Got Back Mice? Navigate This Often Misinformed Medical Craze
Updated April 22, 2015.
Written or reviewed by a board-certified physician. See About.com's Medical Review Board.
Back mouse is a condition characterized by painful bumps located in and around the hips, sacrum and low back. Diagnosing it accurately often stumps doctors and other health practitioners. Because of that, it's a good idea to very carefully consider the treatment recommendations you are offered, should you find yourself with these painful nodules. Let's sort out the known facts so you have a reference for dealing with this back problem effectively.
Back mice have been known to surgeons since 1937 when Reis reportedly named them episacroiliac lipoma. Since then, the condition has been attributed a number of names including: Iliac crest pain syndrome, multifidus triangle syndrome, lumbar fascial fat herniation and lumbo-sacral fat herniation. Many authors believe that of all the terms used to identify back mice, the last two - lumbar fascial fat herniation and lumbo-sacral fat herniation - are the most accurately descriptive.
A back mouse is a fat mass that protrudes abnormally through the lumbodorsal fascia. The lumbodorsal fasica is a big diamond-shaped sheath of connective tissue located in the lumbar and thoracic spine area of your back. Back mice also occurs over the hip bones in back, as well as the sacroiliac region.
Related: What is the Lumbodorsal Fascia?
You might think that a simple fat mass couldn't cause much pain, but generally speaking, that's not so. Patients and their surgeons often report excruciating pain from back mice.
Along with the pain, tell tale symptoms may include visibly notable nodules in the low back and sacral areas, and, when the nodules are touched or pressed, a reproduction of the type of pain that likely drives you to seek treatment in the first place.
Very little medical research has been done on back mice, and that may be one reason why little is known about it. In the meanwhile, the word on the internet street is that articles written by chiropractor David W. Bond provide the most comprehensive information available on this subject. Bond reports that moderately obese women seem to be at a higher risk for back mice than others. He also says that often people with back mice quite often go through a battery of treatments with no pain relief to show for it.
As I mentioned above, it's not uncommon for doctors to misdiagnose back mice. In fact, the condition is commonly mistaken for sciatica. While pain from back mice starts locally, at the nodules themselves, it often, like sciatica, radiates to other areas. Like sciatica, back mouse pain tends to be unilateral, and can increase depending on your position. The pattern of pain radiation is generally not uniform.
Related: Got Sciatica? Here's what to do.
Bond says that irritation due to back mice doesn't show up on nerve root tests - unless you also have a herniated disc. He adds that the condition may be accompanied by spasms in your paraspinal muscles, as well as decreased lumbar range of motion. The intensity of the pain can vary, as can how long it lasts (duration.)
Related: What is a Spinal Nerve Root?
While it's possible to pinpoint back mouse pain and/or tenderness by touching one, back mice are not trigger points. Trigger points present themselves as taut bands muscle, while back mice are felt as masses or nodules.
Back mice are not tight muscles, so pressing down on them will not contribute to their cure or management. In fact, this kind of treatment causes pain, Bond says. this means that a deep massage will likely not be the correct treatment.
One way to diagnose back mice is by injection (or surgery.) If the injection of a local anesthetic relieves the pain - albeit temporarily - the diagnosis is suggested. Case studies from the 1940s show that when back mice are surgically removed, this almost always fully relieves the pain.
Currently, surgery (excision of the mice, followed by repair of the fascial openings through which they emerged) appears to be the only way to achieve durable pain relief from back mice. The problem is, often hundreds of back mice may be present, which complicates the achievement of full pain relief using this method. That said, Bond believes this condition may be successfully treated with a combination of acupuncture and spinal manipulation.
Sources:
Denman C. Hucherson, M.D., Joe R. Gandy, M.D., Herniation of fascial fat: A Cause of Low Back Pain. The American Journal of Surgery. November 1948.
Rosati E1, Mariani D. The role of episacroiliac lipomas as a cause of pseudolumbago-sciatica syndromes. Arch Putti Chir Organi Mov. 1990.
Bond, D. Chiropractic Treatment of the Back Mouse. Dynamic Chiropractic. September 2004. http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=46427
Bond, D. Low Back Pain and Episacral Lipomas. Dynamic Chiropractic. September 2000. http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=31867
Written or reviewed by a board-certified physician. See About.com's Medical Review Board.
