36 year-old lady 2 year of left mid to lower back pain without leg pain. The pain is worse when she trying to sit up or laying down.
She noticed this pain after she started a vigorous exercise routine. Her pain was reproduced with her lying down and forced left hip flexion. Diagnosis: psoas muscle strain. Easy on her exercise. |
81 year-old man 3 months of right far lateral lower back pain worse and catches when he gets in or out of his bed. The pain is static and it does not radiate.
He had severe tenderness over right quadratus lumborum. Diagnosis: quadratus lumborum. muscle pain MRI: L-IDDD and L-spondylosis Management: trigger muscle injection rid him his pain. |
68 year young man 3 weeks right lateral paraspinal muscle pain -- worse with sitting up from a lying down position or lying down in bed..He described it as jabbing and knife stabbing in quality. HE denies trauma, injury or fall, skin rash, weakness or numbness. He developed this pain after a long lawn mower ride.
He has left quadratus lumborum tenderness. Diagnosis: quadratus lumborum strain Treatment: muscle injection relieved pain immeiately |
79 year young lady lateral paraspinal muscle pain -- worse while sitting up from a lying down position.
She denies shooting pain to her leg. She denies weakness or parapinal pain. She has left quadratus lumborum tenderness. She has scoliosis and kyphosis. Diagnosis: quadratus lumborum strain Treatment: Trigger muscle injection relieved pain right away |
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58 year young lady bended forward to reach a drawer and had a sudden sharp pain in her back. The pain is quite severe and any movement seems to hurt a lot. She is afraid of moving. But she denies leg pain. Cough sneeze or defecation did not make it worse. Lying flat and not moving is better.
She has focal paraspinal muscle pain, spasm, and tenderness on examination. Diagnosis: back muscle strain Management: Steroid pack taper and muscle relaxer. This relieved her pain. |
73 year young lady years of left shoulder blade pain to her left chest wall.
She had pain with pressure at the same location. Diagnosis: serratus anterior muscle strain and pain. Treatment: local muscle trigger point injection resolved her pain for three months. |
39 year young lady lateral paraspinal muscle pain -- worse with sitting up from a lying down position.
She denies shooting pain to her left leg. She denies weakness. She has left quadratus lumborum tenderness. Diagnosis: quadratus lumborum strain Treatment: muscle injection relieved pain |
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60 year young man 6 months history of right local lateral back pain only when he sits up from sleep or lying flat. Cough or sneeze does not worsen the pain. He denies leg pain.
He has right lateral lumbar area muscle pain in the location of right quadratus lumborum. Lifting his right leg makes the pain worse. Diagnosis: right quadratus lumborum strain Treatment: Pain is down to 3/10 from above 10/10 after muscle injection. A second injection one week later resolved his pain. |
82 year young man 2 weeks history of right local lateral back pain only when he sits up from sleep or lying flat. Cough or sneeze does not worsen the pain. Lifting his right leg makes the pain worse. He denies leg pain.
He has right lateral lumbar area muscle pain in the location of right quadratus lumborum. Diagnosis: right quadratus lumborum strain Treatment: Pain is down to 2/10 from above 8/10 immediately after muscle injection. |
72 year young lady 2 week history of severe local back pain. Cough sneeze or sudden laugh does not make the pain worse. Any movement makes the pain worse. She can not sit up without a lot of pain.
A CT scan did not reveal vertebral fracture or kidney stone. She has severe left more than right local lower back tenderness with muscle strain. This reproduced her typical pain. Diagnosis: muscle strain Treatment: steroid pack taper; bedrest. heating pad. |
66 year young morbidly obese lady lifted 10 lbs of weight and developed severe back strain. She can not move in any way due to her severe back pain. She denies leg pain or weakness/numbness.
She has severe bilateral lower back paraspinal pain. Diagnosis: back muscle strain Treatment: Trigger point injection done; Pain medication, heating pad. bed-rest. Pain nearly resolved. |
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45 year young man acute onset local lower back pain when he picked up a towel on the floor. The pain is sharp, non- radiating, worse with standing straight up and better with sitting down and lying down flat. No weakness/numbness.The local lower back pain is at worst in the morning when he sits or stands up from a lying flat position from sleep. He finds he can not sit up without using his arms to support himself. Bed-rest helped the pain the most. Heating pad helped.
The pain responded to Ibuprofen 600mg-800mg every 12 hrs. He gets better within two weeks. |
55 year young man with five month of local back pain. Sitting in a chair with his back leaning against a support is a relatively comfortable position.
The most severe back pain happens when he turns in bed or sits up or gets up from his bed. He is dreadful for this moment. The most reliable test for his back pain is the process of sitting up from a lying flat position, such as when he gets up from sleep in the morning.This position change would provoke intense local bilateral middle to lower back pain as showed in the picture. A lumbar spine MRI showed minor degenerative change. |
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