Back pain seems to be related to eating

[Hay_art]

In June 1999 I began to have problems with my lower back. Despite physical therapy and limiting activity that would be harmful, it progressed from the lower back to the back of the thigh and then to the outer part of the foot and ankle (right side). In January 2000 I had a MRI, it showed a herniated disc at L5-S1 and surgery was suggested. I decided to continue with the exercises, rather than surgery. In December 2000 I started experiencing severe sweating on the inner thighs. Since this was more severe in the morning, after breakfast, I stopped eating breakfast and the problem seemed to diminish. This symptom evolved into a chaffing sensation on the inner thigh and groin. In June 2001 a second MRI showed a significant improvement. The L5-S1 herniation regressed. In June 1999 I began to have problems with my lower back. Despite physical therapy and limiting activity that would be harmful, it progressed from the lower back to the back of the thigh and then to the outer part of the foot and ankle (right side). In January 2000 I had a MRI, it showed a herniated disc at L5-S1 and surgery was suggested. I decided to continue with the exercises, rather than surgery. In December 2000 I started experiencing severe sweating on the inner thighs. Since this was more severe in the morning, after breakfast, I stopped eating breakfast and the problem seemed to diminish. This symptom evolved into a chaffing sensation on the inner thigh and groin. In June 2001 a second MRI showed a significant improvement. The L5-S1 herniation regressed. There were still mild bulging discs L1L2, L2-L2, L3-L4, and L5-S1. At this point the symptoms include, excessive sweating in the groin, thighs, and butt, pinching pain on the scrotum, intermittent pain in lower right back, pain in little toes of both feet and an odd taste after eating.  The odd taste feels like a burned tongue and a metallic or bitter taste.  This may be due to altered eating habits. Also, the sweating and pinching sensations are more severe when standing or doing mild physical exercise and after eating. Since January 2001, I have had a physical exam and have seen 5 doctors (Orthopedic Surgeon, Neurologist, Urologist, a Physiatrist and an Internist) and no one has offered a diagnosis or suggested treatment.  I am speculating that this is a pinched nerve.  Currently I am swimming and doing Nautilus exercise about 3 times a week (avoiding activities that put direct vertical pressure on the spine), but I am not seeing any prolonged progress. I am also noticing a snapping or cracking for my back.

Can anyone suggest a possible cause, treatment, or tests that may help diagnose this?

Henry

[CCF-Neuro-M.D.-JT]

Your numerous symptoms are quite possibly unrelated, as I do not know of any one particular syndrome that causes back pain, scrotal pinching, toe numbness, taste alterations, and abnormal sweating. The known disc bulgings can certainly cause back pain intermittently, but would not typically cause the other symptoms. What stands out in your history is the abnormal sweating pattern that occurs in the setting of meals. This is called gustatory (of the taste glands) sweating which is seen in a number of conditions, most commonly diabetes. The sweating is usually in the face and neck area and is thought to be related to an autonomic nervous system dysfunction ( the fight or flight response of your body) It can be treated with anticholinergic drugs and good control of your sugars if you are diabetic. One case report showed that an older woman used a roll-on glycopyrrolate lotion (like an antiperspirant) with meals and that worked well for her. There are of course other autonomic system disorders and other causes of gustatory sweating, but at the very least, you should be checked for diabetes. Consider seeing an autonomic disorders specialist who can perform specific tests such as sweating pattern tests and special blood pressure measurements to see if you do have some kind of autonomic disorder . If you are in the area, Dr. Bob Shields here at the CLeveland CLinic is an excellent autonomic/neuromuscular expert. Good luck.