Hard Knots in Lower Back? (back mice)

(First, please check our video posted in October 2023 on "Cluneal nerve entrapment" and the "back mice phenomenon")

Hard Knots in Lower Back?

*We have published a review about back mice: you may access a free on line pdf in the following link → Historical Review of Studies on Sacroiliac Fatty Nodules (Recently Termed “Back Mice”) as a Potential Cause of Low Back Pain. Cañis Parera et al. Pain ther (2021). Recently, and thanks to an email from one patient, I have realized that the fact that back mice are so UNKNWON by the medical community, even nowadays, makes the search for information about them a hard task. When patients and even doctors try to search information about the nodules by googling, they have to describe them in many different ways, as best they can. Since in most of the cases we don’t know a proper “medical” term to search information about these intriguing painful nodules, people use several descriptions such as: hard knots in lower back, painful nodules in the lower back, painful lumps in low back, painful fatty lumps, and painful lumbar lipoma, among others. This reminds me of my own experience, back in the summer of 2017 when I was trying to find out about these mysterious painful knots in the back because my husband started complaining about backache. Although I am a doctor myself, I had to use these descriptions to find a hint about what they could be. My first attempt was to type the words bultos dolorosos en la espalda (painful lumps in the back), and hope to find information about these nodules on the net. At the beginning, this search led me to some blogs about chiropractic massage that included some medical references and, since then, I have found many more medical articles, and that’s why I am sharing this useful information in this web page. The fact that there are so many names to describe this entity shows that it is still really unknown, and every person that discovers them gives them a different name: edematized subfascial fat herniation, fibrositis of the back, episacroiliac lipoma, sacroiliac lipoma, cellulite nodule, xanthoadipose nodules,   nodolo di Copeman, fibro-fatty nodule, hernia del panniculo adiposo, BACK MOUSE OR MICE… Hard Knots in Lower Back? The purpose of this web page is providing both doctors and patients with relevant medical information in a clear way. We hope it helps to move forward!  Check the youtube channel for more videos related to back mice  -> link to youtube channel Published in January 2019 by Marta Cañis Parera

“Copeman’s nodules (back mice)… the story of a scientific eclipse?

“The incredible story of ‘Copeman’s forgotten chapter’ is revealed in the following videos, detailing how Dr. Copeman and his colleagues investigated fatty hernias (back mice) and their potential relationship with back pain in the mid-20th century. Despite early discovery and a surge of interest, all this knowledge was lost and overlooked, in what is now considered one of the most spectacular scientific eclipses in history. This oversight may have resulted in unnecessary suffering for countless people. ->LINK to Youtube: Chapter 4 (Part 1): The lost chapter of Dr. Copeman about fatty hernias (5 minutes long) english subtitles ->LINK to Youtube: Chapter 4 (Part 2): What did they mean by Non-articular rheumatism. (5 minutes long) english subtitles -LINK to Youtube: Chapter 4 (part 3)…. coming soon -LINK to a Youtube video based on a presentation I did in December 2022 in Poland. Summarizes well what we know so far about the ‘back mice’ phenomenon (Video lasts 17 minutes and it is in ENGLISH) ->LINK to a YouTube video where we show the ULTRASOUND IMAGES before and AFTER dry needling of a PAINFUL RIGHT SIDE BACK MOUSE (VIDEO with ENGLISH SUBTITLES)

151 Replies to “Hard Knots in Lower Back? (back mice)”

  1. My wife has had her back mouse needled twice but after playing golf her symptoms have returned.
    We live 6/12 in Catalonia
    Do you have a clinical practice?

    1. Surgically remove the “back mouse” and treat it like a subfascial lipoma or much more rare a “lumbar hernia” but I’ve found only one lumbar hernia in 24 years of surgery and these rarely will cause the back pain/sciatica pain type syndrome seen so often with what are termed “back mice”.
      Excise the lipoma and you remove the pressure on the L4 and or L5 nerve roots (most common) before they join as part of the sciatic nerve bundle.
      Dr. Salomon Kramer
      Dallas, TX

      1. Your description of them being over nerves is accurate. I’ve lived with mine for 24 years.
        Seriously considering having them removed as they can be debilitating at times. I don’t know if I can afford it though.

        1. I had them for years and finally had them removed. One was so bad it had attached to my spine which was causing even more pain. It made a HUGE difference in my lower back pain. A few have since returned and might have them removed again.

          1. Yes, I have one right now. Not sure exactly what it is. I have had 3 prior back surgeries myself, and was wondering because the location is lower right side of the butt/hip right ontop of where the sciatic nerve is. I was wondering about a schwannoma…. too/

        2. OMG. This is what I have also i think. The pain is horrible. I’ve asked all different Drs neurologist and physical therapist what it is and I’ve gotten everything from SI joint to gluteus medius knot and i know it’s not that have had MRI CT and x-rays and either they don’t or can’t see it . Would live for it to be gone it’s been 2 straight years about the size of three fingers wide and long

      2. I have hundreds of them in my lower back for about 35 years now. As of January of last year there are even more in the outer sides of my thighs and they are very painful. When a doctor pushes on them at the lower back it causes me brief paralysis. They can range from 2″-3″ in length and 1/2″ thick. I had 1 very big one removed and that was a mistake.

        1. I have very similar issues and debilitating lower back pain, why was the removal of a large lump a mistake for you, I’m hoping to get mine recognised by a specialised not sure where to go though

          1. Hello Marta, I have been experiencing back pain for over 20 years, have tried everything. The last two years have been hell. Reading all this is information rings so many bells for me. Can you please send article so I can show my doctor next week? Thank you for your generosity.

        2. Hello Carlton, why would you say it was a mistake? Mine is starting to cause a stinging sensation when I step on my left foot, mostly in the morning when I wake.

      3. Had my back mice removed…. feel so much better. I always back pain but when i noticed a lipoma formed in the lower back; my back pain became more excruciating. Upon having it excised; I honestly feel a lot better. I still have some back pain, but no more sudden sharp pains that radiate.

  2. Hello,
    Are you aware of any doctors in the Boston area who are familiar with back mice? I’ve had a mostly painless movable nodule to the left of the small of my back for over twenty years (at the dimple.) It was diagnosed as a lipoma many years ago and I was told it was nothing to worry about. I developed lower back pain around the same time which has never resolved completely with typical treatments. It wasn’t until recently, after countless theories and a number of rounds of PT as well as regular chiropractic treatment, that occurred to me that perhaps the “lipoma” and back issues are related. I’d love to find someone in the Boston area who recognizes back mice as a possible cause of chronic back pain. Any assistance is appreciated.

