Question: ATTN: Dr. Kakkar,

This is a follow up question to Dr. Kakkar.

I am the one who consulted you regarding herpes last month.

My girlfriend started to feel something wrong on her lower back a couple days ago.
She says it hurts when she moves, and feels a bit weird even when she stands still
or lie in bed. Yesterday she also experienced a constipation-like pain on her lower stomach too,
though the pain is gone now, only a little constipation.

I get really panicky everytime she tells me there's something wrong with her, especially the area
that's close to the genitals. All kinds of symptoms pops up when I google, so

Do you think this is a symptom related to herpes?

I have been constantly using condoms (but occasional oral sex), taking Valtrex at least 2-3 times
per week. No outbreaks nor even a hint of it.
Here's some follow up info:

Because of the excruciating summer heat, she is experiencing the "summer heat fatigue". The constant change in temperature & humidity caused by the heat & humidity outside versus an air-conditioned room is a real harm to her (averaging 35 degrees celcius + over 90 percent humidity everyday).

She hates summer, and does not XXXXXXX her skin at all.

I hope this info also helps.

Waiting for your sound advice yet again.

Her lower back still hurts.

It seems the pain mainly resides on and around the Ilium, both right and left side.

I called upon a masseur to loosen up her back by pressing her pressure point all over her body. It seems to work for a while, but it started to ache again.

The reason why I am being so panicky is because one of the signal before
the outbreak is getting sciatica. I always take Valtrex whenever there even
a slight hint of that myself. Sciatica only happens only on one side each time (either left or right), and sometimes it's hard to pee. Sometimes it's a sign
of an outbreak, sometimes it's just a typical sciatica.

Since her pain is on both sides of the ilium, it seems it is not suggestive of
herpes as you mentioned. But I just want to dish out as much info to you
as possible so you can give me a clearer diagnosis.

Her constipation is still there. Her temperature is normal.
When pressed her pressure point by the masseur, the notable
pain occured at each side of the buttocks, back of both knees,
around her stomach, shoulder, and upper side of both breasts.
The pain (without pressing the pressure point) only resides
on and around her ilium.
Just wanted to clarify the area that the pain resides.

I am not sure if it is ilium, so I will try to explain it as clearly as possible
without using the exact terminology.

it is on both sides of the top part of the pelvis, the width seems to be
pretty wide, also on both sides. She says the bones hurt.

Since I know that the herpes virus goes to sleep at around the sacral bone,
that's why I am so panicky. I myself never experienced any pain where she says
it hurts. Pain on both sides is also something which may lead to not suggestive
of herpes, but...

I DEARLY HOPE THIS IS NOT HERPES RELATED!!!

Waiting for your yet another sound advice.

Hi,

First off, her lower back pain has subsided. It is now more like a tired back, the culprit most likely stemming from summer heat fatigue + constantly subjected to hot temperature outside and cool temperature in the room.

Thanks again for your pinpoint advice!

Here's a follow up question:

I have been having symptoms of sciatica, sometimes followed by an outbreak (last may be way back in 2005). I heard from some doctor that before an outbreak, a patient sometimes notice sciatica-like pain towards the buttocks, sometimes even lower to the back of the knee and/or the ankle. He said it is because the virus comes out from the sacral bone and passes through the nerves, creating pain on the way to the genitals. If I felt that pain, I take Valtrex as precaution, and the pain goes away in about 24-48 hours.

Do you still think this is not herpes related?

If not, what kind of symptoms do I look for to hunt down the virus before becoming a full blown outbreak?

Since I have been taking Valtrex practically everytime when I get the above symptoms to avoid getting an outbreak, I just presumed that I am doing the correct thing.