▲The doctor is treating a patient with low back pain; the picture is a photo of the situation, and the patient in the picture has nothing to do with this article.

(Photo courtesy/Chen Jianzhi)

Text/Chen Jianzhi

A 70-year-old man, who does not smoke or drink, has always felt sore in the depth of his right waist in recent years, especially when bending or turning around.

After receiving X-ray examination of the lumbar spine, it was found that his intervertebral disc was stenosis and bone spurs. He continued to receive physical therapy, and also received folk therapies such as massage, rehabilitation, and meridian regulation.

For the past six months, even if I lie flat at night, I still suffer from low back pain, especially when I lie on my right side. It is difficult to fall asleep, so I have to take painkillers, muscle relaxants and sleep aids before going to bed every day.

In the past six months, the constipation has been severe, with an average of one bowel movement every 4-7 days. I have taken stool softeners and laxatives, but I can only get rid of hard fecal stones, so I have to use intestinal lotion every day.

Please read on...

When I went to the doctor, I pressed hard on his right lumbar muscles, which caused pain, as if I felt a lump.

Arranged for abdominal CT examination, it was discovered that a huge tumor with a diameter of more than 10 cm had grown on his right kidney, compressing the right liver and right rear pleura.

It was determined to be stage 4 renal cell carcinoma. After surgical removal, the low back pain and constipation disappeared.

▲Computed tomography of the abdomen showed lumbar intervertebral disc stenosis and bony spurs (pointed by the blue arrow), and a huge tumor with a diameter of more than 10 cm in the right kidney (pointed by the red arrow) oppressed the right liver and right rear pleura.

(Photo courtesy/Chen Jianzhi)

Diagnosed abdominal visceral involved low back pain

The patient actually suffered from abdominal visceral involved low back pain.

According to neuroanatomy, most abdominal visceral sensory information is directly transmitted to the brain through the vagus nerve, but some of them will pass along the sympathetic nervous system, transmit to the celiac ganglion, and pass through the large and small visceral nerves to the lower thoracic and lumbar vertebrae Together with the spinal nerves, it enters the spinal cord, passes upwards, and enters the brain.

There is no pain-sensing nerve inside the kidney, but if the lesion is large enough, it breaks through the peripheral capsule (with sensory receptors), or compresses the ureter, sending out pain messages. When transmitted to the spinal cord, the lumbar nerve is involved, making the patient mistakenly think it is the lower back Muscle neuralgia.

Surgical removal of tumor discomfort symptoms disappeared

Renal cell carcinoma starts from the renal tubules and accounts for 3% of all malignant tumors. It usually occurs between the ages of 50 and 70 and is mostly found accidentally during imaging examinations.

Most patients will have hematuria (blood in the urine), and will not continue to have low back pain or abdominal pain until the advanced stage of the disease, or feel a hard lump in the waist.

Surgical removal is the most effective way to treat kidney cancer. Five years after the operation, 80% of the patients are still alive and healthy.

It should be noted that stones, inflammation or tumors in the liver or gallbladder can also cause similar symptoms.

Regular health checks are really important.

(The author is a physician at Yuanjing Otorhinolaryngology Neurology Clinic)

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  • constipate

  • the tumor

  • health care

  • low back pain

  • kidney cancer

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