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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18675
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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My partner got pretty case of lower back pain.

Resolved Question:

Hi,
my partner got pretty nasty case of lower back pain. We are travelling and have spent last 5 days walking a lot, while our normal lifestyle is spending days in the office in front of the computer. My partner is fit and exercises regularly. 3 days ago he went for a light run and did couple of sets of burpies & high jumps afterwards. After the exercise session he felt a bit of pain 3/10 on mid-lower back. For the next couple of days we walked around for 6-8hrs each day with back pain being there as 3-4/10, took some ibuprofen during the day. Stretched back and hips in the morning and afternoon. In the evenings took pain killer and rubbed "anti-flame" herbal anti-inflamotory (arnica etc).
Yesterday he was feeling better, could block the pain out. In the evening he got a reasonably light back massage (by me) followed by anti-flame before sleep. No pain at night. This morning woke up feeling significantly worse with very stiff lower back, having difficulty to get up or turning over, pain while standing up, walking, turning over and sitting. Pain in the lower back and tail bone referring to gluteus, sensitive in the lower groin. Pain level now is 7-8/10. Also feeling a little pain when went toilet to defecate. Took pain killers and ibuprofen but not much help.
Normally we'd go doctor straight away, however we are in Tokyo and to find an English speaking med facility or doctor is very very hard. This is pretty scary and very stressful experience.
Please help id how serious this is and whether he just needs to rest (and what kind of rest). Happy to Skype if possible.
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. D. Love replied 2 years ago.
Hello from JustAnswer.
It will help if you could provide some further information.
Is he having any symptoms beyond the pain and stiffness?
For example, is he having any muscular weakness causing the difficulty in getting up?
Or is the difficulty only due to the severity of the pain?
Customer: replied 2 years ago.

Hi Dr, no only pain. Seems to feel a little alleviated once upright and moving about a little. When upright the pain is pinching on tailbone, right above the butt crack (excuse my language please).

Expert:  Dr. D. Love replied 2 years ago.
Thank you for the additional information. There is no need to apologize about your language.

When having acute back pain that is not associated with other symptoms, it is not as serious and it is fine to attempt to treat it without being seen. The most worrisome symptom would be if there is any muscle weakness, but other symptoms can also suggest that there may be nerve dysfunction, such as loss of sensation in the leg.

As long as the only symptom is the pain and the pain can be adequately managed, it is OK to avoid being immediately seen. However, if there is severe pain that cannot be adequately managed, it may still be necessary to be seen for relief of the pain, even if there is no other serious issue present.

There are several over the counter interventions that may be able to help in this situation. The ibuprofen is certainly a good medicine, although it may require a higher dose, up to 2400 mg per day in several divided doses. With stiffness, a muscle relaxer may also be helpful, but they are not over the counter in most countries. The best that can be done with an over the counter medicine is a sedating antihistamine, such as Benadryl. The antihistamine effect is not that helpful, but the sedative effect may help the muscles relax. Local care also can be very helpful, including ice, moist heat, and light massage. If available, soaking in a hit tub is a method for heating the entire back. He should be getting plenty of rest, although this primarily means avoiding the walking and other exertions that he has been doing. It does not need to be strict bedrest unless being upright is painful. In his case, since being upright eases the pain, it is fine for him to be upright, but without other significant exertion.

If the pain eases with these interventions, then he does not need to be seen, but if the pain persists, then he would do better being seen. Whether it can wait until you return home would depend upon the severity of the pain, but with some time, you should be able to find a clinic that can overcome the language issues. If you are staying at a hotel, the front desk usually can direct you to a clinic.

If I can provide any further information, please let me know.
Customer: replied 2 years ago.

Thank you Dr. How many days is something like that likely to persist? Should he be doing stretches? e.g. childs pose and laying back extension

Expert:  Dr. D. Love replied 2 years ago.
The duration can vary significantly, from a couple days to a couple weeks.

Stretching should not be done during the first days. As the pain and stiffness improves, then stretching can be started.
Dr. D. Love and 2 other Medical Specialists are ready to help you
Customer: replied 2 years ago.

Thank you for your help and a peace of mind