    1. Hello Janice,

      Unfortunately I do not know a specific doctor from Boston. Did you notice that when you press upon it, they are o become painful?

      You can ask your doctor to do a simple test with a local anesthetic injection on it. If pain resolves (sometimes it is just hours, sometimes longer) then it means the mouse can be the trouble.

      You can show your doctor the list of recent medical articles that explain about back mice. Maybe then they will better understand it.

      Best wishes,

    2. Hello,
      I had the same issue. Lower back pain behind 2 symmetrical lipomas on each side of my back. After doing every type of therapy over 15 years I decided to have them removed. I thought right after the minor surgery that I was cured( was the local Anastasia) within a couple weeks the wounds had heals completely and I was left with 2 scars and the same lower back pain I had before. Now I’m told it’s arthritis and Facet joint pain.

  3. Hi,

    I had these removed a few years ago. They grew back! They seem to be the cause of relentless, chronic pain for over 6 years now.

    I’m in the midwest and open to any doctor who knows what these even are!

    1. Hi Tara,
      We are currently studying the nodules. Some past medical studies referred that in some cases (not always), after surgical removal, the nodules form again within years. Did you try to manage them with anesthetic blocks, to start?

    2. I read in research papers that they will come back if the hole/tear isn’t closed that allowed the fatty tissue to get between the layer of the dermis & spine forming the back mice.

  4. I was curious if your own study or others indicated whether patient weight loss would affect the back mice. If a patient lost a significant amount of weight, are back mice reduced in size? Or, are they currently padded/protected by fat, and a loss of surrounding fat would make the matter worse?

    Any thoughts or ideas you had would be most welcome.

    1. Hello Brian, good question!

      In general, the studies do not mention the weight loss as a treatment. They do mention that a healthy diet, exercise and good living and working conditions are important to prevent “back mice”.

      There is an old article from a Stockman, a known researcher that did put on diet a patient that presented a general condition “like a mice infestation” called Dercum’s disease – they present multiple painful nodules in many locations including the lumbar zone-.

      Stockman R. The Clinical Symptoms and Treatment of Chronic Subcutaneous Fibrosis. British Medical Journal. 1911;1(2616):352-355.
      direct link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2332909/

      I have noticed that the back mice are usually small in slim patients and bigger in obese patients, but they can be painful anyway.

      I would guess that a Non-fatty hipocaloric diet could have an effect on the fatty deposit tissue, but it needs to be studied.

      What are your thoughts?


    2. I have had these nodules for years. I lost 25lbs and it started to become very painful. My experience only. I had a lipoma removed previously in another area so will look for a doctor to remove this one as it’s debilitating and I am going broke with acupuncture, massage and PT.

  5. Hello, what is the best type of imaging to diagnose lipomas in/near spine and/or SI joint?

    I’ve had nearly 3 years of back pain, and I know I have two herniated discs, but a general dr recently identified at least one lipoma in my lower back in area of pain (he called it angiolipoma since it is painful). He also noted several more on my legs, including one on my hamstring I have thought for 7 years was scar tissue/muscle knot which my massage therapist has worked on. Now I know why it never goes away!

    I have an appt w a neurosurgeon soon and would like to ask him to do an MRI w contrast or whatever type of imaging may best identify if I have other lipomas that could be causing my pain. I don’t want to have disc surgery if there is an underlying lipoma that would still be an issue.

    Thanks, Leslie

    1. Hello Leslie,

      This web page focus with a clinical entity called “back mice” or “episacroiliac lipoma”. These are painful fibro-fatty nodules that can be palpated in the subcutaneous tissue in low back. The best way to diagnose them is by ultrasound. They are “invisible” in MRI. Intra-nodular anesthetic injection can help to know if they are the cause of your low back pain. There are other types of lipomas. So maybe yours are not really “back mice”.

      Show your doctor the recent medical articles in this list:

      Best wishes,

  6. Hi, I’m very interested in the topic.
    Are you aware of any doctors in Italy who are familiar with back mice? I need this info for my brother, who has a three years history of back pain: same symptoms described here, no medication worked, job problems… nothing detectable at MRI, a nodule at ultrasound. He had a local injection and the pain decreased.
    I need to find a doctor to solve definitively his pain, also with surgical treatment.

    1. Hello Patrizia,

      Sorry, I personally do not know any doctor.
      This is the latest Italian article I could found about the subject (1970)


      In Italian wikipedia article they called “Nodulo di Copeman” (Copeman was a known English medical doctor that studied them)


      The best you could do is find an open mind doctor that is willing at least to read the latest medical articles, here there are some of the articles (I could send you them by pdf if it is useful to you).


      Best wishes,
      Marta Cañis

    2. Hi all, I currently have two very painful “nodules” identical position lower and left side of back. Feel gristly, need to Press in deep into muscle to find them. Once pressed up extremely painful. Constant dull ache daily/burning sensation. Made worse when sitting or standing, had MRI which showed my L1 spinal disc is bulging on both sides. But doctors keep dismissing my nodule pains! Is this back mice? Many many thanks!

  7. I know this is what I have. I have lipomas all around my body. Since 2/14/18 I have had chronic low back pain. It wraps around to my front and to the uterus. It feels like contractions like I’m in labor. If I do anything laundry, stand doing dishes to long walk to long it will trigger the pain. What has puzzled primary, chiro, gyn, neuro is that I will spot when I get the pain. So they don’t see how it’s all connected. I think it could be inflamed or something and I have fibroids in my uterus maybe idk but I have a lipoma in my right low back that starts the pain. Thank you I’m gonna go over this with my doctor Monday.

    1. I’m so glad to see your comment!! I have 3 of these “mice” in my lower back. They seem to get larger, more irritated and sore and bothering my hips around ovulation in my cycle. I also have uterine fibroids. I don’t know where to begin to seek treatment. The gynocologist was not helpful.

  8. Hi! I have a back mouse on the right side of my back; could this in any way be causing my right gluteal muscle to fasciculate? Doctors here in NY are so perplexed by this random fasciculation/spasm!


    1. Hi Kjain0633! I am Marta Cañis Parera. I can not help you with your question. The medical articles that I studied do not mention the ‘fasciculation’ as a clinical finding -related to back mice.

