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Lower back pain

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Hi, I have been having a variety of pain recently. It started first, in my back. I have been getting a sharp pain in my lower back lately. Sometimes it happens when I am working hard, other times when I am not. I participate in Equestrian sports, and I also have found my back feels over-arched, though I'm not sure. Also, I have been putting a lot of stress on my ankles, and they seem to want to slip outwards. I have tried different stretches, but might consider a support/brace that I can wear under my boots that will help stability.Finally, my knees often give out with a sharp pain behind the patella. I become unable to support myself (I am actually slightly underweight, so that is not the cause). I have heard my back pain might be in relation to this, but I'm not sure. It would be great if you could help me figure out the condition (if there is one) and/or best solution; whether it is braces, physical therapy, or something more severe. Thank you.

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Category: Family Physician-GP
 21 Doctors Online

Hello, it is an extremely common condition where it may be from sore muscles and tendons, slipped discs, fractures and other problems. This must have been developed over a long period of time. Sometimes it is self-inflicted as well as poor posture, over extension of work, while playing, sitting and lifting things carelessly. It may also occur due to straining the band of muscles surrounding the spine. They happen most in the curve of the lower back and base of the neck. Sometimes aches occur for no apparent reason. Known as non-specific backache. In fibrositis, chronic backache comes from the localized muscle tension. Even hormonal and weight gain can add stress leading to backache. Certain sports, accidents and falls can also lead to this. It can also occur due to impingement of the nerves like in sciatica, herniated disc, slipped disc, spinal stenosis or fibromyalgia, osteomyelitis, tumors. Diagnosis can be made by physical examination and detailed history. I would suggest you to get an MRI/ X ray to find out this cause. You can take a painkiller like ibuprofen twice a day after food for a week to relieve the pain. The long-term treatment requires physiotherapy, Acupuncture, exercise. If the back pain is due to a trapped nerve, you can give steroidal injections to the nerve root that has to be done under CT guidance. If the treatments are not effective, then cognitive behavioral therapy and finally surgery can help. Hence it is best to be assessed by an orthopedician for further management. Hope this helps. Thank you.

Dr. John Monheit
Category: Family Physician-GP
Residecny: North Colorado Family Medicine
Medical School: The Chicago Medical Center
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