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Back pain worse on twisting torso, on waking up.

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Hello, I am a 30 year old male, 6' tall, and 155 lbs. I am in very good physical condition and to my knowledge have no relevant medical history to report.

My question is about back pain. Three or four days ago, I developed fairly severe localized pain in the middle of my back, to the left of my spine. The pain is not constant, but is made worse primarily by twisting my torso and manipulations that require me to arch my back. Some postures relieve it, such as lying flat on a firm surface (e.g. the floor) with no twisting. I would describe the pain as a dull ache that sometimes radiates to other parts of the back. The pain has lessened slightly over the past couple of days but is still present. It tends to be worse immediately after waking up, possibly because of my sleeping position(s).

My question is as follows: are there any additional symptoms that I should watch for, and how can I know whether or not this condition requires immediate medical attention?

Category: Family Physician-GP

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Category: HIV- AIDS Specialist
 26 Doctors Online

Thank you for your query at
I understand your concern.
From the history provided, it seems like a muscular pain, you can apply a local analgesic like Diclofenac gel or take Advil twice daily, and this should come down.
Try to rest for a couple of days, restriction of movements as far as possible, is helpful.
These kind of pain should never have an intensity of more than 5/10, also if the pain starts radiating downwards, for example, towards your flanks, you will need medical attention.
Feel free to discuss further,

Patient replied :

Dr. Sebastian,
Thank you very much for your reply. A follow-up question:
I think I forgot to mention that my back is not sore to the touch anywhere, meaning that I cannot probe the source of the pain just by pressing different parts of my back on the outside. The only consisent thing that causes pain is twisting. Given this, is it still possible for the source of the discomfort to be muscular, or is this an indication that the pain is not musuclar and due to, say, an internal organ?
Thank you again.

As of now, it sounds like a muscular pain.
Kindly take Advil and let me know if the pain subsides.

Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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