      Best regards,

        1. Hello Knika Singh,

          Probably back mice are not visible in MRI because they are formed by ‘abnormal fibrofatty tissue overgrowths maybe herniated’ that are seen in the MRI exactly the same ‘colour and texture’that the surrounding ‘normal fibrofatty tissue’.

          Best regards,

    2. I have a hard fibrous mass in my back after a severe SI injury, I’m 99% sure it’s a back mouse, causes me extreme pain, and when I lay on my back I get the fasciculations every time in that area but keeps my hips and butt in spasms at times as well

  9. I’ve had back mice for many years but never knew what they were. They caused a lot of pain–especially pressed against the seat while driving. In 2016 I went from my dermatologist to my general practitioner to pain management Drs and all agreed they weren’t regular lipomas but no one knew what they were so no one would treat me. I did my own research and found a study that they were back mice and could be treated by being punctured with a needle six to eight times. I took the study into pain management and they agreed to do it. I no longer have tender pain when the lumps are touched. I developed a new one last week that was very painful and had back spasms for days. Yesterday I used anesthetic cream (& all done very sterile!) my husband poked it about eight times with a 22 gauge syringe. Today it doesn’t hurt at all! By the way, if you’re interested I am of a normal weight, but I do have Ehlers Danlos syndrome so I just figure my connective tissue isn’t strong enough to keep my fat in. Thank you for all the information you’ve posted. When I researched it in 2016 there was almost nothing online!

    1. Hello Stephanie D,

      Thanks for your words. Thanks for sharing your case. Specially the fact of your Ehlers Danlos syndrome.

      Take care!
      Best wishes,

      Marta Cañis Parera

      1. I am quite certain I have these too. My massage and chiropractic providers have always approached them as knots but they are mobile, and never reduce in size. They don’t feel or behave like knots either. Since losing 100lbs my sacral indentation is merely skin deep from the bone, but the mice remain as always just lateral to this location on each side. I thought that the weight loss would help with my pain, but it has only escalated. I also have a geneticist diagnosed, non-specific hyper laxity disorder similar to Elhers Danlos. I have suffered chronic pain in my hips (primarily my left hip) for 20 years, particularly in my SI joints which are constantly immobile. The pain spreads around laterally with tender, palpable ridges just superior to my iliac crests on each side. I was always told that my hip pain was related to the very slight scoliosis in my spine, the result of which is a slightly elevated right hip. This is all measured and certifiably diagnosed by multiple medical practitioners from orthopaedic surgeons to physiotherapists. The only thing that helps is many painful hours rolling on lacrosse balls on the floor *not* on the mice themselves, but on the nerves and tense muscles in the surrounding area.

        If this is the cause of all of this suffering for so many years, I will do the biggest face palm the world has ever seen. Thank you for your work and the information you have shared here. This could be life altering for me. The potential alone of ending this pain makes me giddy.

        1. Hi Lynn,
          I hope the information in the webpage can help you. Despite the fatty tissue and the peripheral nerves are is still a causative pain agent very overlooked by mainstream medicine, I hope you can find a physician that can explore you and may perform ultrasound and the nerve blocks to be sure that they are the cause of your pain.

          Thanks for sharing you personal history.
          Best wishes,
          Marta Cañis Parera

  10. I have generalized hypermobility spectrum disorder, which is very similar to hypermobile Ehlers Danlos. I am also not overweight and have realized I have back mice. I’m prone to trigger points so I thought these were just weird trigger points but it exactly matches the descriptions here. I have some instability in my hips and SI joint, so it would make sense that weak connective tissue combined with instability in the region could contribute to something like this. And I think mine came around when my hip pain started happening.

    The weird thing is that I have something sort of similar in my neck. My doctor specifically called it a lipoma. I thought it was weird, though, because it also acts like my muscle knots where pressure causes pain. I also noticed it around when I started having neck and shoulder pain. I wonder if connective tissue disorders might sometimes cause painful lipomas and maybe it is a matter of size or severity that makes them painful.

    The connection with fibromyalgia is also interesting because people with Ehlers Danlos or hypermobility disorders often get misdiagnosed as having fibromyalgia because the symptoms can look similar. I have all the points on the classic fibromyalgia chart, but it is caused by my connective tissue disorder. I actually keep bruising myself in an attempt to massage my muscle knots because I am so much less sensitive to pain than I should be. For example, I just had my partner press directly on my back mice and it did sort of feel electrical but I didn’t even ask him to stop because sometimes my muscle knots feel weird and massage usually helps.

  11. I have what I now think is a back mouse on my left side. I noticed it about 3 weeks ago when I was working out. I figured I had strained a muscle when exercising but when it didn’t improve, I palpated the area and noticed a nodule. It mostly only causes acute pain when I move in a certain way, usually ‘stretching’ in the area but I am now noticing it seems to be affecting my whole left side, from my leg to my neck. Does this sound like a “back mouse” to you and what type of doctor would you recommend I see for evaluation and treatment? Thank you for this informative article. I was relieved to discover an answer to what could possibly be my condition. Thank you kindly.

  12. Thank you for your website. I am hoping this becomes more known to the medical field. I have searched for years and years on the internet for what these could be and am finally finding the answer. I have an appointment to get them removed as I have tried absolutely everything else.

    I have struggled with back pain since onset of puberty over 10 years ago. When my mother got worried a few years after the pain began we started to seek answers with pediatricians. I pointed out these weird knots in my lower back and wondered if they could do anything about them. They said it wouldn’t be an issue and All they could tell me to manage pain was work out and don’t gain weight.
    I have maintained a healthy and active lifestyle with playing sports, physical jobs and never above 130lbs at 5’4.
    By the next year I was in miserable pain, always tight regardless of activity level and didn’t want to do as much with my friends; not ideal for a social 16 year old girl. It hurt to sit over 30 mins in church or a movie theater.
    We went back to the doctor and I begged for pain relief. They prescribed 6 weeks of physical therapy. It did not help and in fact my pain grew more. Over the next few years we tried chiropractic therapy, massage therapy, mild muscle relaxers, a cortisone injection and yet more physical therapy. No help but I have always been determined to work hard and never let the pain deter me from responsibilities even if it meant not feeling as well during social hours…

    Last summer, I was 22, and had a disc slip. It was the most excruciating pain i can imagine. They didn’t want to do surgery it immediately to see if it would correct itself. So 3 long months of not working, not exercising, attending physical therapy and a chiro AGAIN. I was relieved when they agreed to surgery and actually thought that maybe surgery could fix my long term issue! I might be free! Come to find out it would be a year before I felt better and maybe could have healed quicker without these back mice! And I can’t believe that it maybe could have been prevented if I didn’t have the mice to begin with! (At least what my research has shown they are linked…)

    Again thank you for the work you have done to get the word out.

