the family history of kidney stone? I wasnt aware that you can have crystals like that
Can staying dehydrated cause some back pain?
I normally dont drink much water? I drink Maybe 4 8oz glasses per day..
Nerve root irritation has been assumed but unable to be seen on MRI but because i get some paresthesia in my right leg my neuro said it could be happening occasionally.
I also showed some slight radiculopathy on EMG.
I forgot to mention that i also havent had any fever burning or foul odor with urination.
I do have another concern.
My wife has been having bladder/ uti type symptoms but nothing has been found.
She travels a lot with work and our marriage is a bit rough. Could an STD cause my issues or would it have been seen.
Her doctor asked if it could be an STD but she said no. I know that admission might be difficult because of the possible consequences. I also dont want to uneccesarily accuse her of anything..
doctor
Answered by Dr. Indu Kumar (12 hours later)
Brief Answer:
I suggest for physiotherapy and exercises for strengthening back muscles.

Detailed Answer:
Hello
Thanks for writing to HCM

Reports doesn't indicate that you have serious findings.
I suggest for physiotherapy and exercises for strengthening back muscles.
You can take vitamin D and calcium supplementation.

Crystals in urine may be due to dehydration.You should drink lot of water.

Get well soon.
Hope I have answered your query.
Further queries are most welcome.

Take Care
Dr. Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Deepak
doctor
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Follow up: Dr. Indu Kumar (2 hours later)
Can dehydration cause back soreness?
doctor
Answered by Dr. Indu Kumar (1 hour later)
Brief Answer:
Dehydration usually doesn't cause back soreness.

Detailed Answer:
Hello
Thanks for writing to HCM

Dehydration usually doesn't cause back soreness.
Have to rule out other causes.


Hope I have answered your query.
Further queries are most welcome.

Take Care
Dr. Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Deepak
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Answered by
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Dr. Indu Kumar

Radiologist

Practicing since :2004

Answered : 6727 Questions

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What causes back pain with history of disc bulge at L4-L5 and L5-S1 level?

Brief Answer: Hypothyroidism,arthritis,low calcium,low vitD etc should also be ruled out. Detailed Answer: Hello Thanks for writing to HCM Only disc bulge at L4-5 and L5-S1 level is not expected to cause back pain unless there is nerve root compression. Other causes like hypothyroidism,arthritis,low calcium,low vitamin D level etc should also be ruled out as these conditions may also cause back pain. Cloudy urine is most likely due to dehydration as urine examination is normal. It is not a very serious issue. It is good that other investigations are also normal. You may need few more blood test like thyroid profile,HsCRP,serum calcium,vitamin D level etc.You may also need X-rays of both hand,SI joint etc. Get well soon. Hope I have answered your query. Further queries are most welcome. Take Care Dr. Indu XXXXXXX