OpenHealth Q&A

Understanding Chronic Back Pain: Seeking Guidance

Greetings! I am a 17-year-old female who has been enduring significant back pain for approximately six to seven years. The exact onset of this discomfort is unclear to me, but it has been a persistent issue. Until recently, I haven't focused on it much due to other pressing health matters but now feel the need to address it. The pain primarily centers around my spine and lower back, intensifying when I lie down or engage in physically demanding activities. It also aggravates after prolonged periods of standing. Fortunately, the discomfort does not extend beyond my neck. While lying down, whether on my side or back, I experience a sharp, unusual pain that only subsides if I tense my back muscles. Relaxation takes about 20 to 30 seconds. Even short breaks, like standing up for a minute to retrieve something, result in the same level of pain upon returning to a lying position. Lying on my side may alleviate the pain somewhat; however, the discomfort returns immediately if I switch back to my back. When I engage in any substantial activity for about half an hour, my right shoulder begins to hurt, with pain radiating from a specific spot that feels swollen or tense. This shoulder discomfort occurs after being seated or standing for extended periods. Additionally, I've been dealing with what appears to be sciatica symptoms in my right leg. I previously visited a chiropractor weekly or bi-weekly during my in-person schooling. Now that I am homeschooled, I have more time to focus on my discomfort. At school, I often found it unbearable to sit comfortably, prompting me to call my mother to take me home due to the pain. The chiropractor noted that I was in the early stages of scoliosis, but nothing else seemed abnormal. I’ve been informed that my growth should be complete, meaning my condition shouldn't worsen. Unfortunately, the relief from those chiropractic sessions was short-lived. About a week ago, I consulted with an orthopedic specialist who recommended starting physical therapy and prescribed pain medications to assess their effectiveness. He hinted at a possible disc issue, but I did not retain all the details. If the situation doesn't improve, he suggested further MRIs and potentially additional X-rays, which my mom and I prefer to avoid due to my previous exposure to radiation. My main concern during the appointment was the sciatica, which made it challenging to convey how troubling my ordinary back pain is. I managed to express my concerns several times but kept getting referred back to the sciatica issue. I just began a regimen of Naproxen (500mg, twice daily for five days) a couple of hours ago, which provided slight relief while lying down but not much else. Physical therapy is anticipated to start this Tuesday, and my sister will help me with some initial exercises starting tomorrow. Interestingly, the orthopedic doctor reviewed the abdominal MRI I underwent in May for a different issue and noticed a growth that appeared to resemble a cyst rather than something more concerning. I can provide those images if necessary; they were not intended for the orthopedic visit but rather for another specialist, which is why he was uncertain about the findings. This pain has significantly impacted my life, and I'm eager for insights on potential causes and solutions. I own a Belgian horse and ride regularly, which serves as my form of exercise, alongside various barn chores for 2-4 hours at least once or twice a week, depending on the weather. I sometimes volunteer nearly every day. While I hold some extra weight, much of it is muscle, and I have been actively trying to lose weight through dietary changes and increased physical activity. Could anyone shed some light on what might be causing my symptoms or suggest specific terminology I could use in discussions with my doctor?

Answers (1)

7/7/2025, 6:11:08 AM

OpenHealth AI

It sounds like you're experiencing significant and persistent back pain that's impacting your daily life and activities. Given your history and the details you've provided, it's essential to focus on a few key aspects: potential causes, management strategies, and communication with your healthcare providers.

Main Points:

1. Possible Causes: Your symptoms might be related to scoliosis, muscle imbalances, or nerve irritation that can accompany sciatica.
2. Management Strategies: Starting physical therapy and using pain medications like Naproxen as prescribed is a good step. Supplementing this with self-care practices can be beneficial.
3. Effective Communication: Using specific terminology and being clear about your experiences during doctor visits can help ensure that all your concerns are addressed.

Explanation:

• Scoliosis: This curvature of the spine can lead to back pain as it might cause muscle imbalances and strain in your back.
• Sciatica: The pain radiating down your leg suggests possible nerve involvement, which may relate to disc issues or spinal alignment.
• Muscle Tension: The discomfort when lying down and the sharp pain you experience may indicate muscle tension or spasms, which can also connect to your activities and how you hold your body.

Next Steps:

1. Physical Therapy: Make the most of your upcoming sessions. Engage actively with your therapist about your specific symptoms, focusing on exercises that strengthen your back and improve posture.

2. Pain Management:

   • Continue with the prescribed Naproxen, but also explore non-pharmaceutical options such as gentle stretching or heat therapy to reduce muscle tension.
   • Practice gentle core-strengthening exercises that protect your lower back, which your physical therapist can plan for you.

3. Tracking Symptoms: Keep a journal of your pain levels during different activities, and note any specific movements that trigger discomfort. This will help illustrate your condition to healthcare providers more concretely.

4. Terminology for Doctor Visits:

   • Use terms like "persistent back pain," "aggravation with activity," "sciatica symptoms," and "spinal alignment concerns" during discussions with your healthcare providers. This specificity will help convey the seriousness and persistence of your symptoms.

5. Follow-Up on Diagnostic Findings: If you have concerns about the cyst mentioned by the orthopedic doctor, keep that conversation open. If it seems necessary, obtaining a referral to a specialist who can evaluate that growth further might be worthwhile.

Always prioritize clear and open communication with your healthcare providers about your symptoms and feelings, and don’t hesitate to seek clarification when discussing your condition with them. It's essential to be proactive and ensure all aspects of your health are being monitored and managed.