Back mouse is a condition characterized by painful bumps located in and around the hips, sacrum and low back. Diagnosing it accurately often stumps doctors and other health practitioners. Because of that, it's a good idea to very carefully consider the treatment recommendations you are offered, should you find yourself with these painful nodules. Let's sort out the known facts so you have a reference for dealing with this back problem effectively.
A Back Mouse by any Other Name
Back mice have been known to surgeons since 1937 when Reis reportedly named them episacroiliac lipoma. Since then, the condition has been attributed a number of names including: Iliac crest pain syndrome, multifidus triangle syndrome, lumbar fascial fat herniation and lumbo-sacral fat herniation. Many authors believe that of all the terms used to identify back mice, the last two - lumbar fascial fat herniation and lumbo-sacral fat herniation - are the most accurately descriptive.
So What is a Back Mouse, Anyway?
A back mouse is a fat mass that protrudes abnormally through the lumbodorsal fascia. The lumbodorsal fasica is a big diamond-shaped sheath of connective tissue located in the lumbar and thoracic spine area of your back. Back mice also occurs over the hip bones in back, as well as the sacroiliac region.
Related: What is the Lumbodorsal Fascia?
You might think that a simple fat mass couldn't cause much pain, but generally speaking, that's not so. Patients and their surgeons often report excruciating pain from back mice.
Along with the pain, tell tale symptoms may include visibly notable nodules in the low back and sacral areas, and, when the nodules are touched or pressed, a reproduction of the type of pain that likely drives you to seek treatment in the first place.
Very little medical research has been done on back mice, and that may be one reason why little is known about it. In the meanwhile, the word on the internet street is that articles written by chiropractor David W. Bond provide the most comprehensive information available on this subject. Bond reports that moderately obese women seem to be at a higher risk for back mice than others. He also says that often people with back mice quite often go through a battery of treatments with no pain relief to show for it.
Back Mice? Or Sciatica?
As I mentioned above, it's not uncommon for doctors to misdiagnose back mice. In fact, the condition is commonly mistaken for sciatica. While pain from back mice starts locally, at the nodules themselves, it often, like sciatica, radiates to other areas. Like sciatica, back mouse pain tends to be unilateral, and can increase depending on your position. The pattern of pain radiation is generally not uniform.
Related: Got Sciatica? Here's what to do.
Bond says that irritation due to back mice doesn't show up on nerve root tests - unless you also have a herniated disc. He adds that the condition may be accompanied by spasms in your paraspinal muscles, as well as decreased lumbar range of motion. The intensity of the pain can vary, as can how long it lasts (duration.)
Related: What is a Spinal Nerve Root?
Back Mice? Or Trigger Points?
While it's possible to pinpoint back mouse pain and/or tenderness by touching one, back mice are not trigger points. Trigger points present themselves as taut bands muscle, while back mice are felt as masses or nodules.
Back mice are not tight muscles, so pressing down on them will not contribute to their cure or management. In fact, this kind of treatment causes pain, Bond says. this means that a deep massage will likely not be the correct treatment.
Diagnosis and Treatment - The 2015 State of the State
One way to diagnose back mice is by injection (or surgery.) If the injection of a local anesthetic relieves the pain - albeit temporarily - the diagnosis is suggested. Case studies from the 1940s show that when back mice are surgically removed, this almost always fully relieves the pain.
Currently, surgery (excision of the mice, followed by repair of the fascial openings through which they emerged) appears to be the only way to achieve durable pain relief from back mice. The problem is, often hundreds of back mice may be present, which complicates the achievement of full pain relief using this method. That said, Bond believes this condition may be successfully treated with a combination of acupuncture and spinal manipulation.
Sources:
Denman C. Hucherson, M.D., Joe R. Gandy, M.D., Herniation of fascial fat: A Cause of Low Back Pain. The American Journal of Surgery. November 1948.
Rosati E1, Mariani D. The role of episacroiliac lipomas as a cause of pseudolumbago-sciatica syndromes. Arch Putti Chir Organi Mov. 1990.
Bond, D. Chiropractic Treatment of the Back Mouse. Dynamic Chiropractic. September 2004. http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=46427
Bond, D. Low Back Pain and Episacral Lipomas. Dynamic Chiropractic. September 2000. http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=31867
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