  13. Bona vesprada! Coneixeu algun metge a la zona de Valencia o Castelló amb experiència en ratolins a l’esquena? Us he escrit un mail a l’adreça de contacte explicant el meu cas. Moltes gràcies i enhorabona per la vostra investigació.

  14. Great discussion. Nerve blocks are short term. Look up Dr. Panagos in New York as he has published a very interesting case study here https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6298621/. Conservative care such as exercise, massage, chiropractic (my specialty) cortisone, etc only offer short term relief. Surgery for middle cluneal nerve entrapment (MCN) and superior cluneal nerve entrapment appear to be effective (SCN) but I would consider Fascial Plane PRP injections as demonstrated by Dr. Panagos. There is a youtube video of the patient from the study that is available here https://www.youtube.com/watch?v=JNSYuw_0osg&feature=emb_logo

  15. I’ve already had 4 removed in 2 different surgeries, and now have another one. It’s a deep one and I’m really not up to another surgery yet, so I’ve started taking gabapentin for the pain again. It helps.
    As for weight loss helping, I’ve found it to worsen mine. Perhaps they’re not related, but these things seem to have a mind of their own.
    Doc’s are currently testing me for Cushing’s as my hormones levels are completely out of whack now. Thought i was going through menopause at 40, but blood results indicate hyperthyroidism though I struggle with mild “obesity” (I’m 30 lbs above what the charts say i should be for 5’7”), hirtuism, and unexplained lactation (my only child is 22, i stopped breast feeding 21 years ago).
    All seems par for 2020

  16. Hello Marta,
    I have noticed a nodule/mass/lipoma on my left lower back near where dimple would be that occurred after lifting something heavy. It’s been a year now and the local back pain has now caused left lower extremity pain off and on with tingling and numbness. Could this be backmice causing radiculopathy? I had it injected, not sure if done appropriately. Mri was done didn’t show anything. I see it on ultrasound.

    1. Hi KDd,
      Back mice can cause local pain that patients can feel referred to several sides, specially to the leg. It is not related to radiculopathy, it has to do with the dermatomes and the involvement of peripheral nerves like the superior cluneal nerves, may be compressed by the turgid fatty mass.
      Local anesthetic injections into the back mice, can help with the diagnose, since local pain and referred pain disappear, at least for a while.
      Best regards,
      Marta Cañis Parera

      1. Thank you Marta. I have a lot of heavy pain in my heal and leg and back where this lipoma is. Sometimes it hurts to walk. Could it be because of the lipoma? I’m having a hard time explaining this to my doctor. I have seen a pain and ortho spine doctor now. Could you send me the papers also to show them.
        I appreciate your time and expertise.

  17. Hello
    I have had ongoing back pain for the last 9 years, I have a constant ache in my lower back/sacrum and intermittent nerve pain which alternates sides and is a sharp electrical pain in either side of my lower back, sometimes my hips. I have what have been diagnosed at lipomas in my lower back, either side of my back ‘dimples’ rubbery type nodules, not particularly big. But I notice when I massage/press these it makes the ‘nerve’ pain worse. I’ve had an MRI which didn’t really show anything apart from some Edemas. Now they are exploring underlying inflammatory conditions. Even tho NSAIDS have been ineffective in the past for me. Nobody seems to take these lumps seriously and have dismissed that they could be the cause of my pain. Any advice or help would be very very appreciated

    1. Hello Kia,
      The only way that doctors take you seriously is if you show the doctors medical papers that have been published about this clinical entity. Ask for an ultrasound and anesthetic blockage for the diagnose, as performed in the medical articles.
      I will send to you some medical articles to show to your doctors.
      Best whishes,
      Marta Cañis Parera

      1. I would greatly appreciate the literature be sent to me too. This is chronic issue I have had for years and would like any info you can provide.

        1. I have been struggling with this type of issue for quiet some time. I tried chiropractic and massage therapy but neither provided relief. I also tried a high dose short term use of prednisone. I work in law enforcement and at times this is nearly disabling whether I’m driving my patrol car, or simply wearing my duty belt. Sleeping also becomes a task just trying to get comfortable. My doctor is a close friend and by far the best doctor I’ve ever had but even she hasn’t heard of back mice. However after telling her about your article she is also interested in learning more so that she will possibly be able to treat this for me as well as future patients. I would be so appreciative for more literature and education about these.

          1. Dear Codi,

            Thanks for your comment! We hope to go further with our research and may help much more patients. Tell me if I can help you somehow.


      2. I need these documents, too. I am bringing my daughter to the doctor in a few weeks and I need to be armed with information.

          1. Can you provide a link with the documents in a public Google drive to make easy of acces for anyone to print and take to their local doctor?

  18. I’m 21, female, and I’ve had hard lumps that are “knot-like” that reside right on my “back dimples” and they are very painful some days. Should I be concerned there are “back mice” (possible lipoma growths)? They’ve been around for years now, since I stopped competitively swimming, actually.

    1. Hello, It could be!
      Swimming should be a good practice to avoid them from getting swollen!

      1. Swimming makes mine bigger and can trigger extreme lower back pain for a couple of weeks.
        My bump feels almost like a bone and is not far from my spine l4-l5 and last two years Without exercise (thx covid; all gyms closed) im having severe pain. Before covid,m. I use to have back pain maybe 3 to 4 times a year where I will be in bed for 2 weeks not being able to put my own socks on. My bump showed up same year as my first lower back pain incident 2015.
        On the mri it shows as a fatty tissue inflammation and my surgeon gave me anti inflammatory drugs for 2 weeks to see if it will go away before doing a nerve block on the facet joints. I told him it might be lipoma, but he says lipomas don’t look like this on mri. He said maybe a liposuction can help remove the bump but he doubts this bump is causing the problème. Other than ultra sound and local anesthesia what other methods can help diagnose it? How does it look like on ultra sound, how to remove it? What treatment other than surgery can be done? Everyone I have seen can feel it in my back but nobody think it causes any problem nor know how to remove it. It’s like I have severe lower back pain that are very local and no further radiation down legs and right next to the area of pain there is a big bump and everyone is like it’s not the problem! Im a very active person and swims like 5 times a week, can do a one hand stand which means my core is strong enough but everyone wants me to just add strength to my lower back with exercices. I’m desperate. Going into the third year without going to the gym cuz I’m afraid I will trigger the extreme pain and just accept a bit of pain all the time.

