DH's Back pain medical mystery?

[bisous]

DH has had back pain since January. For background he ALWAYS has back pain. Everything from lower back strain, to a broken shoulder blade that flares up to some damage to the discs in his spine. Since the pain never really relented he finally had it looked at.

This is pain in his left lower side. The doctor suspected a kidney infection. An initial urinalysis determined that there is significant blood and mucus (ew!) in his urine but it didn't show any significant bacterial presence. He is allergic to IV contrast (broke out in severe hives for 2 weeks last time he tried it, over 15 years ago) so they first tried an ultrasound which didn't show anything. Then they tried a CAT scan without IV contrast. They discovered that he DOES have a kidney stone (.4mm--so small)...but on the RIGHT side, not the left where he's having pain!

Is that so weird?

Doctor referred him to PT. The pain STARTED when he moved oddly. I have always thought it was probably some kind of bad movement?? It is a little strange though that the pain has not at all abated and also that he has blood and mucus in his urine?

Another strange thing, his back hurts worst while he is SITTING. He can take down a shrub in our yard and while his back still hurts, it isn't excruciating, but it kills him while he sits?

Would love any thoughts you've got. We're working with doctors but nothing is making sense.

THANK YOU!

[Liziz]

If he hasn't done PT before now, I have high hopes for that. Low back pain is pretty terrible, but PT can make a huge difference. For many people, once there's an initial strain or injury, it really doesn't just go back to "normal" on its own without doing consistent exercises/stretches. The good news is that PT can work wonders if people put in the effort. My DH had a pretty significant back injury years ago - his pain is like your DH's -- he can move around and do things without too much issue, but sitting is much more painful. Thankfully he's doing better these days --mostly after putting in the work with exercises and staying consistent over the years with continuing to do them. I recently hurt my back too (much more minor) and have had a similar experience recovering -- that exercises/stretches are the thing that really helps, but also the part that sitting is more painful than doing things.

I wonder if the urine issue is unrelated to the back pain.

[KpbS]

I’d like him to follow up with a urologist.

I’m guessing the back pain relates to nerves from the discs. Seems like he would benefit from an MRI.

I’m sorry he’s hurting and hope you can figure out more.

[bisous]

The urologist is a good idea. I think I'd like a better explanation about why there is blood and mucus present in his urine. That doesn't sound healthy!

I think it is possible that pt will help with his back! I'm really hoping so. He's been so uncomfortable.

The way that his back has been feeling better when he's been more active (vs just sitting at his desk) does sound like it is related to muscle or tendon pain and maybe pt will help? But the weird labs we've gotten are also concerning.

[MSWR0319]

The urologist is a good idea. I think I'd like a better explanation about why there is blood and mucus present in his urine. That doesn't sound healthy!

I think it is possible that pt will help with his back! I'm really hoping so. He's been so uncomfortable.

The way that his back has been feeling better when he's been more active (vs just sitting at his desk) does sound like it is related to muscle or tendon pain and maybe pt will help? But the weird labs we've gotten are also concerning.

So I think there may be two issues going on. Definitely follow up with a urologist, but also start with PT. Even at the first PT eval they will be able to tell him if his back is tight or what muscles are causing issues. If he goes to the eval and they find nothing, then he doesn't have to go back. My DH has back issues that flare if he's not careful and sound like your DH's. DH's back gets very tight when he sits all of the time. The PT has told him she can't believe how tight his muscles are. They are able to loosen them with ultrasound, a TENS unit, and various other tools. I got him a massaging gun for Christmas and he uses it on his lower back everyday. It's really helped keep the issue at bay because his muscles don't get tight and stay tight.

[echoesofspring]

DH had years of back pain, eventually doing PT, surgery, a new bed, new chairs, etc. At one point he even had a PA tell him it was due to a prostate infection and he ended up at a urologist who was ...very confused why he was there. His back pain was followed by knee pain, PT, surgery, etc., which was then followed by 18 months of foot pain. (You can follow some of his story in my various older posts). When his podiatrist started talking foot surgery he got really scared and did a lot of research/self education. He was quite taken with the book Crooked, which he felt reflected a lot of his experiences and has ultimately decided that much of his pain is a manifestation of psychological pain. (That's not to say that you wouldn't see issues with his spine or knee or foot on an MRI, but rather that the magnitude of pain wasn't in line necessarily with the injury). After a lot of hard, hard work and therapy he's rarely in pain now and when he is he can usually pinpoint what conflict or stress in his life is causing it. I mention this not to dismiss all the other real physical possible causes of pain but - it's been a tough year and I've noticed an uptick in the number of people in my life complaining about back pain and I've wondered how many people are going through something similar to what he did. It's been really incredible to see the transformation he's gone through the last 2 years.

[bisous]

I think it is entirely possible that there are two things (or more!) going on with his pain. That's a really good observation. I am a huge advocate of PT. I feel like we all probably need it!

I also think he might absolutely have some issues of psychological pain! I will have to read Crooked. Thankfully he's already attending regular therapy sessions so I'll let him know about this stuff and maybe he can work with his therapist.

[KpbS]

Keep us updated with his follow-up with a urologist! Can he go see a new pt or have an mri on his back? Those would be good starting points.

Hoping he can feel better soon.

[StantonHyde]

Get a standing desk! “Sitting is the new smoking”. Also—does he need to lose weight—especially in his stomach? The PT will give him exercises that he needs—especially for his core.

[zukeypur]

DH had an entirely different issue causing his back pain which got progressively worse over the course of 9 months or so. After several months, he went in for an MRI, but the ordering physician forgot to mark with or without contrast, so the imaging center just did it without contrast (incorrectly), as the urgent care was closed by the time he got to the imaging place. The radiologist misdiagnosed him with desiccating disks. Fast-forward to 6 months later when a friend found out he had gone through numerous spinal injections with no relief, was sleeping 30 minutes per night, and could only find relief standing or lying at a steep angle on a wedge pillow. She was just graduating medical school and her husband is an interventional radiologist, so we sent them the images. He immediately saw a tumor in DH's spine that the radiologist missed 6 months earlier (same image). He was in surgery within days to remove the ependymoma, and still suffers from back pain and nerve damage from the tumor continuing to grow unchecked for 6 months.

Not to scare you, as this situation is exceedingly rare. Just something to consider if all of the other things don't pan out. And if anyone wants to do imaging, ask if they need contrast.