General Discomfort in Abdomen and pinching/pressing sensation in the lower back

Bones, joints and muscles
1

I am an Indian male, 27 years old, 5'7" in height and weighing about 122 pounds. I have had no major health issues for the past two years and particularly for the past one year I have had no health issues whatsoever. (Before the onset of my present problem).

    It all started about a 4 weeks ago, when I started feeling some discomfort on the right side of my abdomen, in the region between the hip bone and the lower rib. While the discomfort was spread around on the front and back of my abdomen, pressing around the region usually made it look like the pain was originating in the side, almost right from my ribs. Nonetheless, since it was on the right side, I walked to the health center to make sure it wasn't anything related to my appendix. Other than the discomfort, I was perfectly healthy, with no fever, nausea and a normal bowel movement and bladder function.

    The doctor recommended that I visit the ER. They did some urine work, blood work, an ultrasound and an x-ray, and concluded that it was probably something muscular.

    For the next one week, I was mostly in bed, only stepping out to cycle for about 15min-20 min on a couple of occasions. I didn't have any other symptoms during this time, other than some mild constipation ( Bowel movement every 2 days, but no pain or severe difficulty), but was passing a lot of gas on some occasions.

    One week after my first appointment, I started having severe discomfort in my back. It wasn't like pain, but more like general uneasiness spread all over my back. This was so uncomfortable, that I went to the ER again one night as I was unable to sleep ( The discomfort was worse when lying on my back or lying on my left side). Again they did some blood work and urine work, and this time a CT scan of the abdomen (No contrast). The doctor again told me that all the tests were normal and told me that it was probably muscular. Around this time I had lost my appetite as well, and I was mostly preferring easy to digest foods (and lots of fluids).

    I followed up with my primary healthcare provider, and he suggested checking my kidneys just to make sure that there were no kidney stones. A basic urine test came out clean and a few days later, he did a blood test, which showed that I was borderline anemic (HCT at 39.3% corresponding to a lower limit of 40%). He recommended that I take some Vitamin supplements, which I have been taking since.

     For the past 5 days however, I started having a pinching sensation just above my right buttock (on the right part of the sacrum) and occasional pressure/tingling in the lower part of my spine. My backbone itself doesn't hurt when I touch it (The doctor tapped around strongly all over my back and other than the impact, I didn't feel any pain outside the normal). There are no noticeable lumps or swelling on my back on at the point where I can feel the pinch. When I lie down, I feel as if my backbone is being pushed out (The sensation is limited to my lower back, and my upper back feels normal). and as if something is pressing against (or pinching) a spot just above my right buttock. I visited my doctor and the ER again a couple of days ago when the discomfort was at it's worst, and again with my blood work normal and with no other symptoms (No fever, no nausea, vomiting, no diarrhea, no visible blood in stools, normal urine, no pain while urinating etc) I was told that this was probably a muscular/skeletal issue and nothing dangerous and was given some tylenol, muscle patches and told to do some basic stretching.

     Since the last diagnosis (2 days ago), the irritation in my lower back (the pinching sensation and the bone-jutting out sensation) have somewhat decreased, but still trouble me depending on my position (Walking or standing is usually the best, with some seating positions, while it's the worst while lying down). And my left leg feels weak (no numbness or tingling, but a general weakness around the knees). Also, sometimes pressing around on the front of my abdomen and groin also causes that pinching sensation in the lower back. And I have to add that other than some short bursts of activity, I have been mostly lying in bed for the past 3 weeks.

     I am scheduled to move to a new city in the next week and the lack of a diagnosis for my problem is really messing around with me. While I am calm most of the time, I get very agitated some times. To top off that, my friend googled my symptoms and naturally that turned up a lot of dangerous ailments and this has got me further worried.

    Any suggestions about a possible course of action or an account of a similar experience will be really helpful.

   

2

Just to give some background, while I don't do any intensive physical exercise, I typically used to walk a mile or 2 everyday. For 3-4 months before the onset of my present problem however, I was very stressed out, and while I was walking around a lot, my diet wasn't impressive, typically taking one light meal, one heavy meal and occasional snacks on an average day and with a completely destroyed sleep cycle.