        1. I am exactly same! doctors said I had “weak glutes” but can single leg press way more than my body weight, they said weak core even though I go gym 4 times a week.

  19. I have one on my right side. It’s not painful but I feel it there just sitting.

    The doctor diagnosed me with RLS, and I explained that when my husband puts pressure on the back mouse the restless leg goes away. The minute he stops the pressure it comes back.

    The restless leg can happen on either leg and the leg tightens up from the foot to the back of the knee.

    Do you think the back mouse might have something to do with that lower leg discomfort?

    1. Hello Jodi,
      For the time being, it is the first time I hear about this possible relationship. I do not know how the back mouse could be related to RLS, sorry. Anyway, Thanks for sharing your experience. Maybe time will tell.
      Marta Cañis Parera

  20. I have a lot of heavy pain in my heal and leg and back where this lipoma is. Sometimes it hurts to walk. Could it be because of the lipoma? I’m having a hard time explaining this to my doctor. I have seen a pain and ortho spine doctor now. Could you send me the papers also to show them.
    I appreciate your time and expertise.

  21. I am sure I’ve had back mice for at least twenty-five years. My doctor then told me it was a “fatty lipoma” and there was nothing to be done with it as long as it wasn’t bothering me. Since then, only one side has been periodically symptomatic. It had not given me any real trouble for the past twenty years or so, but has recently been causing chronic pain in the area of the lump and wrapping around my hip. I was thinking it was a slipped disk due to several recent injuries – a fall, a rear-end collision, and being used by my 40 pound, 4-year old son as a jungle gym. I actually just had an MRI today and will be picking up the results tomorrow. But, it just suddenly occurred to me that it could be the back mouse that’s causing the pain. When I last searched for information about it, I found very little. So, I really appreciate this website. I wonder if you might provide me with copies of the clinical papers you’ve mentioned so that I can show them to my doctor?

  22. I had a severely herniated disc at the L5 vertebrae, S1 nerve and had laparoscopic surgery to decompress the nerve on December 29, 2020. After surgery I had 10 weeks of physical therapy and weekly deep tissue massage. I did have initial pain relief but after returning to work now part time for 6 weeks, on feet 4 1/2hrs straight, heavy lifting, bending, and squatting I am continuing to have similar pain as before surgery. I noticed a new “knot” in my lower back earlier this week and went to massage therapist yesterday to have her work it out, only for her to evaluate the lump and suggest it may be back mouse lipoma. Can you please send me the medical articles you referred to in this website so I can take the information to my PCP? Thanks so very much!

  23. Hi there! Thanks for the research!
    I actually just had an ultrasound and they say nothing showed up. I am almost certain this is exactly what I have. I feel like I need another ultrasound- I was thinking an MRI until I read your previous comments. I have already been to the chiro, regular doc, physical therapy with no relief!
    I get sciatic pain down my leg, lower back pain, mid back pain. Trouble sitting long/ standing long, crossing my legs is really uncomfortable, twisting, turning, leaning back.
    I just want some relief.

    1. Hello Holly,
      It has been described that “back mice” are sometimes not visible to any of the current images techniques (no ultrasound, no MRI). That is one of the main problems to study them. Sometimes they are easily palpable, and the patient and the doctor feel the tens painful nodule, whereas other times they are just found as a painful spot. That complicates the story. Nevertheless, the doctor can try a local subcutaneous anesthetic blockage if your pain is REALLY LOCALIZE IN THE SACROILIAC REGION and when pressing it increases. If the pain disappear -the effect can last hours, days or much more time-, it is worthy to try and to repeat it several times if it is necessary.

      Marta Cañis Parera

  24. Hi I was wondering if you can email me the documentation so I can share with my rheumatologist. I’ve had these painful lumps all over my torso especially my back.
    When I was 11 years old I slipped off an icy curb and fractured 3 vertebrae in my mid back. I’ve had chronic lower back pain only when pressed on but pain where I could jump through the ceiling if pressed.
    I have lupus and sjogrens syndrome and was told I have fibromyalgia because of these autoimmune diseases and because of the positive trigger point pains I have when checking for fibromyalgia.
    The lipomas I have in my back do get worse at times especially when I have a lot of inflammation but they are always tender. I would like to try treatment on them and would like to show my doc this information.
    Thank you

    1. Ok Christine! I will send you the articles. The fibro-fatty tissue may react to several factors (it is an endocrine system): inflammation, hormones, stress, wheather… That’s way the lumps could become less or more tender according to certain changes.
      Marta Cañis Parera

  25. Hello Marta, I have been told I have back mouse on my lower back right side over iliac crest area. I’ve have had this for well over 10 years and have done all the conventional methods for treatment ie. chiro, massage, physiotherapy, acupuncture, topical creams, Advil etc. with no lasting relief from the pain and tightness it causes. Currently I am seeing a pain management doctor for weekly injections of anaesthetic, so far there has been no immediate improvement. Dr wants to carry on with the injections for a couple more weeks before using cortisone injections. Failing this he suggested surgery for removal of the back mouse. Can you please send me the medical articles you referred to in this website so I can take the information to my Dr? I am grateful to have found this.

  26. Great work on back mice!
    As a rheumatologist fellow I had difficulty to find any literature so good as your site!

  27. Hi I have an episacral Lipoma on left side NHS in uk requested an ultrasound on the site and wasn’t detected it can be felt with manipulation MRI on lower back didn’t show it.
    I consulted a dermatologist who says I need a plastic surgeon could you please e mail me the medical article re episacral Lipoma

  28. I had back mice for a few years that would flare up and down. Doctor really couldn’t see the issue or advise on them? I ended up in hospital having emergency surgery for a twisted bowel which was over 6 years ago and I have never had them since, so I am convinced my body was trying to tell me something!

  29. Hello Marta.
    Just wanted to add my personal experience on backmice and hopefully this will contribute towards your research.

