My mother is 59 years old. 2 weeks ago, she slipped on the floor and hurt her back. After that, she started having problems defecating. She feels pain on her lower back whenever she lies down and gets out of bed. There is no pain when she is standing upright, and when she bends sideways. However, she feels pain when sitting down or bending forward. She is taking dulcolax and suppository but is still having a hard time pooing. She is taking a lot of liquids and is on soft diet.

Dear lybrate-user, looking at the history given by you, she is having low back pain on movements. But it is not clear if she is having any neurological symptoms like radiating pain, pins/ needles, numbness or weakness in legs. Does she have any changes to her habits of passing urine? If she does not have any neurological and urinary symptoms, the possible cause for back pain are 1) osteoporotic fracture of lumbar vertabrae 2) muscle spasm. Xray of ls spine would help to diagnose this. If there are neurological/urinary symptoms, then we should rule out disc prolapse/ cauda equina syndrome with mri scan. So, I advise you to consult a local spine/ orthopaedic surgeon for assessment and management urgently.  

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Dr. Vipin GuptaOrthopedic Doctor9yrs exp

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Hello dear summarising your case: your mother is a postmenopausal female with 2 weeks old injury to lower back leading to a pain which gets worse by sitting and forward bending and relieved by walking. Additionally has got a problem defaecating which probably is not a true defaecation problem but is probably because of increased pain related to the posture during the activity. Now, I feel you have provided a meticulous history but does lack a few points: 1. Has she had low back pain problem previously? 2. When did she attain menopause? 3. Has she had bone pains after the onset of menopause? 4. Does she have any medical illness and is she on any medicines currently and for how long if yes? Although it seems more of a mechanical pain, but x-rays of her lumbar spine are a must before putting her on any kind of treatment. She might need additional investigations for osteoporosis or an mri lumbar spine if the x-rays are suspicious. Contact me in case you need additional help. 

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