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"Why do I have on-and-off lower back pain on my right side? "


I am a 39 year old white male with a 4 month history of sporadic, yet severe, lower back pain. The pain is on my right side and feels like a spasm. Various medical tests have ruled out kidney stones as the culprit. Also, there appears to be no gastrointestinal cause for the pain. The pain does not seem to be precipitated by any painful muscular injuries or movements. What might be causing this pain?


There are a variety of causes for intermittent low back pain that radiates down one side. Questions to consider include does the pain radiation worsen with position, (i.e.

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sitting, standing, ,or laying flat)? Does the pain radiate down one leg? Any pain or tenderness to palpation along the area that is bothering you? These questions, along with your medical history and clinical exam will help your primary care doctor decide upon the appropriate work up. This may include imaging studies and perhaps a referral to a specialist for further work up. It appears from your description that a thorough work up has been done to date which has been negative. Possible other causes to consider include symptoms related to spinal nerve root compression syndromes, often caused by degenerative changes. In these cases, an MRI of the low back may help find something potentially causing compression. Treatment of the symptoms that you are experiencing may include NSAIDs, heating or cooling packs, stretching, epidural steroid injections, and physical and occupational therapy. But again, it is recommended that you discuss this with your primary care doctor who will best be able to decide upon the appropriate work up and treatment options available.

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