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Forum Name: Spinal problems and back pain

Question: Lump at base of spine


 ben9292 - Fri Jan 02, 2009 8:18 pm

I have a Soft lump at the base of my spine, top of my bum crack on my left bum cheek. The lump itself is not painful to touch but the skin around it is. When no pressure is applied I feel no pain but sitting and lying on my back will cause it to hurt as much as applying pressure to a normal bruise would, so not "that" painful but still noticeable. The lump is about the size of two flat marbles and is soft. The skin on the lump is slightly red. Ive had the lump for four days, the pain has not got any worse but I seem to have only noticed the lump on the third day, though it is small. I sit at my computer a lot, but I do go walking along the beach/ take small breaks, but I'm still sitting more than the average person. I am 18 years old and slightly overweight (if that helps). Since there seems to be no change I'm afraid this may become worse but I don't know.
 Tom Plamondon PA-C - Sat Jan 03, 2009 10:59 am

User avatar There are three possibilites:
The first two (most likely) are epidermoid cyst and the other is a lipoma. Both are benign. Both are common.
An epidermoid cyst (EC) is a bit firmer than a lipoma which is usually soft and mobile.
If bothersome, either can be treated in a physician office with excision or incision and drainage (esp EC).
Lipomas can grow. If one grows beyond 5 cm then may suspect liposarcoma (malignancy).
A third possibility is pilonidal cyst which is an local ingrowth of hair typically in the sacral area. This cyst is very painful and should be excised.

See a physician to make definitive diagnosis

Keep us posted.
 ben9292 - Tue Jan 06, 2009 8:42 pm

Ty for your reply, out of the three I'd assume its the first. It is fairly hard, not very mobile at all and not that painful. I've decided that I'd see how it goes, and so far so good. It seems to be getting smaller slightly every day. The pain has not increased nor decreased but I can easily ignore the slight discomfort. The skin around it had turned to a bruise which seems to be shrinking as well. Sometimes I see a yellow tinge below the bruise but it isn't always there and hardly noticeable. The pain is only felt while sitting/laying still and after I stand up it seems to slowly go away. Also, after sitting for a while, it could be my imagination, but it seems to go harder and after removing pressure it goes a little more soft.
Its been a week and a half now, and I believe its getting better, slowly. Is this normal?
 Tom Plamondon PA-C - Wed Jan 07, 2009 1:10 pm

User avatar Hello,
If indeed this is an epidermoid (sebaceous) cyst, it may return since the sac containing the fluid has not been removed.

Usually these cysts are somewhat mobile perhaps not as mobile as a lipoma.

In general, skin lesions which are hard, non mobile, and non tender should be evaluated by a physician to rule out cancer. Also look at the lesion or spot for: asymmetry, irregular borders, change in color, increase in size, and elevation of the lesion.

Let us know how it turns out.
 ben9292 - Fri Jan 09, 2009 3:28 am

I had it checked, the doctor says its an abscess, and he prescribed Brufen (1 tablet @ 4 times a day). He said after about 20 days it should be gone. I'm glad its not something bad.
 Tom Plamondon PA-C - Fri Jan 09, 2009 1:04 pm

User avatar Hello,
Did the physician say it was an infection (abscess) or something else like a cyst?

An abscess is an infection and the treatment is typically incision and drainage.

Take care.
 ben9292 - Fri Jan 09, 2009 10:14 pm

abscess infection, and it was Ibilex 500 i was prescribed, I read the prescription wrong. Is drainage the only way?
 ben9292 - Sat Jan 10, 2009 7:09 pm

Also, it just burst last night, a lot of blood and pus to wipe up. There was also this block dot that came out, I don't know what it was.... A lot less pain now, lump subsiding and colour returning to normal. Is it over?
 Tom Plamondon PA-C - Wed Jan 14, 2009 12:39 pm

User avatar Hello,
I like to incise and drain abscess in the office because it provides pain relief, removes most of the pus, and provides a way to culture the pus in case the infection is MRSA. Most incised and drained abscesses do not require anti biotics.

This abscess sounds like it is taking a natural course of healing.

If symptoms worsen or re-occur, see your physician... otherwise it should be fine.

Take care.

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