Lumps in the Low Back – Top of Hip
Do you have lumps in your low back, or across the top of you hip bone?
These are firm, movable lumps in between the skin and the muscle or in between the skin and the top of the hip bone (the iliac crest). They are also found the “dimple” between the butt and the low back. They can range in size from very small and round to oblong and several inches long.
First let me tell you they are NOT cancer and they are not malignant.
But if you have low back troubles, it important that your read on.
The lump is a back mouse. I’ll give you some other names so you can do further research if you like or you wish to see a doctor about them. Other terms are: Episacral lipoma, iliac crest pain syndrome, multifidus triangle syndrome, and lumbar fascial fat herniation
They are quite common. As a massage therapist, I have felt them on hundreds of people.For a long time, nobody I asked could tell me what they were.
It is estimated that between 10% to 25% of the population has them.
They are not in the muscle, so they are not “knots”.
They are like lipomas (fatty lumps) that a lot of people get. But lipomas are never painful when you push on them.
However, back mice can be painful when you push on them. Most people who have them can live with them. BUT….
In about 10% of the people who have them they can cause excruciating back pain, or refer pain down the leg or into the knee.
They mimic a herniated disc. And probably the majority of doctors are not aware of this.
What they are is fat that has leaked (herniated) through a rip in the facia (membrane) and often take nerves with it. These rips can be caused by trauma, lifting, sitting too much, or other possible causes.
Like trigger points, which are tender spots in muscles, back mice can refer pain to somewhere else on the body. But trigger points can be massaged away with pressure.
Back mice should NOT be massaged, because that only creates more pain. Massaging will not make them go away.
Massaging the back MUSCLES is a good idea. BUT NOT THE LUMPS.
If you have back pain or pain radiating down a leg, you should check to see if it is caused by a back mouse, before submitting to an MRI or other expensive procedures.
Lie face down wearing loose pants (no jeans or belts). Have a friend feel the low back (around waist level) and on the upper part of the hip bone for lumps. Have them push fairly hard on any lump they feel.
If pushing on a lump causes the the same pain you have been having, bingo. Then you can probably blame the mouse
The next step is to see a doctor or clinic (write down the earlier mentioned medical terms for reference). The true test to see if the back mouse is causing your pain is to have it injected with anesthetic. If that makes the pain go away, you have found the culprit. The anesthetic wears off in a couple hours.
Just about any doctor or qualified medical person could inject the anesthetic.
But for the actual surgery, if it were my back, I’d like someone with experience with these things, even though it is not major surgery. Besides removing the lump, the hole in the facia needs to be mended.
If the back mouse is causing the pain what can you do about it?
I do not know of any technique to get rid of the back mice. except surgery.
As I may have mentioned, about 90% of the people who have them are not seriously bothered by them.
Chiropractic may help to some extent, as would massage of the muscles – not the mice.
Drugs and pain killers do not help.
Forward stretching and twisting are not advised while you are in pain.
Ice packs may be helpful for pain.
Rub on Relief, a natural pain relief cream, may be helpful.
This is just about all I know about back mice. Please Comment, but I can’t really answer questions about them.
Free: Healing a Herniated Disc Guide Right Click to Download. Then choose “Save Target As” or “Save Link”
To both Celeste and Jim,
First of all the injection question is not within my expertise. I am a massage therapist.
To both of you, finding a doctor who knows what they are may be difficult. It may be easier to find a doctor who is open to doing some research. The surgeon I went to for a simple lipoma removal on my arm had never heard of them when I talked about them.
Unfortunately there is not a lot on the internet. If I were approaching a new physician I would print out an article written by a medical doctor. I would write my name and phone number on the top with a brief note. Something like, “This is what I think I have and I need to find someone who can help me.” Hand it to his/her receptionist.
Further down I found a few articles, but not the one I was looking for.
Note to Celeste, the one on your shoulder may not be what is causing your migraines or numbness. Obviously I don’t know the location or size of your lump. You might want to check out my post here: http://discomfortfree.com/2009/01/numb-hands-from-tight-scanlene-muscles/
I don’t have time to talk about migraines right now.
