Could a fracture be causing your back and abdominal pain? The two most common causes of back pain radiating to the abdomen are, vertebral compression fracture, and herpes zoster.
Other serious conditions include trauma, spinal infections, and metastatic disease which may cause back and abdominal pain. But in these cases the abdominal pain is generally a late finding, and occurs only after the disease is advanced and the back pain is very severe.
Vertebral Compression Fracture
Osteoporotic compression fractures may cause back and abdominal pain. When you have osteoporosis, the bones become thin and frail, placing you at risk for a vertebral compression fracture. These can occur with the slightest stress, such as a sneeze, or stepping off of a curb.
If you are a thin white female, over the age of 50, you are at risk for osteoporosis. If you have sudden onset of severe back pain, while you are doing something such as bending or lifting, you may have a compression fracture.
The pain from this type of fracture may radiate around to one or both flanks and onto your abdomen.
This radiating pain can occur when a nerve is pinched, or when the inflammation from the fracture, begins to irritate the nerves.
"cause excruciating pain"
In most cases, the back pain will be very sharp, and much worse than the flank or abdominal pain. The pain will be worse with any activity. Things like bending, or twisting, or even taking a deep breath may cause excruciating pain.
"if you are unable to take care of yourself"
When this type of back and abdominal pain occur, you need to call your doctor. If your pain is severe, if you are unable to take care of yourself, you need to be seen right away. If your doctor cannot see you, go to the emergency room.
If your pain is less severe, and you have someone to help you fix meals, and bathe, etc., you may be okay waiting a few days to see your doctor. These fractures are generally not life threatening, but the pain can be very, very severe, and then get worse with any activity.
"your doctor will order x-rays, or an MRI, or a nuclear bone scan"
Depending on your medical history, and the severity of your symptoms, your doctor will order x-rays, or an MRI, or a nuclear bone scan, for evaluation of your back and abdominal pain. These imaging studies will help determine exactly where the fracture is, and how old the fracture is.
If your fracture is old, meaning it is healed, treatment would be similar to the treatment for arthritis. Your doctor may give you anti-inflammatories, and send you to physical therapy. If the fracture is new, your treatment options would include, bed rest, vertebroplasty, and kyphoplasty.
"Much better, are treatments that..."
Bed rest, as a treatment for a compression fracture, will last 2-3 months, and presents several risks. Being in bed more than a few days, will cause weakness as your muscles atrophy, and some people never regain their strength. Being inactive presents increased risk of pneumonia, blood clots, and bed sores, and all of these can have life threatening consequences.
Treatments that allow early mobilization are much better. Relatively new procedures, such as vertebroplasty and kyphoplasty, have been developed that stabilize the fracture. This controls the pain, allowing you to get back on your feet.
"This stabilizes the fracture immediately..."
Vertebroplasty, and kyphoplasty, are very similar procedures. But kyphoplasty is more useful in the more severe cases, where vertebra is more compressed, or collapsed down.
In both techniques, the surgeon places a large bore needle into the fracture and fills the fracture with methyl methacrylate, which is special bone cement that has been used for years to hold prosthetic hips and knees in place. This stabilizes the fracture immediately and gives significant relief of back and abdominal pain.
"In cases where the vertebra is deformed..."
In cases where the vertebra is deformed, or crunched down, a kyphoplasty can restore the height of the vertebra, preventing permanent deformity. In a kyphoplasty, before the cement is placed, a balloon in introduced into the fractured vertebra and expanded. When the shape of the vertebra is restored, the balloon is deflated and removed. Then the void is filled with the bone cement.
Recovery from either of these procedures is quick, with most people, up and walking the next day. Then return to baseline activity levels, over the next few weeks.
Herpes zoster, or shingles, may cause back and abdominal pain. Symptoms most often begin on the back or flank and radiate onto the abdomen. These outbreaks can also affect the head and other areas of the body.