[18F] With severe lower back and side pain, headache, and chest discomfort

Patient Description

An 18-year-old female presents with severe, sharp, and consistent lower back and right side pain that has been worsening over the past week. The pain radiates to her right back side, around her hip, and to her lower abdomen, occasionally extending to her leg. She experiences difficulty finding a comfortable position to sit or lay down, and neither pain medication nor muscle relaxers have been effective. Additionally, she has been suffering from a throbbing headache for two days, which somewhat responds to medication. She also reports pain upon taking deep breaths and occasional sharp chest pains. The patient has had fever and chills, but a recent ER visit ruled out kidney infection, kidney stones, UTI, and bladder infection. She is not on any form of oral contraceptives or hormone therapy and has no family or personal history of blood clotting disorders. Her medical history is significant for ADHD, diagnosed at age 7, and she is currently taking Adderall 30mg daily. No known drug allergies or other medications reported.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, possible causes include:

  • Kidney Stones: Despite the ER ruling out kidney stones, the pain you're describing is characteristic of this condition. Kidney stones can cause severe pain in the back and side, below the ribs, and radiate to the lower abdomen and groin. The pain may come in waves and fluctuate in intensity. However, you mentioned that your pain is consistent, which is less typical for kidney stones.

    • Treatment: Over-the-counter pain medications and drinking lots of water can help pass a small stone. Larger stones may require medical or surgical intervention.

  • Musculoskeletal Strain: This is a common cause of back pain and can occur as a result of poor posture, lifting heavy objects, or sudden movements. The pain is usually localized to the back and can be sharp or dull.

    • Treatment: Rest, physical therapy, and over-the-counter pain relievers can help.

  • Pulmonary Embolism: This is a serious condition where a blood clot gets lodged in an artery in the lung, blocking blood flow to part of the lung. Symptoms can include sharp chest pain that worsens with deep breaths, shortness of breath, rapid heart rate, and unexplained cough. Given your chest pain and difficulty breathing, this is a possibility that should be ruled out, even though you don't have a known history of clotting disorders.

    • Treatment: This is a medical emergency and requires immediate treatment with anticoagulants or clot dissolving medications.

Please note that this is not a comprehensive list and other conditions could also be causing your symptoms.

What you can do

Given the severity and duration of your symptoms, it's important to seek medical attention as soon as possible. If you haven't done so already, consider visiting a primary care doctor or urgent care clinic. If your symptoms worsen or you experience new symptoms such as severe chest pain, shortness of breath, or fainting, seek emergency medical attention immediately.

What you should look out for

Watch out for symptoms that may indicate a more serious condition, such as:

  • Severe chest pain
  • Shortness of breath
  • Fainting
  • Blood in your urine
  • Fever and chills that don't improve
  • Severe or worsening abdominal pain

Remember, I'm an AI and this advice is based on the information you've provided. It's always important to consult with a healthcare provider for an accurate diagnosis and treatment.

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9 mo ago

People Also Ask

What are the common symptoms of a pulmonary embolism?

Common symptoms of a pulmonary embolism include sharp chest pain that worsens with deep breaths, shortness of breath, rapid heart rate, and sometimes an unexplained cough. It is a serious condition that requires immediate medical attention.

How can musculoskeletal strain be differentiated from other causes of back pain?

Musculoskeletal strain often results in localized back pain that can be sharp or dull and is usually associated with physical activity or poor posture. It can be differentiated from other causes by the absence of systemic symptoms like fever or chills, and it typically improves with rest and physical therapy.

What are the typical symptoms of kidney stones, and why might they be ruled out in this case?

Typical symptoms of kidney stones include severe pain in the back and side, below the ribs, radiating to the lower abdomen and groin, and pain that may come in waves. They might be ruled out if imaging tests do not show stones or if the pain is consistent rather than fluctuating.

What should I do if over-the-counter pain medications are not relieving my back pain?

If over-the-counter pain medications are not effective, it is important to consult a healthcare provider for further evaluation. They may recommend alternative treatments such as prescription medications, physical therapy, or further diagnostic tests to determine the underlying cause of the pain.

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