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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Pain In The Lower Back?

my 15 year old daughter started with pain in her right lower back in February She is a competitive dancer but there was no point of injury - just one day she began hurting. We initially went to the chiropractor and he advised that her hips were out of alignment but she continued to complain of nerve pain down the same leg and he referred her for MRI of low back - which showed nothing abnormal. We then went to the orthopedic and they thought bursitis, so we did a cortisone injection which did not help at all, there we also did a round of prednisone and visits to PT - no change, if anything only continues to get worse. Then 2nd orthopedic thought it was the SI joint and did a 2nd injection - again no relief. He then ordered bone scan and it revealed nothing abnormal. He ordered blood work with only showed slight elevation of the antinuclear antibody 1-80, which he advised was not anything to be alarmed over. However RA does run in my family and my moms sister has been diagnosis with Lupus . He insists that it is just a dance related injury that will require rest. She has been resting and not dancing since February and continues to get worse and has swelling in the lower back and is very sensitive to touch. We are now seeing a chiropractor again which upon xrays revealed that her hips are out of alignment and somewhat rotated as well as curve in the spine. We are 10 visits in and no relief. She has taken advil daily for months and no relief. I do not know where to go next? Do you think I should be concerned about lupus or ra? continue with chiropractor? I am one frustrated mom - not only is this effecting dance she really can t do much of anything without pain - missed a day at the beach with youth group this week because she just felt to bad to go - very unlike her!
Tue, 5 May 2015
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Sports Medicine Specialist,  's  Response
Hello,

Thank you for contacting ‘Ask a Doctor’. I will try to address your concerns to the best of my ability. I see a lot of athletes with back pain. If the MRI is normal then the problem is likely mechanical in origin. That means there is some possible overuse in the soft tissues. Often times in these cases, even with tests like an MRI, it is very difficult to give you a specific anatomical diagnosis.

My advice would be;
1. No dancing for the moment - gentle activity like swimming would be fine.
2. See a good physical therapist who can do a good biomechanical assessment and put your daughter on a good home rehab program - to include stretching and strengthening exercises.
3. Over the counter meds such as ibupropfen or tylenol. Or a prescription anti inflammatory from your MD.
4. No further tests at this time.

Often there are no 'quick fixes' for these problems - hang in there. I'm sure it will improve soon.

I hope this helps.


Best wishes,

Adrian Rawlinson MD
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What Causes Pain In The Lower Back?

Hello, Thank you for contacting ‘Ask a Doctor’. I will try to address your concerns to the best of my ability. I see a lot of athletes with back pain. If the MRI is normal then the problem is likely mechanical in origin. That means there is some possible overuse in the soft tissues. Often times in these cases, even with tests like an MRI, it is very difficult to give you a specific anatomical diagnosis. My advice would be; 1. No dancing for the moment - gentle activity like swimming would be fine. 2. See a good physical therapist who can do a good biomechanical assessment and put your daughter on a good home rehab program - to include stretching and strengthening exercises. 3. Over the counter meds such as ibupropfen or tylenol. Or a prescription anti inflammatory from your MD. 4. No further tests at this time. Often there are no quick fixes for these problems - hang in there. I m sure it will improve soon. I hope this helps. Best wishes, Adrian Rawlinson MD