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What could be the reason for extreme pain in the lower left back sacral joint extending into the buttocks?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

I have had extreme pain in my lower left back sacral joint extending into my buttocks for two days. I cannot lie flat or on the left side. I struggle to sleep, and the pain worsens when I stand, lower myself to sit, and lie flat. I am currently taking Oxycodone, Diclofenac, and Co-codamol 30/500 mg for chronic pain from endometriosis and fibromyalgia.

Answered by Dr. Suman Saurabh

Hello,

Welcome to icliniq.com.

I read your query and understand your concern. I would like to know if you sustained any trauma or have a history of lifting relatively higher weights. I would also like to know the exact site of the pain. For that, you can show the picture. It would be advisable to get an MRI of the lumber spine and sacroiliac joint. Meanwhile, you can take some analgesics. Consult your specialist doctor, talk with them, and take medications with their consent.

Thank you.

Investigations to be done

Investigation: X-ray lumbosacral spine AP (anteroposterior) and lateral view. MRI (magnetic resonance imaging) of the lumbosacral spine along with both SI (sacroiliac) joints.

Treatment plan

1. Tablet Aceclofenac 200 mg once daily for five days. 2. Tablet Thiocolchicoside 4 mg twice daily for five days. 3. Tablet Omeprazole 40 mg before food for five days. 4. Diclofenac gel for local application.

Preventive measures

Avoid bending forward. Complete bed rest for five days.

Patient's Query

Hello doctor,

I have taken Voltarol suppositories, Co-codamol 30/500 mg, and slow-release Oxycodone. Along with these medications, I had cold packs and applied Diclofenac gel to the site, but nothing was effective. I have not slept in 48 hours. There was no history of an accident or fall. Had a sore or aching left-sided back pain for a few days and then suddenly could not move. I am feeling stuck as I cannot lie down or sleep. Please advise if there is an injection I can have to assist with inflammation and pain.

Answered by Dr. Suman Saurabh

Hello,

Welcome back to icliniq.com.

You can use an injection of Ketorolac 30 mg for relieving pain. Consult a specialist doctor and take medications with their consent. But the diagnosis must be made with MRI (magnetic resonance imaging) as supportive treatment would not work for long. So try to get MRI done as early as possible.

Thank you.

Answered byDr. Suman Saurabh

Medically reviewed byiCliniq medical review team

Published At November 24, 2022
Reviewed AtJune 20, 2024

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Suman Saurabh
Dr. Suman Saurabh

Orthopedician and Traumatology

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