Discussions By Condition: I cannot get a diagnosis.

Lower back pain, constant headaches, muscular problems?

Posted In: I cannot get a diagnosis. 5 Replies
  • Posted By: spotlightstealer
  • April 16, 2009
  • 10:58 PM

Here is a list of symptoms that I have been experiencing.

1. Intense lower back pain. I do not think that this is kidney related because there is no worsening with direct pressure to that area. It is both a muscular ache and a sharper pain upon bending and moving.

2. Hyper-dense pituitary gland was recently discovered on a CT scan, with no other apparent problems. I was admitted because one pupil had dilated and was unresponsive to light.

3. When I was younger, I experience infrequent migraines. I believe I only had three from ages 10-12 before they stopped entirely. I now have frequent headaches (usually about 1 per day) of varying pain levels, types, and lengths.

4. I cannot hold up three fingers in the normal fashion. It's not that it hurts or is hard to do it, my muscles simply do not move that way. I also cannot snap my fingers.

5. Hypoglycemia. I occasionally get shaky, weak, feel very very warm, and then cold if I a) don't eat for a few hours and b) sometimes not long after I eat.

These may not all be related. Since they migraines stopped, they may no longer be part of the equation.

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5 Replies:

  • Please tell me whether you're male or female and what lab studies have been performed? Best regards, J Cottle, MD
    JCottleMD 580 Replies Flag this Response
  • Female; I've had a CT scan and an MRI. I wasn't tested for the hypoglycemia because both of my parents have it.
    spotlightstealer 2 Replies Flag this Response
  • The pupillary phenomenon is known as anisocoria and generally represents a parasympathetic response in some persons. In these instances, it's always important to make certain which eye is the affected one. In other words, a constricted pupil, such as in Horner's disease can make the opposite pupil appear dilated. It's also important to differentiate these conditions from a Marcus Gunn pupil which demonstrates a rather paradoxical response when using the swinging flashlight test. I merely mention these variations because there are underlying clinical conditions to which these various pupillary responses can be associated. I would ask at this point whether you are able to perform a situp maneuver from a lying position or do you have to roll over in order to use your knees to rise up? If you clench your fists very tightly and hold them for 15 to 20 seconds or so, can you then spring them wide open very quickly, or is there a hesitation and the hands open more slowly under steadily decreasing muscle tension? If you can form an OK sign with your index finger and thumb, can you rapidly tap your thumb with the index finger while the hand is in that position or does it appear to be forceful and slow in responding? Can you open and close you hands very rapidly or does either hand move in a spastic or slow and forceful manner? Tell me about the back pain? Also realize that Kidney pain is usually exacerbated when sharply striking the area of the back proximal to the kidneys rather than merely pressing the tissues. When kidneys are inflamed, the capsules become sensitive to jarring motion. It is similar to using rebound tenderness techniques of other organs that can be manipulated from the abdominal region. Compressing the abdomen tightly at the liver for instance, then suddenly lifting the hand away will cause intense pain in a patient with an inflamed liver or gall bladder because it causes a rebound against the tissues. When you bend and move, where does the sharp pain seem to originate and is there radicular pain down either leg at the same time? I'm also curious about the hypoglycemia. Realize that true hypoglycemia is actually very rare and it would be remarkable indeed if both your parents have this condition, unless it's associated with diabetes. It's important to note here that hypoglycemia is largely misdiagnosed in a great number of patients who demonstrate adrenal overstimulation due to stress, etc., which causes tremulousness, weakness, sweating, nausea, sensations of warmth alternating with chills and sometimes mental fog or confusion. I mention this here because patients who have adrenal overstimulation will remark that it had to by hypoglycemia because it went away upon eating something. This occurs in these instances not because serum glucose levels have been restored, but because eating causes a parasympathetic nervous response, which reduces adrenaline or epinephrine stimulation. Also, I will briefly note that hunger is a sympathetic nervous response, followed by a parasympathetic response upon ingesting food. This cycle is often confused as being related to hypoglycemia in instances where patients describe intense hunger pangs followed by nausea, sweating, weakness etc. until they eat something. Alternatively, if both your parents have underwent testing and have documented lab studies that clearly demonstrate hypoglycemia, then it would represent a rarity indeed although I suppose it would not be entirely implausible. I would suggest that if you can take a paper cup and freeze some water in it, then tear away half of the paper on the cup, you can have someone hold the cup end and rub the ice on your back at the area of pain for about 20 to 30 minutes, then slowly stretch the back muscles by lying flat and bringing your knee to your chest or as close as possible, one leg at a time. Continue until you have thoroughly stretched the muscles. The ice will act as sort of an anesthetic to reduce the pain while stretching the muscles. Once the muscles are stretched, have someone lay a warm towel onto your lower back while laying face down for another 20 minutes or so. If the problem is muscular strain, then you should experience relief after following the procedure. If it's related to a disk or osteophytic process, then it will be worse or at the least, no better. Lastly, heaches of unknown origin can and do occur in otherwise healthy children. Even seizure activity can occur because the brain is still undergoing change at early ages and up to about 10 or 11, these phenomenon can occur while not representing disease or other condition. Do your headaches occur in the same location or does it change? These could be either tension headaches, somewhat dependent upon location, or they could be vascular or migrainous in origin. Is there any type of prodrome prior to the onset of the headache, such as auras or odors, tingling sensations or similar symptoms? Once some of the questions have been answered, I may be able to direct you further. Best regards, J Cottle, MD
    JCottleMD 580 Replies Flag this Response
  • I cannot do a sit up without someone either holding my feet or having my feet pressed firmly against a wall; otherwise I have to roll over and use my knees to stand up. There is no hesitation in quickly opening my hands after clenching my fists, but I cannot making the "ok" symbol with my fingers and quickly tap my thumb against my forefinger, there is definitely some hesitation.As for the back pain, it started maybe two years ago, and I stopped using a one-shoulder bag in an attempt to help it. It did not really make a change, but the pain did recently subside, and then return worse than it had been before. The pain starts in my mid-lower back and does not move into my legs.I talked to my doctor about the hypoglycemia, and she chose not to test me because she felt I had it under control as is.My headaches occur in different areas and is different types of pain. There is no tingling, odors, or auras before hand, although I did experience spots in my vision before my migraines (which, along with nausea, was how I identified them as migraines as opposed to bad headaches).
    spotlightstealer 2 Replies Flag this Response
  • I have similar condition severe pain in right flank area with constant headache . I cant sit for too long my lower back burn. please tell me what did you do about condition
    nabeelan 1 Replies Flag this Response
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