Dr. Atul Prakash
Orthopedician and Traumatology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I am concerned about bone cancer. I have terrible upper back pain that is now going to the ribs and lower back, including the hips. It gets better with rest, but it has been going on for three months. I have had lots of tests and doctor visits with no answers. Previously I have had back pain on and off for years. Currently, I am taking Atenolol, and I have had a CT scan of the chest and an MRI of the neck and thorax.
Thank you.
Hello,
Welcome to icliniq.com.
I am keen to help, but the information is too scant to be specific.
Please share the following information:
1) Clinical examination findings.
2) Investigation reports.
3) What is the reason for concern regarding cancer? Is it unexplained weight loss, night pain, persistent pain because you said the pain gets better with resting, night sweats, etc.
4) Have you had physiotherapy, and what modalities have you tried?
Regards.
Patient's Query
Hello doctor,
I had a chest CT scan, and it was clear. I had a head, neck, and upper spine MRI that showed stenosis, nothing major. I had an upper-right abdominal scan to check the gallbladder, and it was normal. All blood work is in the normal range. My primary care doctor said my night sweats are hot flashes as I am menopausal. But I am not sure. I get them constantly at night and during the day. The pain is not worse at night. It some times better with rest. I am concerned because the pain is widespread in the entire back and now hips and has been going on for months with no improvement, and I cannot figure out the reason. My doctor keeps telling me the pain was gastrointestinal-related. I saw a gastrointestinal specialist who said it was not.
Kindly tell me what to do.
Hello,
Welcome back to icliniq.com.
You can go about in two ways.
1) Insist for a PET (positron emission tomography) scan to rule out any abnormal activity in the bone and soft tissues and help rule out any neoplasms.
2) The other option is to wait it out.
Take Vitamin D and Calcium, try anti-inflammatory tablets, and perhaps add Duloxetine or Pregabalin to help control pain. Do manual therapy and massage. To help with focal pain, try IFT (Interferential Therapy) and TENS (Transcutaneous Electrical Nerve Stimulation).
I request you to share your blood work and check your Vitamin D levels and thyroid profile.
Thank you.
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Orthopedician and Traumatology
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