Low back pain

A 40 year old female awoke one morning finding she could not get out of bed - sudden incapacitating back pain - and other symptoms: severe muscle weakness and pain, numbness and tingling. Called 911. ER docs diagnosed acute back pain and sent her home - but also pulled some blood.

The phone rang a few days later. Lyme. Two tier CDC positive She had more symptoms: increasing joint pain, headaches, neck pain, sweats, and others. No brain fog to write home about. Pre-existing migraines became more frequent and severe. Back pain was exquisite.

An MRI showed a bulging lumbar disc. An orthopedist and chiropractor were satisfied.

Physical therapy and chiropractic manipulation did not help.
Oddly enough, the back pain improved with antibiotics. And nearly went away.

After one year of treatment for Lyme and co-infections, she stopped antibiotics - on her own, feeling better.

Now, a year later, she returns. Back pain has increased. Tingling, numbness, joint pains, jaw pain and low grade fevers are back. Migraines bad again.

She is worried Lyme is back. So am I.

A zillion people have bulging discs. Studies have shown that many asymptomatic people have herniated discs per MRI. (including me - I had sciatica years ago)

When the chief complaint is back pain Lyme is low on the list of differential diagnoses. It is the constellation of symptoms, taken as a whole, that changes the list Unfortunately, most doctors stop with the chief complaint and do not go any further. Other symptoms are for another day. If there are too many symptoms patient may be labeled "a crock." "High serum porcelain level" I heard in medical training. And God forbid the patient utter the word Lyme.

Bulging discs don't generally hurt. There are tons of causes of low back pain. Frequently, the cause is never known. Not in this case.

Kudos to the ER docs.