One-sided back pain on the left side radiating to the left rib cage flank.
April 5, 2012 | 45,00 EUR | answered by Dr. med. Hendrik Bernau
Hello,
I have pain on the left side of my back that radiates towards the middle to the lumbar area and exactly the same pain at the same level in the front on the left ribcage. Sometimes at night I wake up feeling like everything is pressing down and my stomach also feels extremely tense. I also feel like I need to go to the toilet but can't and have bloating. I am really afraid that it might be the pancreas or some hidden cancer there.
Previous examinations:
Several blood tests with lipase and amylase determinations,
Organ ultrasound,
Chest X-ray,
MRI of the cervical spine,
Gastroscopy, all without findings.
The only finding is from the radiologist who took an X-ray of the cervical spine and shoulder:
Finding: no evidence of paraarticular calcifications in the left shoulder joint suggesting periarthritis humeroscapularis.
Significant misalignment of the cervical spine,
The lordosis completely abolished,
Posterior bending with apex at C4/5.
I asked the gastroenterologist if he could see the pancreas with the gastroscopy, which he denied. Basically, I would like to know if normal lipase and amylase values and inconspicuous pancreas ultrasound can still cause the pain. What would you advise me to do next? I really need advice as my quality of life is extremely limited and my young son suffers a lot because I focus on this pain and always feel like I have to lie down or lift up the left ribcage with my hand.
Also, because of the severe one-sided pain, I recently saw a neurosurgeon who ordered the MRI of the cervical spine and he said: "Well, not so bad, just do some back exercises." But for me, the pain is not so bad, I wake up from it at night.
Best regards and thank you.
Dear questioner,
Before I address your actual question, let me briefly summarize what has happened so far:
1. You have had your (pancreatic) lipase and (pancreatic) amylase levels tested multiple times - without any findings.
2. You have undergone a sonography, a gastroscopy, and a magnetic resonance imaging - without any findings.
3. You have undergone X-ray diagnostics and received the result "The lordosis completely eliminated" (So no physiological -natural- convex curvature of the cervical spine), or "Dorsally directed kink formation with apex C4/5" (So a pathological -unnatural- concave curvature of the cervical spine between the 4th and 5th cervical vertebrae).
From the information you have provided, I understand that you have completed a comprehensive pancreatic diagnostics without findings. If these laboratory values and imaging procedures are current and no further investigation has been recommended by your specialist (Further options for further exclusion of such carcinoma could be, for example, the tumor markers CA 19-9 or CEA (Carcinoembryonic Antigen).), do not fixate on a tumor.
Much more likely - especially in light of the diagnoses you have listed - an orthopedic cause for your partially radiating pain seems to me. The question here is whether you have already consulted an orthopedic specialist in addition to the radiologist you mentioned, in order to possibly establish a differential diagnosis.
A colleague with orthopedic expertise is certainly also able to offer you a helpful therapy beyond the initially mundane "back exercises". It should also be mentioned here that a strong back musculature can alleviate (chronic) pain - Therefore, guided training to strengthen the muscles is often very advisable.
What about your movement? Are you moving enough, are you active or do you sit a lot (perhaps during work)? In light of your argument that you especially feel stronger pain at night and in the morning (after longer periods of rest), changing your mattress/slat base might also be an option. Your specialist can also provide you with suggestions here.
In conclusion, I do not want to confirm your fear of a tumor, but rather encourage you to find an orthopedic treatment approach with your specialist.
I hope I have been able to help you. If you have any further questions, I am always available to assist you.
Wishing you good health.
Best regards,
Dr. med. - anonymized -
