Question
I have a bulge on my back to the right of the L3-L4 area and no one knows what it is.

At the beginning of January I developed lower back pain ?one day started as being stiff in the lumbar area.  By next morning I was in severe pain. Even hurt to the touch. Chiropractor (Chiro) did the best she could considering the pain level.  Said I had a 搇umbar twist?that hurt the muscles. I saw my primary care doctor (GP) a few days later as I was still in significant pain.  She said could be herniated muscle because of the large bulge to the right of my spine, wide spread inflammation, and very tender to the touch.  The bulge was visible from across the room.

Xrays showed minor mis-alignment and arthritis but otherwise good spacing, SI joints intact and no aggressive bone behavior.  GP referred me to physical therapy (PT).  PT focused on pressure points, massage, electrical stimulation, ultrasound, and progressive exercises for the pelvic and hip areas.  There were significant muscle spasms.  PT also found an area of muscle atrophy with fatty deposits near the 搇ump?area during an ultrasound guided muscle exercise.

Pain is much better after 10 PT visits.  I am seeing the Chiro weekly. Now I am back to just being stiff and tender at the L3, L4, and L5 areas.  Some muscle pains persist.  Pain management went from 800 mg ibuprofen 3 times a day, 500 mg Tylenol twice a day, and muscle relaxants at night down to 200 mg ibuprofen twice a day and 500 mg Tylenol twice a day.  The exercises seemed to really help.

However, I still have that bump to the right of the spine, with a small lump to the left side.  At the beginning the area of extreme tightness was wide spread.  It slowly decreased to a knot on both side of the spine with the large side being on the right.  Both the Chiro and the PT says it is hard and feels like bone.

The Chiro & PT have theories. PT thinks that I have one or two vertebrae twisted such that the transverse process is bulging up to a point that it is visible across the room when I bend forward.  The Chiro says that I would still be having significant systems if that were the case, things that PT wouldn抰 help.  Chiro is looking over the xrays from back in January.

While my pain is manageable, I would like to know what this thing in my back is.  Will it go away? Will it get worse and make the extreme pain come back?  Do you have any theories to help guide my medical team?

Answer

Hanna Somatic Educatio   Hi, Sandy,

When a muscle goes into spasm, it shortens and thickens, giving rise to a "bump" which is not swelling or inflammation, but just the change of shape muscles go through when they contract.

The following articles give both an explanation (that actually makes sense) and a way to end the muscle spasms and pain.

http://somatics.com/back_pain.htm
http://somatics.com/chronic_back_pain.htm

This page explains medical terms
http://somatics.com/back_pain_terms.htm

This video can get you started relieving the spasms (preparation for another exercise).
http://somatics.com/video_pages/back_pain_exercise_video.htm