    I have had these for few years now and one side has gone worse in the last year (2020-2021).
    The right hand side that has gone worse is definitely sometimes pushes on my nerve and I get a that numbing pain sometimes for a week or longer. But if I physically press on the area with my thumb I don’t actually feel anything and that indicates that it’s definitely a nerve.
    Another thing that I have noticed, is that it definitely gets worse in the winter, one – is because it’s cold and two because I normally put on a lot more weight (fat) in the winter (because I am a bodybuilder and can gain up to 10kg or more when off season ) and guess that all that extra fat around my lower back only makes it worse.

    So recently I been trying to keep my weight down and that stopped mostly all the discomfort. I have also been trying to massage them out myself and recently purchased a muscle gun and it seems to work a little. It feels now mostly like small gristle, so guess with a lot of determination and consistency, hopefully will be able to break it all down.
    My theory is of course healthy diet would always help, but same time I keep telling myself I’m here for good time not a long time.
    Stay safe people and hope your backs feel better.

    If you can’t be good, be careful 🙂

  30. I believe this may be my problem. Lump in my lower right back causing pain for 15 years. Nothing seems to help. Can you send me the articles to show a doctor? Thanks for shedding light on this it is appreciated.

  31. I had an MRI that showed a lot of fat deposits on my back. They said this is nothing to worry about. I had ACDF level 2 fusion cervical 5 years ago. I eat keto for about 8 years now. I was fine in shape. I had back herniation now it is only fat deposits coming up on my MRI. I lift a 15 lb. Kettle bell using my hips using swing for my stomach it has been over a year, and I have chronic back pain down my left leg. I take all types of painkillers, gaberpettin, soma muscle relaxer, and nothing helps me. They say palliative care meaning medical Marijuana or painkillers. They say it is stenosis vx spondolosis. IDK if they are right or is this back mice. I walk ,after 5 minutes it is hard for me to walk it hurts. I have to stop, and then start walking again, and it starts hurting again. I don’t know what to do. I work full time. I sit a lot. I don’t want to get surgery. Especially , if it something else. I don’t know what to do. I did buy a roller for my lumbar, and it was periodically giving me electric shots down my leg. Help what is wrong with me. I am not ready to give up,I want to live a semi comfortable life.

  32. Hi-

    I’ve had issues with a lump in my lower back since I was 24, im now 32. I can go months sometimes a year with no issues but if I somehow move wrong and pinch the area where the fat nodule is I can’t even walk for a couple days in the most serious cases. This usually occurs when I quickly pick something up incorrectly or move in an odd way. Perhaps there is a nerve entangled in the nodule?

    I’ve brought this issue up to numerous doctors and orthopedics but they all say nothing is wrong and I need to strengthen my core. For clarity I’m now 5”11 170 and decently athletic, but more so when I was younger. Only once did I get lucky and an urgent care doctor injected a steroid or something which helped immensely.

    Could you or anyone reading this comment help me with a better way to approach this issue with a doctor? I feel like they all think I’m making this up. I am hoping to get it removed or something.

    1. Show to the doctor the most recent article we have published. If you need it I can even send you some more articles. Then, the doctor maybe will ask you to perform an ultrasound to start with.

      1. Hi Martha and everyone:
        Can you send this article and whatever else most helpful articles on this issue?

        1. Recent painful lump on lower right back:
        For the past week, I noticed a painful lump / knot on my right side lower back/ upper hip area (the pain is constant / radiating / throbbing and sometimes it gets worse with sharp pain when I move). It does not feel HARD like a muscle knot – but a bit more squishy like a lump / nodule. The descriptions by others on this forum seem very similar to what I am experiencing.

        2. Pre-existing right side lower back / hip pain (not related to the recent painful back lump) that may or may not be related to cervical cyst:
        Upon turning 40 few years ago and a little after having my second kid, I started having pain on my right side – in the area surrounding my lower back right side only / right hip / right side of my abdomen/uterus. Saw multiple specialists to figure out if it’s an ortho issue or gastro or obgyn issue. They did find / removed a golf ball sized nabothian cyst (benign fluid filled cyst) just outside of my cervix (again on the right side) which reaccumulates and has been a reoccurring condition that I get removed every year, when it gets big enough.
        But the lower back / hip pain does not seem to be related to the cyst because even after getting the cervical cyst removed every few months, the pain is still there.

        But this recent right side lower back lump and the pain associated with same feels different than my preexisting lower back/hip pain and is in a different area (ie: recent lump pain is more centralized in and around the lump/nodule).

        I’d like to get more info on:
        1. what this is
        2. The cause / treatment for this painful lump
        3. what specialist I need to see (ortho or endocrinologist or GP surgeon etc?)
        4. Make sure it’s not a malignant growth or a sign of some other life threatening condition (like cancer)

        Really appreciate all the information on this forum. Thank you.

        1. 1. what this is? As far as we know ‘back mice’ are fibro-fatty nodules that somehow dysfunction by being herniated tissue within the fascia layers.
          2. The cause / treatment for this painful lump? We are still investigating these issues, as many other researchers did, the cause of them. Probably there will be many causes. Treatment, for the time being, is just to get pain relief, and the most common one is needling with or without local anaesthetic, to break the fibrous capsules of the nodules that are painful.
          3. what specialist I need to see (ortho or endocrinologist or GP surgeon etc?)? Big trouble, because the “back mice phenomena is a very unknow entity”. You must find a “willing to listen” doctor.
          4. Make sure it’s not a malignant growth or a sign of some other life-threatening condition (like cancer). Usually, by imaging ultrasound or MRI usually it shows clear that it is not a malignant growth.

      2. Hi Marta could you please please send me the article I am really struggling with pain 16 months now and my doctors are not helping thanks !


  33. Thank you for creating and posting this. I have found a few back mice recently and was extremely terrified! This helped me relief some fear. Mine are not painful unless I push on them and move them a lot, then its like a bruise. I actually accidentally made a bruise on one from ruching it around so much. Most of them move around a lot and easily, but one barely moves, and I keep trying to move it because I know if its moving then its a lipoma, but I have pushed it so hard and so much I bruised my back in that spot. Please continue to spread the word about back mice and how they are not necessarily a bad thing.

  34. Is it possible for back mice to be located not in the “dimples of your back,” but near the spine itself? I have what I believe is a lipoma next to my spine, and I noticed it about 7 years ago. At first, it wasn’t painful, but in the past couple years, it has become painful to the touch and I’ve developed jarring lower back issues, and at times, pain radiating down my leg. It’s possible it has grown and maybe is sitting on a nerve and that’s why I’m now feeling pain. Any ideas or advice? Do you think this could be back mice?

