Discomfort in Lower Back with Bruising
I’m a 28-year-old male, standing at 5 feet 10 inches tall and weighing 105 kg. Over the last five days, I’ve experienced some unusual sensations in my lower back—likely due to overexertion from work and my gym routine. The area right above my buttocks feels particularly tight and uncomfortable. My girlfriend, who has a fascination with skin care, noticed a sizeable bruise on my back when she was inspecting it and took a photo. I haven’t experienced any falls or direct impacts that could have caused this bruise, and its location corresponds exactly with where I am feeling discomfort. I’m seeking advice on what steps I should take to address this issue.
Answers (1)
9/9/2025, 12:50:39 PM
OpenHealth AI
It sounds like you are dealing with discomfort in your lower back and an unusual bruise that may be causing you some concern. This discomfort could be related to overexertion, which is common, but the presence of a bruise without any known trauma is worth paying attention to.
Explanation
Bruising can sometimes occur from minor internal bleeding due to muscle strain, especially if you’ve been pushing your body hard at work or the gym. Muscle fatigue or strain can manifest as tightness, pain, or discomfort in the back. Over time, if the muscles are overworked or improperly used, they can lead to sensations like you're describing. While it's good to be cautious, many lower back issues due to overexertion resolve with proper care.
Next Steps
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Rest and Recovery:
- Avoid strenuous activities that could further strain your back. Allow your body to heal for a few days.
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Ice Therapy:
- Apply an ice pack wrapped in a cloth to the bruised area for 15-20 minutes every hour to help reduce swelling and relieve pain. This can be especially helpful in the first 48 hours after noticing the bruise.
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Gentle Stretching:
- Once the initial pain subsides, engage in gentle stretches for your lower back. Focus on movements that stretch your hamstrings and lower back muscles, which may alleviate tightness.
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Over-the-Counter Pain Relief:
- Consider taking over-the-counter medications like ibuprofen or acetaminophen to help with pain and inflammation, as per the recommended dosage.
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Observe:
- Monitor the bruise and your symptoms. Look out for any changes such as increasing size of the bruise, worsening pain, or development of new symptoms (e.g., numbness, weakness, or changes in bowel or bladder function).
If your discomfort worsens or the bruise doesn’t improve in a week, it might be beneficial to investigate further for underlying causes. Keep track of your symptoms and any changes over the coming days. If you have any further concerns or if changes occur, don’t hesitate to reach back.
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# 7-Month-Old Child with Abernethy Malformation - Exploring Treatment Options ## [7-Month-Old] Identified with Abernethy Malformation (Congenital Portosystemic Shunt) - Treatment Methods? **Age:** 7 months **Gender:** Female **Height:** Age-appropriate **Weight:** Currently 9 kg, was 2.8 kg at birth **Ethnicity:** Asian **Duration of Symptoms:** Present since birth **Location:** Uzbekistan **Pre-existing Health Issues:** Abernethy malformation (congenital portosystemic shunt), liver hemangiomas, chronic jaundice, anemia **Current Treatments:** Supportive management --- ## INITIAL PRESENTATION (June 2025 - July 2025) Our daughter arrived on **June 27, 2025**, presenting with: - Birth weight: **2.8 kg** - Marked jaundice (yellowing of skin and sclera) - Pale or clay-colored stools - **Bilirubin level: 245 μmol/L** (typically <20) An immediate ultrasound indicated multiple liver anomalies, initially thought to be hemangiomas. --- ## FIRST COMPREHENSIVE ASSESSMENT (August 1, 2025 - 1 Month Old) ### Multislice Computed Tomography (MSCT) with 3-Phase Contrast (August 1, 2025): **RESULTS:** - 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7 Months Old) - **Weight:** 9 kg (good growth rate in spite of condition) - **Jaundice:** Continues to be present (yellow skin) - **Stools:** Remain pale/clay-colored - **Development:** Achieving appropriate milestones - **Energy:** Appears to have a good energy level - **Feeding:** Normal appetite --- ## QUESTIONS FOR r/AskDocs We have been informed this is **Type 2 Abernethy malformation** (portal vein present). **Three treatment avenues have been proposed:** ### Option 1: **Endovascular Coil Embolization** (minimally invasive approach) - A catheter is inserted via the leg vein to access the shunt and deploy coils/plugs to close the abnormal vessels - Pros: No surgical incision, minimal discomfort, short hospital stay (2-4 days), no scars, enhanced safety - Duration: 1-2 hours - Recovery: 2-4 weeks for jaundice to show improvement ### Option 2: **Open Surgical Intervention** - An incision in the abdomen to ligate abnormal vessels and redirect blood to the liver - Pros: Direct visualization, effective results - Cons: Surgical scar, longer recovery time (7-14 days in hospital) - Duration: 2-4 hours ### Option 3: **Liver Transplantation** - We have been advised this is not necessary as the portal vein is functional and liver health is improving. --- ## SPECIFIC QUESTIONS TO CONSIDER: 1. **With a functional portal vein (6.1 mm) and improving liver function (ALT normalized), is it advisable to pursue endovascular closure as the preferred treatment?** 2. **Despite ALT levels improving, the bilirubin remains consistently high (242). Should this be a cause for concern? Is there a prospect for it to normalize post shunt closure?** 3. **Are the hemangiomas/nodules (11.6×20.7 mm) linked to the shunt? Will they likely resolve following shunt repair?** 4. **How urgent is the proposed intervention? Is immediate action required, or is there flexibility to wait a few months?** 5. **What complications should we be vigilant for during the waiting period?** 6. **Regarding endovascular closure - what is the average success rate for infants aged 7 months? Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. Seeking expert advice on optimal treatment strategy and timing.