    About 2-3 weeks before the onset of my problem, I broke free of the stress and was in good spirits, but my eating and sleeping habits were still the same and I struggled to get them back to normal. About 10 days before my problem started, I did a bout of cycling for about 2 hours (The roads here are rather uneven as it is a hilly region). While it isn't anything radical, It had been several years since I exerted myself so much. I felt tired and sore for the next couple of days, but I seemed to be back to normal before the pain in the right abdomen started.

3

Anirudh, that all sounds awful.  I hurt my back six months ago but actually my whole problem began with pain around the right hand side of my ribcage an in my pelvis.  When I say pain it was more like you describe, tightness nd pressure almost.  I am a 52 year old female, I was extremely fit and active and never really  have any health problems.  I was having a particularly stressful time in my marriage at the time and was not sleeping well so I was probably over exercising and under rested.    Anyway to cut a long story short I had a CT scan, blood taken, liver tests, kidney tests etc etc and everything was fine.  I had an MRI which did shoe degeneration in my left lumbar spine area but nothing severe.  I had no back pain but like you also mentioned I couldn’t sleep on my side and the pressure felt worse when lying on my back.  I was told it was muscular.  It was extremely frustrating not to really have an answer.  I then began getting tingling in my lower back, calves and sometimes my pelvis and it was concluded by my GP that I had a trapped nerve as well as a muscular issue that was causing the rib tightness. I then began to get back pain and  was given a flexion x Ray which established I had bulging discs L4/L5 and L5/S1.   This seems very long winded an I only mention it all as I think by the sounds of it you have strained something doing your long cycle that your body wasn’t used to.  I never got to the bottom of my rib tightness but another GP told me that your spine is so integral to all movement that it can give you very confusing symptoms sometimes.  I know it’s extremely frustrating just to be given a vague answer but at least you have had lots of tests to rule out anything nasty which is the most important thing.  I have gradually got better although I’m not back to normal yet but I would suggest you try to keep walking etc to keep your body movement flowing and eat well and take care of yourself and your body will heal. Cycling though can put a good deal of pressure on your lower spine as your discs are compressed most when you are sitting.  I don’t know if any of this helps you but I hope it does but if you’re still worried go back to another GP and ask his opinion.   Take care 

4

Has anyone tested a stool sample for blood? That's a test that I would suggest you ask about having. If you had an impacted colon that would have shown up on one of the types of imaging you had done but blood in your stool would not show up in any kind of test you mentioned. You also want to go to the hospital and wherever else you had test run and get copies of those results so that you have those when you move to your new location. It'll be easier for you to get it now while you're local then when you have to do it by mail later on.

Your first pain on your right side may have been referred pain from your back. It is possible, as it happened to me, for you to feel the referred pain before you feel the source of the pain. In my case, my back. Sometimes back pain happens for no apparent reason. And that's something many of us have a hard time accepting. Of course giving your young age it is more likely that your back pain is caused by something such as an accident, injury or illness.

Another thought is to go back to what the doctors are saying that it's possibly a muscle problem. There are muscles that holds your ribs together but allow the ribs to expand whenever you take a breath. Those are called intercostal muscles. If you pull one or some of these muscles it can be extremely painful. And it can take several weeks to a few months for it to start getting better. When I had the problem it lasted me about a month maybe a bit longer and the pain was excruciating. In your case I would suggest you try alternating ice and heat on the affected areas. Be sure to include your right side as well as all the way around to your spine. If this is the problem then rest is the best thing for you. But if it is your back that's causing the problem then being in bed all day can make things worse. It may feel better to lay around resting but what that does is weaken your back and all of your core muscles. Then you don't have good solid muscles to support the areas where the pain is.

I am 56 years old and have suffered from lower back pain for 13 years. So I do know a thing or two about back pain and pain in general. It has been my observation that younger people like yourself are not treated the same way as someone my age when it comes to pain particularly undiagnosed back pain. I hear from all kinds of young people like yourself that suffers needlessly because their doctor have a problem being aggressive with their pain.