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Lipoma on RT side of back (Lumbar), radiating pain.

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I have a few lipomas in other locations, no bigger than the size of dimes, and they cause me no pain. I have a lipoma (according to my PCP) in my back. This was after massage therapy wouldn't take the mass away and ruled out any muscle problems. It is the size of a golf ball, moves around when pressed on and is almost rubbery in texture. The area itself is constantly sore, but more concerning to me is the radiating pain down my back all the way to my right knee. Anyone else with this problem? What helps quiet the radiating pain?
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First Helper User Profile Gaelic
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replied April 16th, 2011
Especially eHealthy
BusyBodyMommy,

The lipoma within the subcutaneous tissue is not the source of your radiating pain. It may press on local skin nerves, but they would only affect the local area. Radiating pain, down the back, buttocks and posterior leg is from compression of either a nerve root in the back or of the sciatic nerve in the posterior hip/thigh. If you have multiple lipomas through out the body, they can occur in areas other than under the skin. Lipomas have been known to form within the vertebral column and press on nerve roots. But, there are also other causes of nerve compression.

Discuss this with your physician. A thorough examination should be able to determine where the compression is coming from. The treatment will depend upon the cause.

Good luck.
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Users who thank Gaelic for this post: BusyBodyMommy 

replied May 19th, 2011
fascial hernia, pseudolipoma, referred pain
Gaelic is correct in that you should contact your physician before you can be sure what is causing your pain.

That said: radiating pain CAN be caused by a subcutaneous lumbar "lipoma" (pseudolipoma) as it is not uncommon for these masses to turn out to be small thoracolumbar fascia hernias. The thoracolumbar fascia is innervated by the same nerve roots which are responsible for lumbago-sciatica, most predominantly the L5-S1 nerves; it is not unheard of to have pain mimicking a lumbar nerve radiculopathy (sciatica) if the aforementioned fascia is irritated (from hernia and/or spasm), or if the associated cluneal nerves are entrapped and inflamed, may both produce referred pain along the same dermatomes as T12-S1 nerve roots.

All of these problems are rare on their own, and having more than one at once drops the odds down further, but only a properly trained doctor with experience in diagnosing various types of back-pain-causing issues can determine what is going on in your particular case. Most likely, a diagnostic local anesthetic injection into the mass or an advanced imaging scan (usually for muscle MRI/MRA or ultrasound) is going to be any well prepared doctors first diagnostic tool. An MRI/MRA is going to give your doctor a wider look at the health of your spine and surrounding tissues, aiding he or she in ruling out the possibilities of spinal stenosis, bulging/herniated discs, tumors, and much, much more; meanwhile, giving you the best look at the surrounding muscle and fat tissues, as well as blood vessels (and some view of nerve root cavities). Ultrasound is useful because of its high resolution and ability to be used in real time, helpful if you are trying to image a mass that easily moves or seems to disappear with just the slightest change in posture or position.

See your primary care Doc again and if they aren't experienced with these problems ask for a referral (or if you have to, demand one!) to a doctor with an expertise in this area (Either an: orthopedic spine surgeon, neurosurgeon, and if it is just a simple subcutaneous lipoma and you still want it removed for peace of mind, a plastic surgeon or dermatologist). Good luck with your pain, hope it resolves quickly. Smile
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replied July 10th, 2011
Possible right side lipoma, lower thoracic, upper lumbar area.
I have a similar lump on my lower thoracic, upper lumbar area. I originally thought it was my scoliosis progressing (I am 41), thinking my ribs were rotating. I went to a minor emergency center to address this lump (about the size of a golf ball), and was told it was possibly a lipoma. I have constant burning pain in the same (right) side. I work in surgery (a surgical technologist), and asked 2 neurosurgeons about it. Both said it was shingles. I have no rash. I also have developed a periodic wheezing cough. Usually occuring at bed time, either upon laying down or getting up. It disappears within a few hours. I have been told by a chiropractor (20 years ago) that I have scoliosis, a twisted/slipping vertebre, 2 pinched nerves (at the beginning and end of my curvature), and whiplash. Could this lump possibly be a herniated disk? Is it a lipoma? Do I see a pulmonologist? A neurosurgeon? A plastic surgeon?