    1. Hi Emily,
      As far as I know, it is possible that a growing deep lipoma can cause you pain. The lipomas are easier to be diagnosed by ultrasound or MRI, your doctors can check on that. Lipomas can cause problems if they grow in certain specific locations.
      According to the studies, back mice are not “exactly” lipomas. And are more difficult to be diagnose by image techniques.

  35. Great article. Thank you for taking time to tackle this. I have had these back mice for years and sometimes they are debilitating. I had also thought of surgery but fear no improvement or return of the mice. I’ve tried massage, acupuncture and meds to no avail. So ice is the best and only suggested treatment? I hope someone is researching for a better treatment.

  36. Hello Marta,
    Can you also send me the article?
    My back mice assuming that’s what they are have improved with shockwave therapy. Improved a lot actually. Probably about 80-90 percent.
    But I still want to show doctors your research.
    My email: sh2367@caa.Columbia.edu

      1. Hi Martha,
        It is so interesting to always come across new literature in diagnosing certain pain extremes that our own GPs turn a cheeck and have a hard time even navigating anything themselves.
        It always leads to us, the patient to come across blogs like this to get to the point .
        I too suffer back mice , along with L5 disc hernitionand sciatica issues. Can you please send me any info as well. Greatly appreciated.

  37. Hello Dr. Parera, 

    I am contacting you to see if I or my physician can provide you with any information that would be useful for your research or audience regarding my upcoming surgery on April 28, 2022 to excise the painful fatty nodules in my back that meet the criteria you describe in your literature. I sent a more detailed message to CONTACT@backmice.info.

  38. I am almost in tears after discovering this wealth of info you’ve shared – thank you! It explains what I have and am determined to get a diagnosis. If you can send me the info to share with my doctors, I’d greatly appreciate it. Thanks so so much.

    1. According to the researchers, yes! Back mice can increase in size and result from a fascia tear after a trauma in some cases.

  39. Hi Martha!
    Request for all the information you’re able to send to show my health care proffesional.

    I could cry happy tears finding this information. I am almost completely certain this is what I have. One on each side and on the same photos as all of the diagrams and photos. I am a 26yo female who has had this issue for about 4 years now. I can’t stand in line at the grocery store for long without leaving or crying, can’t play with my toddler, to for walks or hike or go to fairs or amusement parks and my quality of life has been so low it’s caused some awful thoughts to occur. I have been to many doctors and specialist. I’ve done months of physical therapy, had x-rays and mri, trigger point injections and no one seemed to know what they were! It was so frustrating when a doctor literally told me he doesn’t know what they are so there is nothing he can do! I’ve been feeling hopeless for years and never knew of the words for these until now. I recently moved to a new state and am having to start a new doctor and specialist again and was hoping you could also send me whatever information I need to show my health care professionals. I struggle to have a strong voice as I have anxiety so I would also love any advice on how to better advocate for myself to be taken more seriously. I have actually broke down in tears more than once at the offices for not being taken seriously. Thank you for putting all this information online and in an easy to understand way!

    I know many people have asked for the information and I’m sorry to have to ask too I just want to do everything I can to get this solved so thank you in advance I appreciate you! This could be life changing for me.

  40. Hi Marta

    Thank you so much for your research into this. I am seeing my doctor in the UK about suspected back mice next week and I would really appreciate if you are able to send me the most up to date articles on the subject. I have suffered from sciatica and a slipped disc in the past. I have recently lost around 15kg and been exercising more and it is the weight loss which made me notice these physical ridges in my lower back, around where I have the pain.

  41. Hello.

    I’ve been suffering for 10 years now, since my lowermost 2 discs were damaged. For some years, I noticed the nodules(1 either side of my spine), but my general practitioner told me they were nothing to worry about. However, last year I was particularly bad again and tried a private physio, who said they were cause by my steroid injections…scar tissue damage. I didn’t fully believe him tbh, but then I had no real reason NOT to believe him.

    Nevertheless, they are still painful, especially right now, so would you please be able to send me the most up to date articles?

    Thank you

  42. In the past year I have developed several of these in my lower back, have slight back pain, extreme pain when they’re moved or pressed, and pain in my hip area when I walk. I think massage has made them worse. I’d like to have some info sent, as well, in case I end up trying to find a doctor to help. Thanks!

  43. Hi Marta,
    I had a back mouse removed a year ago and had great relief from the pain for several months. However, I think it’s growing back, or maybe a different one is growing now. Could you send me the articles, too?
    Thank you,

  44. Hi Marta!
    About 6 years ago, a doctor identified a “complex nodule” in my lower back, exactly where back mice typically are. The thing is, mine doesn’t move easily. It feels more solid, fixed and egg like. When I press on it it’s very painful. It makes the muscle seize up. She told me that she didn’t think it was cancerous after speaking with a surgeon. But I still feel unnerved by the experience. Do you think all this time it could have been a back mouse?

    1. Dear Autumn,
      It could be a back mouse. But the best thing to do first is an ultrasound of that area, that would help the best to know if it is really a back mouse, or something else.

  45. Hi Marta,

    I had my lipoma removed and it seems to have not been completely removed or part of it grew back. No doctor will connect this to my back pain. Can you recommend any doctors in Boston. I have asked for an ultrasound ,but since I have had 2 MRIS and a CT scan they say there isn’t a need for one. Is this true is there something I can say to the doctors to convince them of ordering an ultrasound. Thanks


    1. Hi Casey,

      Maybe you could ask for a diagnostic test to see if your pain is originating from the superior cluneal nerves. These nerves are typically irritated by fatty hernias or trapped edema in the fatty hernia. The procedure is simple and involves a local anesthetic block at the site of maximum pain upon palpation. This test is diagnostic for cluneal entrapment. If the pain disappears temporarily, it indicates that the problem lies there. This test can also be repeated multiple times for pain management treatment. Any doctor can do that.

      1. Hi Marta,

        Thanks so much . My doctor was going to try an si injection but I am going to ask about your recommendation. Thanks again!


  46. I had a lipoma in my groin area and my doctor told me it would go away on its own or get surgically removed. It went away on its own. Now, I got a lipoma on my right lower back right where my sciatic nerve runs, but I read that Chickweed Salve can dissolve them. I read many positive reviews on amazon, I think will try that first.

