Large abdomin low back pain
by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
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("Abdomen" may often be misspelled "abdomin" when doing an internet search.)The numerous causes of this combination of symptoms are:
Increased lordosis of the low back (lumbar spine), meaning accentuation of the normal concave shape of the lumbar area may be used to offset the weight of a large abdomen. This stresses the low back and leads to low back pain.
An obese person with a large abdomen places more stress on the low back. Low back pain is a common complaint in obese people.
Pregnancy causes low back pain often. First, as the fetus grows, a woman's abdominal wall stretches to accommodate the expanding uterus, and the extra room needed for this has to come from somewhere. Because the abdominal muscles are stretched, they lose their ability to support body posture and as a result, the lower back is stressed.
The hormone relaxin is the second explanation for low back pain. During pregnancy, the hormone relaxin is present in 10 times its normal concentration. Relaxin's function is to relax the joints in the pelvis so the baby has room to pass through the birth canal. Unfortunately, relaxin also causes abnormal motion in many other joints of the body, causing pain. Fortunately, there are a couple of simple strategies that can help minimize the pain:
•Reduce physical activities. If possible, minimize certain activities that maximally stress the lower back and pelvis. These activities include climbing stairs and walking long distances and standing for long periods of time.
•Take many short breaks, try to lie down, and avoid low back stress. Also, avoid lifting.
•Strengthen the back muscles.
Uterine fibroids are another cause of low back pain and a large abdomen.
About 30 percent of women past the age of 30 years have fibroids, and they usually appear between the ages of 35 and 45. Some women are more likely to get fibroids, including black women, women who have never been pregnant and women who have a mother or sister with fibroids.
The cause of fibroids is unknown.
When symptoms of fibroids occur, they can include:
• Heavy menstrual bleeding
• Bleeding after intercourse
• Bleeding or spotting between menstrual periods
• Unusually frequent urination
• Abdominal swelling
• Low back pain during intercourse or during menstrual periods
• Fatigue or low energy from heavy periods and excessive bleeding
• Infertility if the fibroids are blocking the fallopian tubes
• Repeated miscarriages
An aortic aneurysm is the bulging of a portion of the aorta, usually at a weak spot in the aortic wall. The aorta is the largest artery in the body. The aorta starts from the heart in the chest and then arches downwards, traveling through the chest (the thoracic aorta) and into the abdomen (the abdominal aorta). The normal diameter of the abdominal aorta is about one inch.
Most aortic aneurysms occur in the abdominal aorta, the main cause is atherosclerosis. Major risk factors for atherosclerosis are smoking and high blood pressure, and genetics.
Other causes of aortic aneurysm include:
1.trauma to the aorta, for example a crush injury to the chest following a car accident,
2.inflammation of the wall of the aorta,
3.rare hereditary conditions such as Marfan's syndrome (a major cause of thoracic aortic aneurysm),
Many people can have an aortic aneurysm for years before any symptoms develop. When they do become evident, symptoms vary according to the type and location of the aneurysm. Symptoms of an abdominal aortic aneurysm include:
1.a pulsating feeling in the abdomen,
If an aortic aneurysm becomes very large, it can rupture (burst). This causes excruciating pain in the abdomen and back. There is internal bleeding which is usually fatal.
Chronic constipation may lead to a condition called fecal impaction. This is a situation where the stool becomes hard and causes stoppage in the bowel. The major factors that cause impaction are opioid pain medications, inactivity over a long period, changes in diet, and long-term use of laxatives. Regular use of laxatives for constipation contributes to the development of constipation and impaction.
Patients with impaction may have back pain (the impaction presses on sacral nerves) or bladder problems (the impaction presses on the ureters, bladder, or urethra). The patient's abdomen may become enlarged.
Ascites is the abnormal collection of fluid in the abdominal cavity, most often as a result of chronic liver disease.
Ascites is a medical condition in which excess fluid begins to accumulate in the abdominal cavity. This fluid is outside of the intestines and collects between the abdominal wall and the organs.
Advanced liver failure accounts for the majority of cases, but about 20% of patients with ascites have a cause other than liver disease. It may be secondary to heart failure, kidney disease, or cancer. Rarely, ascites is due to pancreatic disease, hypothyroidism , malnutrition, or tuberculosis.
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