So, you’ve recently started experiencing back pain and now there seems to be a lump in the same place?
You’re pretty sure it wasn’t there before, but now you can feel it. And the more you check it, the more obvious it seems.
Sometimes there really is a change in the tissues. Pain and irritation can be accompanied by localised swelling and inflammation, and there are other things that can cause genuine lumps and bumps.
But very often, nothing new has appeared at all.
What you’re feeling may simply be a completely normal bit of your anatomy that you’ve suddenly become much more aware of because it hurts.
Most of the time, we’re remarkably unaware of our own anatomy. There are bumps, ridges, muscles, tendons and bony prominences all over us, but unless we have a reason to pay attention to them, we don't give them much thought.
Pain changes that.
When an area starts to hurt, you naturally start paying much more attention to it. You might touch it, press it, compare it with the other side and check it repeatedly.
And suddenly you discover things that have probably been there all along.
That little bony prominence. The edge of a muscle. A joint. A rib.
Suddenly, it feels like something new.
No.
You really can feel something there. The question is whether what you’re feeling is actually new.
There’s an important difference between “I can feel a lump here” and “a lump has developed here.”
Think about your tongue after you’ve chipped a tiny bit off a tooth. Suddenly that microscopic rough edge feels enormous. You can't stop finding it with your tongue.
The tooth hasn't suddenly become huge. You've simply become much more aware of something that was previously insignificant.
Something similar can happen when your back hurts.
People are sometimes told that these lumps are “gristle”.
Gristle is an everyday word usually used to describe cartilage or tough connective tissue, but it isn't really a useful explanation for a newly noticed lump.
There certainly are connective tissues and cartilage in and around joints, but that doesn't mean that a painful bump on your back is a mysterious piece of gristle that has suddenly grown there.
Very often the explanation is considerably less exciting:
It was already there.
None of this means that every lump should be dismissed as normal anatomy.
If you have a genuinely new lump or swelling — particularly one that is growing or changing, is red or hot, doesn't settle, or doesn't seem to correspond to a normal anatomical structure — it's sensible to get it checked.
But if you've developed a sore back and suddenly discovered a bump in exactly the same place, it doesn't necessarily mean that something new has grown there.
Sometimes the tissues have changed. Sometimes there is some local swelling. And sometimes your anatomy is exactly the same as it was before — you've just discovered a bit of it you never had a reason to notice.