Note: There is also a “lumbar hernia” which is more rare.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1030570/pdf/annrheumd00160-0035.pdf
http://www.ajronline.org/content/148/3/565.full.pdf
http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=31867
http://www.chiroweb.com/hg/18/19/04.html
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2441105/pdf/tacca00116-0131.pdf
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1397620/pdf/annsurg00397-0126.pdf
Still battling to find someone to help me. It’s becoming more clear that the pain source is the “mice”. They are fairly large. One is along the iliac crest and seems to be cylindrical–about 4x 3 cm and about 5 or 6 cm from midline. The other is superior to it and more medial. It is larger, about 4×4 cm and immediately inferior to 12th rib about 3-4 cm from midline. I’m trying to get someone to inject it with lidocaine as a diagnostic maneuver. Should the margins be injected or the mass itself or both? Jim
I first noticed small lumps in my lower back when I was about 30 yrs old. I had mild pain that was only aggravated by shoveling snow or any activity that put excessive workload on my lower back musculature.
I tried massage, which was painful & only aggravated the problem. I also tried physical therapy where we focused on strengthening my abdominals, pelvic floor, & spinal muscles. I had limited success with therapy.
I visited a local cosmetic surgeon who was willing to remove the “lipomas”, but would only remove the ones that were larger & higher on my back. He did not feel it was necessary to remove the smaller ones that are located near my sacrum & the most painful.
I choose not to do surgery with that surgeon, due to my belief that he did not truely understand the nature of my pain. I also felt that he may not feel confident about doing surgery at a site where nerve involvement was likely.
Currently, I am still continuing with strengthening exercises & still searching for a surgeon that understands this issue.
Celeste
I have had back pain for 12 years after the birth of my first born child. I like I am sure many others have been pushed from pillar to post. I have seen every doctor under the sun, taken every medication you can think of. I am of course on antidepressants!!! I have only recently found out what my problem may be and I am convinced it is the back mouse. I have one in my shoulder area causing migraines and pain going down my arm and a few on my hop area and lower back with pain radiating down my leg.
I just wish I could find a Surgeon here in Sydney to help me. I went to a surgeon yesterday who said these lumps were not causing me any pain and he was not prepared to remove them!!! I won’t give up as I want my life back!!!! Good luck to you all, it is comforting to know there are other people out there who have the same problem!!
Hi Jim,
First of all, if you have had the problem for less than a month, I would wait. The reason I say this is because sometimes also having back spasms or tight low back muscles can aggravate the symptoms.
However if your problem is more long term, this is what I would do. I would Google each of the following terms: “Episacral lipoma”, “iliac crest pain syndrome”, “multifidus triangle syndrome”, and “lumbar fascial fat herniation”.
You won’t find a lot of stuff. But what you want is articles written by a medical doctor using medical terminology.
Then I would look in the phone book for Surgeons (under Physicians) and call them. Talk to the receptionist or whoever answers the phone and tell them you have a problem and rather than explain it you would like to email a medical article with your symptoms. Say please, please, please for someone to call you back.
I would do the same for every office.
Attach the file to the email and wait a few days. It is amazing returning phone calls seems to be a lost art.
If no one calls you back, call again.
You do want a surgeon who not only removes the lump stuff, but also seals the herniation (hole that the fat came through).
I had a regular lipoma removed from my arm by a surgeon. He had never heard of the back mouse, but was willing to find out about them.
I also had a client that I only saw a couple times for massage. She had had back pain for years. She told me her MRI showed a white spot on the top of her hip and she told me she thought her back pain was coming that spot. I then explained about back mice and gave her a printout of my article (which is not in medical terminology). She went to a neurologist and told him about it an he said “I don’t think that could be it.” So because a doctor told her “I don’t think that could be it” she did not pursue it any further.
That frustrates me.
Chances are you will find someone who can help you. Ask ahead what the charges would be and also ask if any other entity will be sending a bill. Because the clinic may bill separate than the doctor and unless you ask they may not tell you that.
Let me know how it goes.
Hilma
I have two back mice and pain down itb and glut medius with radiation to lateral calf. Nobody I have gone to “gets it”…I’m an Internist and don’t know anyone in my medical community (Cleveland, Ohio) who I can turn to. Jim