Confused & scared.
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replied January 18th, 2013
Lipomas
I have six lipomas in my lower back ranging from golf ball size to the size of a baseball. The lipomas CAN cause pain. Mine are very deep and cause discomfort while sleeping all the time. If you suffer from Fibromyalgia, Chronic pain, or an autoimmune disease you can have pain!!! I have a problem with them putting pressure on my sciatic nerve. When palpated they hurt. I spoke to the head of my nursing school and she told me that its common for them not to cause pain, but that's not for everyone. Have an MRI or ultrasound on the areas you are most bothered, have them tested and removed. I have them throughout my body....at least 100! They will only remove the ones that are causing issues. It has taken 10 years to get a doctor to actually look beyond his training and realize not every single person has the same health experiences!! I can't wait to get them ripped out!!!!!
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replied December 14th, 2013
Back Lipoma, Painful and/or Pressure on Nerves: "Back Mouse
Lipoma - Article Links

If you have painful Lipomas in your lower back, don't be surprised if doctors, including your primary, spine specialist, pain specialists and ER doctors may tell you it is simple Sciatica: give you a prescription for 800 mgs ibuprofen to take three time a day and even some printouts of exercises for your supposed Sciatica.

However, the problem is, Sciatica is caused by pressure on a nerve usually from a pinched nerve from a slipped disc where anti-inflammatories are helpful, but painful back Lipomas are caused pain with the exercise you are told to do when you have Sciatica and the pain is not from a inflammation or pinched nerve, the pain comes from a Lipoma putting pressure on a nerve or nerves.

Yes, in one way, a sore Lipoma is inflamed, but anti-inflammatories do not relieve the pain because most Lipomas are made of fat and some have nerves. So you will get literally little to no relief.

I have suffered with Sciatica my whole life, and the pain one gets from lower back Lipomas is much worse, though it does effect the same areas: from lower back down past your back-end and to the bottom of your feet and toes, but the pain is much, much worse and literally debilitating with the back Lipoma I am speaking of.

Which is the reason why I am sharing all informative I can find with as many who may be dealing with this or know someone who is.

I am NOT a medical professional or sales person, the articles I mention below we're not written by me or a company I work for, all the information and authors are presented at the public websites the links below take you to.

Good luck!

A GREAT article to read if you have "back mouse", but first here are a few names that have been used to describe them and year they were documented from the following articles:

Episacraliliac Lipoma, 1937
Fibrositis, 1944
Lumbar and gluteal fibrositis, 1947
Multifidis triangle syndrome, 1955
Sacroiliac lipimata, 1966
Episacroiliac lipoma, 1972
Iliac crest pain syndrome, 1991
Back Mouse, 1993

and;
lumbar hernia,
lumbar fascial fat herniation
Iliac crest pain syndrome

So far, this is the best article I have come across:
2003/2004
* The Problem With The Back Mouse - Diagnosing and Dealing with Episacroiliac Lipoma
Dr. W. David Bond
http://www.massagetherapy.com/articles/ind ex.php/article_id/602/The-Problem-With-The -Back-Mouse-

Also I put together a little list of informative websites, some are just abstracts of articles written, including ones published as recent as 2013 from NIH's website ncbi.nlm.nih.gov

(NCBI: National Center for Biotechnology Information / NLM:
U.S. National Library of Medicine /
NIH: National Institutes of Health)


(* Basic Information from the many articles linked to below)

* Episacral lipoma is a small, tender subcutaneous nodule primarily occurring over the posterior iliac crest.

* Episacral lipoma is a significant and treatable cause of acute and chronic low back pain.

* Episacral lipoma occurs as a result of tears in the thoracodorsal fascia and subsequent herniation of a portion of the underlying dorsal fat pad through the tear.

* This clinical entity is common, and recognition is simple.

* The presence of a painful nodule with disappearance of pain after injection with anaesthetic, is diagnostic.

* Medication and physical therapy may not be effective.

* Local injection of the nodule with a solution of anaesthetic and steroid is effective in treating the episacral lipoma.