    1. Dear Lily, back mice are not really “true lipomas” (despite they are sometimes called episacroiliac lipomas, was a wrong name). Back mice are formed by “subfascial fat herniation”. The best way to determine if the fatty nodule you are feeling is a lipoma or a subfascial fat herniation (back mouse) is to ask your doctor for an ultrasound.

  47. Just got my MRI, had ultrasound a month ago. Seeing specialist Orthopedic & tumor surgeon in a week. Still preying that he will remove them as I have been totally let down by the system prior to now. 10 years of lipoma pain. Seen physios, GP’s, massage acupuncture the works & tried multiple things myself. Surgery is the best hope it seems.

    1. Dear Gareth,

      I understand that you are considering the possibility of surgery, given the discomfort you’re experiencing. Before resorting to surgery, however, it’s important to confirm whether the fatty nodule, potentially a back mouse, is causing your pain. It is important to perform a local anesthetic blockage. This procedure involves blocking the local nerve transmission, specifically the cluneal nerves. If your pain subsides as a result, it would indicate that the pain is indeed originating from that area.

      The effect of the local anesthetic may last a few hours. If your pain returns once the anesthetic wears off, the local anesthetic block can be repeated. Another option could be dry needling. These are both less invasive methods of pain management and are worthwhile to consider before opting for surgery.

      If pain persists despite these treatments, then surgery may be an option. Please note, surgical intervention should be performed by a healthcare professional knowledgeable about back mice and potential cluneal nerve entrapment.

      Have any doctors performed a local anesthetic block on you yet? This could provide valuable insights into the source of your pain.



  48. Dear Marta,

    I’m from Portugal (35years old). I have low back pain since last year. I maked all the possible exames (TAC and MRI abdominal and spinal torax/sacrolombar areas and a lot of blood analyses) and everything is normal (except two little disc hernias at L4-L5-S1. This hernias are not the cause of pain).

    I have made an lumbar facet infiltration and it was terrible.

    This week, I discovered the back mices and it was confirm by ecography. I maked the superior cluneal nerve blockage with an amazing pain doctor, but I did not feel a consider difference in my low back pain.

    Do you believe that the cause of the pain could not be the nodules? Or its necessary to apply the anestesic/anti-inflamatory directly in the nodules (we didn’t make it)?

    Other question:

    The herniation its through the anterior or posterior part of the toracolombar fascia?
    The fat its from subcutaneos layer or its from abdominal? Or can be both? I tryed to understand looking at atlas of human anatomy, but its dificult.

    1. Dear Joana,

      Thank you for your message. The presence of fibrofatty nodules is not in itself the cause of the pain. According to our studies, it is the high level of edema and tissue tension confined within the fibrous layers of the fibrofatty tissue (now referred to as fascia) that is often the cause of pain. Sometimes it is the fibrofatty nodule alone the place of maximum edema. Sometimes is a complete area including the nodules.

      We understand that the fibrofatty tissue near the superior cluneal nerve may become edematous and then may irritated the superior cluneal nerve. It even may create an entrappment as the nerves crosses an osteofibrous tunnel from a deep to a superficial plane location above the iliac crest. In such cases, the superior cluneal nerve anesthetic blockage proves to be very useful for pain management. However, in other instances, it is an entire area that is malfunctioning, then the superior cluenal nerve blockage is not enough or we get unsatifactory results.

      Could you please send me a photo marking the area that is painful upon palpation to contact@backmice.info? Perhaps I can assist you further. (I repeat, the area that is painful upon deep palpation)

      Understanding these fatty hernias using a human anatomy atlas can be challenging, as the atlas does not represent the layers of superficial and deep fascia within its illustrations. Our limited knowledge of the true structure of the fascial system is the reason we do not yet fully comprehend its dysfunction as its herniation. We are currently engaged in studying this tissue through ultrasound and cadaveric dissections.

      Best regards,

      Marta Cañis Parera

  49. I have had one cyst on lower back above buttocks back hips it’s more like sack of fluid sometimes burst then refills now I have a matching one on the other side hurts bad more sore then I felt before goid to know 30 yrs later it’s got a name I was told by chiro it was when muscle and bone rub

  50. I’m wondering if this is the cause of the pain and discomfort I’ve been dealing with for 10 plus years. Please send me the latest article(s). I have not felt a painful to the touch nodule or lump but it may be deep in and further toward my buttock. Is that possible? I feel a pulling and tight tension in the area when standing for a prolonged time. It’s so bad, my back will crack in the area from me bending forward. Have you heard of anyone having exacerbated discomfort from holding their urine? I find it’s definitely worse when I can’t go to the bathroom when I need to right away. I’m having an ultrasound of my kidneys tomorrow morning and when I’ve complain about the pain in the past, doctors have sent me to get an ultra sound of the ovary and found nothing. I wonder if I can ask the ultra sound tech to look for back mice. Please share your thoughts on that. Thank you!

    1. Hi Lisa,

      Typically, one reason to suspect pain originating from lumbar fibrofatty tissue is the presence of painful ‘back mice’ nodules upon palpation. However, our 5-year research indicates that fibrofatty dysfunction can also occur in other areas, such as the gluteal regions. It’s challenging to assist you via email, but if you palpate the fatty tissue in the gluteal, inguinal, or sacral areas, do you experience pain in specific spots upon palpation?


      1. This article may have just saved my quality of life. Please I’m begging for you to send me the articles and documents so I can have a doctor remove mine!!!

  51. I am experiencing this exact description in my lower back, on both sides symmetrically.

    I have taken treatment into my own hands. One thing I am testing is the fact that my hamstrings are EXTREMELY tight. Physios have said to strengthen my core etc.

    I am curious if anyone else has abnormally tight hamstrings? They are tied to the lower back muscles. I have been unable to touch my toes for years. Even sitting on the floor with my legs straight out so I am at a 90 degree angle, will cause me to fall backwards if I am not sitting against a couch or something to keep me upright.

    I am now on my 4th week straight of stretching hamstrings, hips and lower back (all of which are linked to lower back pain) to see if I can loosen the muscles up. Every massage therapist has told me I am extremely tight. I am curious if anyone here is extremely flexible and still experiencing the same issues? I am noticing my pain to subside as I increase my flexibility but the nodules are still there.

    Still can’t touch my toes, but I’m near my shins which is a major improvement.

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