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Suggest Treatment For Sharp Right Sided Back Pain
Posted on
Sat, 11 Feb 2017
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Sat, 11 Feb 2017
Answered on
Thu, 2 Mar 2017
Last reviewed on
Question : I have very sharp, yet quick bursts of pain in my lower right side back. The pain radiates into my right buttock. The pain is often so great my right leg almost buckles. The sharpest pain shoots down my right leg. if I sit still, the bursts of pain virtually goes away, but if I twist/turn a dull but persistant pain occurs. The bursts appear when I walk or move my upper torso. Standing, there is a dull pain. I've had this issue off and one for years, never this bad. Also, if I cough or sneeze I get the burst of pain.
Brief Answer:
Nerve root compression likely.
Detailed Answer:
I read your question carefully and I understand your concern.
Judging from that description of pain starting from the lower back, spreading into the lower limb and increasing when pressure into the abdomen is increased (coughing, sneezing) I would say that the most likely cause would be a nerve root compression.
Most common cause are degenerative changes of the spine which happen in many people with age leading to disc bulges (herniated disc) and bony spurs (osteophytes) which may compress the nerve root. They also cause local inflammation and muscle spasms which further contribute to the compression.
The initial approach is through anti-inflammatory pain killers like Ibuprofen and muscle relaxants. Physical therapy is also important in preventing future recurrences. Hot and cold compresses also may help, in the first few days cold compresses, afterwards warm ones. If not enough later on medication for neuropathic pain such as Gabapentin or Pregabalin may be added.
Most patients improve through these measures inside a month. If not working then imaging is recommended through preferably MRI (if not available CT scan). That is done to determine whether the extent of the changes is such that it may require surgery but also to make sure there is not some rare cause such as a tumor (unlikely in your case since you say to have had similar milder episodes for years). Depending on imaging results local steroid and analgesic injections or surgery may be considered as the next step.
I remain at your disposal for other questions.
Nerve root compression likely.
Detailed Answer:
I read your question carefully and I understand your concern.
Judging from that description of pain starting from the lower back, spreading into the lower limb and increasing when pressure into the abdomen is increased (coughing, sneezing) I would say that the most likely cause would be a nerve root compression.
Most common cause are degenerative changes of the spine which happen in many people with age leading to disc bulges (herniated disc) and bony spurs (osteophytes) which may compress the nerve root. They also cause local inflammation and muscle spasms which further contribute to the compression.
The initial approach is through anti-inflammatory pain killers like Ibuprofen and muscle relaxants. Physical therapy is also important in preventing future recurrences. Hot and cold compresses also may help, in the first few days cold compresses, afterwards warm ones. If not enough later on medication for neuropathic pain such as Gabapentin or Pregabalin may be added.
Most patients improve through these measures inside a month. If not working then imaging is recommended through preferably MRI (if not available CT scan). That is done to determine whether the extent of the changes is such that it may require surgery but also to make sure there is not some rare cause such as a tumor (unlikely in your case since you say to have had similar milder episodes for years). Depending on imaging results local steroid and analgesic injections or surgery may be considered as the next step.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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