When Back Pain is Really Something Else

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Back pain can suck the joy out of your days for weeks, months, even years. While back pain can cause debilitating pain at times, it is rarely cause for something more serious. In fact, pain intensity is a poor indicator of back pain ominousness.  As a clinician we are trained to know when it is “just” back pain or if something serious is going on, but for the general public this pain can be scary as it is confusing. In this article I delve deeper into the extremely rare cases where back pain is really something else.

Kidney

Kidney stones or a kidney infection may cause back pain. Because your kidneys are located toward your back and underneath your ribcage, it may be hard to tell if the pain you’re experiencing in that area is coming from your back or your kidney. The symptoms you’re having can help you figure out which is the source of the pain.

If the pain is coming from your kidney, it will have these features:

1. Kidney pain is felt in your flank, which is the area on either side of your spine between the bottom of your ribcage and your hips. It usually occurs in one side of your body, but it can occur in both sides
2. Kidney pain is usually sharp or a dull ache. Most often it will be constant. It won’t get worse with movement or go away by itself without treatment.
3. Unlike back pain, it usually won’t change with movement

Accompanying symptoms include, but not limited to: fever and chills, nausea and vomiting, cloudy or dark urine, an urgent need to urinate, pain when you urinate, a recent infection in your bladder, blood in your urine.

Cancer

Spine cancer, prostate cancer, and lung cancer are three types that may produce back pain. There are defining features with cancer, that are as telling as they are unique. Chief among them are the location and types of pain experienced, which are quite different from your typical, chronic backache.

Some signs of symptoms that a person may have include:

• Back pain that is present at rest
• Back pain that is worst at night
• Back pain that occurs without any activity
• Back pain that worsens the longer you lie in bed
• Back pain that gets worse when you take a deep breath
• Kidney pain, or painful urination
• Pain in the mid to upper rather than lower back
• Comes with other signs of being unwell

Pancreatitis

This condition involves inflammation of the pancreas, which may cause upper abdominal pain that spreads to the lower left quadrant of the back. Patients may describe the pain as a dull sensation that may be aggravated by eating, especially foods high in fat.

Abdominal Aortic Aneurysm

Most common after the age of 60, abdominal aortic aneurysm is an otherwise rare condition in which the aorta enlarges. While most enlargements present few, if any, symptoms. When they rupture suddenly, two of the most obvious symptoms are sudden onset of severe abdominal pain and sudden onset of severe back pain. The pain may spread to your groin and buttocks, and may radiate down your leg, as well.

Other symptoms of abdominal aortic aneurysm include: passing out, clammy skin, dizziness, nausea and vomiting, rapid heart rate, shock

Ulcerative Colitis. This inflammatory bowel disease is characterized by persistent inflammation in the large intestine, also called the colon. Frequent abdominal cramping from ulcerative colitis can cause lower right back pain. Other symptoms include chronic digestive problems such as diarrhea, rectal pain, weight loss, and fatigue

Appendicitis

While it’s a low risk at 7%, for developing appendicitis in ones’ life, it is most common in children ages 10 to 19. It isn’t hereditary and you can’t pass it on to others, but there is nothing you can do to prevent it or reduce your risk of getting it.

The appendix is located in the lower right hand side of the abdomen. If the appendix is infected (due to blockage) and becomes inflamed, it starts leaking or ruptures It may cause symptoms that include lower right back pain. A typical presentation is sudden-onset abdominal pain with a focal point in the lower right abdomen, with possible additional symptoms of fever, nausea and vomiting, and/or lower right back pain.

Please note that this is not an all encompassing list of more serious cases that cause back pain. Always, always, ALWAYS check with your doctor if you have any concerns about your back pain.

Marina White- CAT(C), CSCS