[19F] Experiencing sharp back pain with associated nausea and loss of appetite

Patient Description

A 19-year-old female is reporting sharp left-sided lower back pain for 1.5 weeks, which worsens when lying down and during deep breathing or coughing. The pain radiates from the right shoulder to the left mid back. She rates the pain intensity as a 6 out of 10 and finds some relief when sitting up. Alongside the back pain, she has been experiencing nausea for one day, especially when feeling a pushing sensation in her mid back, rating the nausea as a 3 out of 10. She also reports a loss of appetite and has not eaten for a couple of days, although she has not noticed any weight changes. She has no recent history of injuries, fever, chills, urinary symptoms, or neurological deficits. Her past medical history includes high cholesterol diagnosed 5 years ago, but she is not currently on any medications and has no known drug allergies.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible explanations for your symptoms include:

  • Musculoskeletal Pain: This is a common cause of back pain and can occur as a result of poor posture, strain, or injury. The pain is often localized and may be associated with muscle spasms. It can be exacerbated by certain movements or positions, such as lying down.

    • Treatment typically involves rest, physical therapy, and over-the-counter pain relievers.
  • Kidney Stones: These are hard deposits made of minerals and salts that form inside your kidneys. Pain can be severe and usually starts in the back or side below the ribs, radiating to the lower abdomen and groin. Nausea and a loss of appetite can also occur.

    • Treatment can range from pain management and drinking lots of water to pass the stone, to medical procedures to remove or break up larger stones.
  • Kidney Infection: This is a type of urinary tract infection that starts in your urethra or bladder and travels up into your kidneys. Symptoms can include back or side pain, and nausea.

    • Treatment typically involves antibiotics.
  • Gastrointestinal Issues: Conditions such as gastritis or peptic ulcers can cause back pain and nausea. These conditions are usually related to inflammation or damage to your stomach lining.

    • Treatment typically involves medications to reduce stomach acid and possibly antibiotics if the cause is bacterial.

Please note that this is not an exhaustive list and other conditions may also explain your symptoms.

What you can do

Given the severity and duration of your symptoms, it's important that you seek medical attention. Here are some steps you can take:

  1. Schedule an appointment with your healthcare provider as soon as possible. They can provide a formal assessment and order relevant tests if necessary.
  2. In the meantime, try to rest and stay hydrated. Over-the-counter pain relievers may help with the pain.
  3. Avoid heavy lifting and strenuous activities that might exacerbate your back pain.

What you should look out for

Seek immediate medical attention if you experience any of the following:

  • Severe pain or pain that gets progressively worse
  • Fever or chills
  • Blood in your urine
  • Difficulty urinating or a strong urge to urinate
  • Persistent vomiting or inability to keep down fluids

Remember, I'm an AI and not a doctor. It's important to consult with a healthcare professional who can provide a formal diagnosis and treatment plan.

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10 mo ago

People Also Ask


What are common causes of sharp lower back pain that worsens when lying down?

Common causes of sharp lower back pain that worsens when lying down include musculoskeletal pain due to strain or poor posture, kidney stones, and sometimes gastrointestinal issues. It's important to consult a healthcare provider for an accurate diagnosis.


Can kidney stones cause nausea and loss of appetite?

Yes, kidney stones can cause nausea and loss of appetite. The pain from kidney stones can be severe and may radiate to the lower abdomen and groin, often accompanied by nausea.


What symptoms indicate a kidney infection?

Symptoms of a kidney infection can include back or side pain, fever, chills, nausea, and sometimes urinary symptoms like a strong urge to urinate or pain during urination. It's important to seek medical attention if these symptoms occur.


How can gastrointestinal issues lead to back pain and nausea?

Gastrointestinal issues such as gastritis or peptic ulcers can cause back pain and nausea due to inflammation or damage to the stomach lining. These conditions can sometimes refer pain to the back and cause digestive symptoms.


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