Can a Lipoma in the Lower Back Cause Pain to Go Further Up my Back?

Charity,
You did the right thing by seeing a doctor to evaluate the masses that you feel in your arm, breast/rib cage, and lower back. You are correct, it is impossible to tell with certainty what the masses are until you have them excised and the pathologist looks at them under the microscope. However, lipomas are common and have consistent characteristics which makes the diagnosis more likely. The lipomas usually are mobile (not stuck to underlying structures), soft and have no overlying skin changes. More worrisome masses are hard and stuck to surrounding structures, including your skin. Your back pain may be due to compression of the lipomas or change in posture from adjusting to the mass on one side of your back and not the other. The lipoma may well be causing your pain, but you can only know for sure with a complete evaluation by your doctor. You may also have pain for some other reason that is not identifiable.

Most experienced surgeons can diagnose a lipoma by direct physical examination. However, simply because a soft tissue mass looks and feels like a lipoma, it is no gurantee that it is in fact a lipoma. The most definitive means of diagnosis is to remove the lesion and have it evaluated by a pathologist. Although most lipomas are not painful, some do cause pain by direct compression of surrounding structures.

Lipomas can interfere with normal sensory and pain fibers on the body. A lipoma diagnosis is only made under the microscope. Uncommon and rare symptoms should always be evaluated by a trained surgeon and preoperative diagnostic testing is often required to exclude other more serious causes of referred pain.

It is unusual for a lipoma cause pain. If the lipoma is compressing on nerves or other structures, this may cause discomfort. Be sure that your surgeon thoroughly evaluates you and if there's any concern that your lipoma is affecting nearby structures, further diagnostic imaging studies such as an MRI may be indicated.