Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.

Adrenal Nodules


Adrenal nodules are growths on the adrenal glands. You have 2 adrenal glands, 1 located on top of each kidney. The adrenal glands make several hormones that regulate your body’s:

  • Response to stress
  • Salt and water balance 
  • Metabolism

The majority of adrenal nodules are not cancerous. Most nodules are smaller than 4 centimeters and these are almost always benign. Nodules more than 4 cm tend to be of more concern and may require surgery.

Most nodules do not cause symptoms. However, some adrenal nodules produce hormones that can cause serious medical problems. These are called functioning nodules.


There are 4 main types of adrenal nodules.

Adrenal incidentaloma. This is the most common type. It is benign (not cancerous) and often causes no symptoms. Typically, if they are nonfunctioning, they don’t require treatment.

Functioning adrenal adenoma. Adrenal adenomas that make hormones can cause problems and usually need to be removed.

Pheochromocytoma. These types of nodules are rare and usually benign. However, they can make excess hormones that can cause:

  • High blood pressure
  • Headaches
  • Anxiety
  • Rapid heartbeat

Adrenal carcinoma. This is a very rare type of cancer that forms in the adrenal gland. These nodules can be functioning or nonfunctioning.


An adrenal nodule that is not producing hormones will generally not cause symptoms.

A functioning adrenal nodule can cause different symptoms. This will depend on which hormones are produced. Symptoms may include:

  • Changes in face and body shape
  • Acne
  • Unexplained weight gain or loss
  • High blood pressure
  • Muscle weakness
  • Diabetes
  • Increase in body hair in women
  • Occasional headaches and/or abdominal pain
  • Excessive sweating
  • Abnormal fatigue
  • Sexual dysfunction


Nonfunctioning adrenal nodule

We may order a CT scan to monitor the size of the nodule.

Functioning adrenal nodule

We will order blood and urine tests to check the amount of hormones being produced by the nodule. Sometimes additional imaging tests may be necessary.


Most adrenal nodules don’t require treatment. We will monitor them to make sure they do not change.

We may recommend treatment if a nodule is:

  • Very large (over 4 cm)
  • Producing excessive hormones
  • Growing larger

Some nodules may need to be surgically removed. If an adrenal nodule is causing high blood pressure, we may prescribe medications to control your blood pressure until surgery is performed.


We use several techniques to remove adrenal nodules. The most effective approach will depend on:

  • Your overall medical condition.
  • The size of the tumor.

Laparoscopic adrenalectomy is a minimally invasive procedure. It is the most common surgery used to remove an adrenal nodule. During this procedure, the surgeon will:

1) Make small incisions in your abdomen.
2) Insert long, thin instruments through the incisions. These instruments carry tiny fiber-optic cameras. They help the surgeon to guide the instruments to the adrenal gland.
3) Remove the gland containing the nodule through the incisions.

Hand-assisted laparoscopic surgery (HALS). This is very similar to a Laparoscopic adrenalectomy. Special devices are used to remove larger tumors through a 2-inch incision.

Open surgery is used to remove very large nodules that are 5 to 6 cm or larger. The surgeon makes a larger incision through the abdomen or back.

If an adrenal nodule is cancerous, additional treatment may be necessary. Treatment may include chemotherapy and radiation therapy.

Living With Your Condition

After the removal of an adrenal nodule, you will require periodic follow-up examinations. You may need:

  • Imaging scans.
  • Blood and urine tests.
  • Steroid medications. These drugs replace the hormones from the removed gland. Usually, the remaining adrenal gland will eventually compensate and produce enough of these hormones. If both glands were removed, you will probably need to take hormone replacement medications for the rest of your life. You should also wear a MedicAlert bracelet at all times.
  • Moderate exercise. This will help you regain your energy and strength.

You will also need to maintain a healthy diet and weight, and avoid smoking.

Additional References:

If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.

This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.