Kidney infections are famous for referring dangerous mimics of back pain to one side of the back, where the ribs meet the lower back. This is called costovertebral tenderness and is elicited by percussing at the lowest ribs along side the spine. Severe pain in this region can be an indicator of a kidney infection.
Gynecological problems can refer pain to the back. Endometriosis and ovarian cysts are two good examples. This pain will normally be cyclical with the patient’s period. A pelvic infection from any number of causes can also cause pain. Ectopic pregnancy, a surgical emergency, can refer to the back. It is important to get a thorough history of the patient’s cycles and activities to help rule this in or out.
Occasionally, diverticulitis can cause back pain. This occurs when small outpouchings of the intestinal wall become inflamed.
Gall bladder attacks can cause lower back pain. Normally, these would be worst after a fatty meal and are crescendo de- crescendo (get worse and then better in a matter of minutes) type of attacks. That is- the pain rises and falls as a crampy type of pain.
Cancer can obviously cause back pain. If a vertebra or pelvis fractures because the bone is weakened, the pain will be like typical fracture pain. X-rays and especially an MRI would differentiate this. Compression of a nerve or the cauda equina will give symptoms associated with these specific structures.
If you have additional questions regarding dangerous mimics of back pain, or would like to discuss your cause of lower back pain in great detail, please contact Dr. Donald Corenman, spine specialist and back doctor serving the communities of Vail, Aspen, Denver and Grand Junction, Colorado.