Can bilateral psoas abscess cause lower back pain that extends to the legs?

Question

Hello doctor,

I am seeking guidance regarding my father's health situation. He is a heart patient who is currently experiencing persistent low back pain that extends to his legs. We have consulted an orthopedic specialist, who diagnosed him with early osteoarthritic changes. He was prescribed calcium, but there was no improvement after two weeks.

Following this, we visited a physiotherapist who recommended an MRI. After reviewing the MRI report, the physiotherapist initiated some treatment, which provided partial relief from the pain. However, upon reading the MRI report myself, I noticed three notable findings:

Bilateral psoas muscle concerns
Bilateral psoas abscess
Hemangioma

We also consulted a neurologist, who suggested normal exercise and the use of a belt. Despite these efforts, my father's pain persists.

The pain is localized to his lower back and not his spine. Interestingly, he experiences minimal pain while walking, but upon waking up in the morning or evening, the pain intensifies.

My father underwent angioplasty four years ago and is currently on a regimen of heart medications and tuberculosis medications.

Please help.

Thank you.

Answer 1

Hello,

Welcome to iclinq.com.

I read your query and understand your concern.

Based on the information and findings, it appears that your father is dealing with an infection in the lumbar spine area, likely attributed to tuberculosis (TB). Urgent attention is required due to the potential for his symptoms to worsen. If the abscess in the psoas muscle ruptures, it could lead to a loss of strength in both lower limbs, potentially necessitating spinal surgery and resulting in adverse outcomes.

Prompt initiation of treatment is necessary. Your father should begin anti-tuberculosis medication immediately. These medications are readily available at government hospitals in India and are provided free of cost. The treatment regimen typically spans 9 months to 1 year, and it is important to adhere to it consistently.

Please note that these medications cannot be prescribed through online consultation. I strongly suggest you to consult a nearby government hospital promptly to begin the appropriate treatment.

With the prescribed treatment and adherence to medical advice, your father's condition should improve significantly. During this period, I would suggest he use a Taylor's brace for back support, ensure ample bed rest for at least 3 months, and avoid bending or lifting heavy objects.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

No surgery needed currently. Consistent use of anti-Tuberculosis tablets is essential, and symptoms will gradually diminish. Left side pain is not caused by increased uric acid.

I hope this answers your query.

Thank you.