* Treatment:

Each nodule was treated with multiple puncture technique (6 to 8 punctures of the fibrous capsule of the nodule)

Then injected with;

3 cc of lidocaine hydrochloride
40 mg methylprednisolone acetate

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+ Articles:

2013
* Episacral lipoma: a treatable cause of low back pain
http://www.ncbi.nlm.nih.gov/m/pubmed/23720 083/

2012
* The Frequency of Episacral Lipoma
http://onlinelibrary.wiley.com/doi/10.1016 /S1754-3207(11)70789-1/abstract

2010
* Inferior lumbar triangle hernia as a rarely reported cause of low back pain
http://www.ncbi.nlm.nih.gov/pmc/articles/P MC2943654/


2010
* Lumbar hernia
Authors:
SS Teiblum
http://www.ncbi.nlm.nih.gov/m/pubmed/20334 799/

2009
* Lumbar hernia misdiagnosed as a subcutaneous lipoma
http://www.jmedicalcasereports.com/content /3/1/9322

Book: 2004
* 'Low Back and Neck Pain: Comprehensive Diagnosis and Management'
By David G. Borenstein, Sam W. Wiesel, Scott D. Boden
"Sacroiliac Pain"

2004
* 'Treasures in the attic'
by Dr. Peter Curtis
The British Journal of General Practice
http://www.ncbi.nlm.nih.gov/pmc/articles/P MC1266214/pdf/bjpg54-473.pdf

2002
* Back and Hip Pain
PDF: http://www.med.unc.edu/aging/fellowship/cu rrent/presentations/Back%20and%20Hip%20Pai n%20Fellow%20Talk%2002.19.10.pptx

2001
* Low Back Pain (LBP)
Summary by Philip Meinhardt
Causes of low back pain
Pathoanatomic Diagnoses in Mechanical LBP
http://personal.health.usf.edu/slongfel/fm /LOW%20BACK%20PAIN.doc
"Back Mouse- Discrete subcutaneous nodules that feel like sebaceous cysts in the sciatic notch area. Actually herniations of deep fat into the superficial area that cause acute LBP or symptoms radiating into leg like sciatica. Needling to express contents or excision is said to alleviate pain"

2000
* Fibro-fatty nodules and low back pain. The back mouse masquerade.
http://www.ncbi.nlm.nih.gov/m/pubmed/10778 841/

2000
* Treatment of low back pain associated with "back mice'': a case series.
http://www.ncbi.nlm.nih.gov/m/pubmed/19078 461/

2000
* Low Back Pain and Episacral Lipomas. Dr. W. David Bond
(PDF:http://carpaltunnelmaster.com/Episacr alLipomasAndLowBackPain.pdf)

2000
* Fibro-Fatty Nodules and Low Back Pain. The Journal of Family Practice Online
http://www.jfponline.com/home/article/fibr o-fatty-nodules-and-low-back-pain/64d55951 4ecfbc274cdb66c827df1ce2.html

1993
* In Search Of The Back Mouse
http://www.ncbi.nlm.nih.gov/m/pubmed/85056 09/
Abstract: "The "back mouse" is a tender, fibrous, fatty subcutaneous nodule found in the lumbosacral area in up to 16% of people. It can be a treatable cause of low back pain that may be unrecognized by both specialists and generalists."

1983
* Hernia of the inferior lumbar space. A cause of back pain.
http://www.ncbi.nlm.nih.gov/m/pubmed/62254 11/

1966
* Another cause of low back pain: lipomata in the sacroiliac region.
http://www.ncbi.nlm.nih.gov/pmc/articles/P MC2441105/

1961
* Sacroiliac (Episacral) Lipomas
http://archsurg.jamanetwork.com/Mobile/art icle.aspx?articleid=559945

1956
* Soft tissue lesions as cause of low back pain: Anatomic study
http://www.sciencedirect.com/science/artic le/pii/0002961056901398

1952
* Subfascial fat herniation as a cause of low back pain; differential diagnosis and incidence in 302 cases of backache.
http://www.ncbi.nlm.nih.gov/pmc/articles/P MC1030570/

1950
* Episacroiliac Lipoma as a Cause of Low-Back Pain
Kermit H. Katz, M.D., and Morton S. Berk, M.D.
November 30, 1950
N Engl J Med 1950; 243:851-852
http://www.nejm.org/doi/full/10.1056/NEJM1 95011302432202

1946
* Herniation of Subfascial Fat as a Cause of Low Back Pain: Report of Thirty-Seven Cases Treated Surgically
http://www.ncbi.nlm.nih.gov/pmc/articles/p mid/18623755/
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replied August 11th, 2014
Thank you corypaul for all of the info and references you posted. I've been dealing with severe low back pain for 18 months and have had numerous treatments, been on different meds, seen different doctors, pt's's, acupuncture etc. with no relief.
Thanks again, Kassy
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