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back problem causing abdominal/pelvic pain

Posted by chris on June 15, 1999 at 22:07:27
How likely is it that a back problem would cause only abdominal/pelvic pain for 2 years?  I came down with right lower quadrant abdominal pain 2 years ago. I've had a negative colonoscopy and 2 laparoscopies. I do have adhesions around my sigmoid colon which were lysed, plus they found that my sigmoid colon was pulled over and stuck to the right pelvic wall. The pain was relieved for about 3-4 months after each lap. When they did the second lap, they found that the adhesions worked on during the first lap had not reoccurred, yet the pain felt exactly the same. I started a step aerobics program in March and it was after this my pain started to escalate Not only the right quadrant pain, but also severe nighttime attacks
of pain across the lower right quadrant. These go away when I change position in bed, although the area remains sore. It gets much better when I get up and walk around. In April I had a normal gyn exam and it was after this I noticed that the pain went through to the right side of my back
and down the right buttock and also over to the right hip. A colo-rectal specialist advised me that a bone/joint problem could be the source of the pain and that the improvement seen after the laps could have been  coincidental. Tests for diseases like rheumatoid arthritis are negative. Last week I did about an hour of gardening and in the evening I had a lot of pain. The right quadrant pain went down into my groin, and seemed to be stabbing me in the rectum, as well as going out to the right hip and through to the right side of my back. I also have intermittent pain in my legs-in back of my thighs, sometimes front and sides of thighs, and funny sensations, not numbness or pins and needles, in the soles of my feet. I have had these leg symptoms intermittently for years. I don't have any loss of function. Does this sound like it could be caused by a back problem?  I had an lumbar-sacral MRI last night and am waiting for the results. I'm sorry this is so long but I'm really getting discouraged. My activities are so limited now because just about anything increases my back pain, yet I don't know what is wrong.  Thank you for your opinion.
Posted by CCF Neuro MD msf on June 28, 1999 at 17:23:49
Dear Chris,
Thank you for your question. I apologize for this late answer. Yes, a back problem could cause pain in the abdominal and pelvic areas. For example, if a nerve root is compressed by a herniated disk, this can cause pain all along its trajectory. Usually, back pain is present at the same time, but it is not always the case. The symptoms you are experiencing in your legs could also be due to back problems. An MRI should detect any significant process(e.g. herniated disk, narrowing of the spinal canal). If it comes back negative, it could be useful to be evaluated by a neurologist, to further discuss the possibility of a problem with your peripheral nerves. I read in another of your messages that you thought about fibromyalgia. You are right, fibromyalgia usually causes diffuse pain, with tender points on examination. Also, all other possible causes should be ruled out before concluding that this is fibromyalgia.

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