Suggest Remedy For Persistent Sore Throat And Fatigue

Posted on Tue, 17 Nov 2015

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Tue, 17 Nov 2015 Answered on

Tue, 8 Dec 2015 Last reviewed on

Question : My 10 yo son has had chronic lower back pain sore to touch in a very localised area pain on standing and sitting since July 2015. Had Mri in August results were clear,bloods all clear except low feritin levels all else normal. He had an infection in September - sore throat, painful to swallow lasting about 7 days, but since then is feeling extremely exhausted and unable to participate in any physical activity at school or home. His face is very pale also. His back pain continues to improve but he is just so exhausted. Have had a second blood count and it was normal. No immune or inflamatory diseases detected in bloods, liver function fine.Test revealed no blood in stools. Any suggestions on what I can Do?

Answered by Dr. Diptanshu Das (2 hours later)

Brief Answer:
The problem is probably due to muscle spasm.

Detailed Answer:
Thanks for asking on HealthcareMagic.

In absence of MRI pathology, the cause of the low back pain is probably postural. In that case, maintaining proper posture is the key to solving the problem. I would suggest you to visit a physical therapist and to get his muscle tone evaluated. It is possible that the muscles of lower back are going into spasm and hence getting fatigued. So, the solution lies in proper relaxation. Hot compress will provide relief. The physical therapist would be able to point to the right exercises that will be helpful. I would also suggest to learn yoga techniques.

About the exhaustion, it could be due to low hemoglobin levels which in turn is due to low iron store as reflected by low ferritin levels. Iron supplementation is therefore essential. Dietary intake of iron containing foods (just google out) in addition to iron supplements should take care of this problem.

Let me know if I could help further.

Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Diptanshu Das (4 hours later)

Thank you for you reply. He has seen a physiotherapist who advised that it is not musculoskeletal and that he couldn't help, but he did give him some exercises. A chiropractor thinks it is ligament damage in his lower back but this should have shown up in the mri. He has support cushions for his chair at school, without them he has only been able to sit on a normal chair for about ten minutes before he has to get up and walk around to relieve the pain. He describes it as a sensation of pressure pushing down on his spine which causes pain. However, like I mentioned, it is slowly improving. My son has been taking an iron supplement since September. My doctor has said it is strange but cannot do anything more so I have no where esle to turn. I am beginning to get worried because his face is so pale and he is so exhausted all the time. With his back pain and chronic exhaustion the last few months have been very stressful.

Answered by Dr. Diptanshu Das (7 hours later)

Brief Answer:
I still feel that physical therapy is what is needed

Detailed Answer:
Thanks for writing back. I do not find validity in the chiropractor's statement. The situation at school still conveys to me that the problem lies at the level of spine to muscle and physical therapy is the solution you should be looking for. Still, get a neurological opinion.

About the iron supplements and persisting paleness, I would seek to know the hemoglobin levels over time. Also mention the total leucocyte count, the eosinophil count and the RBC morphology. This will help me to correlate. In any case the chronic exhaustion is probably related to this anemia.

Regards

Above answer was peer-reviewed by : Dr. Sonia Raina