[31F] With severe back pain and urinary changes

Patient Description

A 31-year-old female has been experiencing severe pain under her rib cage, extending to her back, for almost two months. The pain is described as sharp, akin to being stabbed or muscles tearing, particularly when moving quickly or sitting up from a lying position. Additionally, the patient reports discolored and smelly urine for the same duration. There is no history of recent injury or physical activity that could have triggered the pain, and no treatments or medications have been tried yet. The pain occurs throughout the day but is particularly exacerbated by certain movements, such as coughing or moving the wrong way. The patient has not reported any other symptoms at this time.

Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

Kidney Stones: The severe pain under your rib cage and in your back, especially when moving or coughing, could be related to kidney stones. These can cause sharp, stabbing pain and may also lead to discolored or smelly urine. Kidney stones are hard deposits made of minerals and salts that form inside your kidneys.
Urinary Tract Infection (UTI): Discolored and smelly urine can be a sign of a UTI, which can sometimes cause back pain if the infection spreads to the kidneys. UTIs are infections in any part of the urinary system, including the kidneys, bladder, or urethra.
Musculoskeletal Issues: The pain you experience when moving quickly or sitting up could be related to muscle strain or other musculoskeletal issues. This type of pain is often sharp and can be triggered by certain movements.

It's important to consult a healthcare professional for a formal diagnosis. They may recommend tests such as a urine analysis, imaging studies, or blood tests to determine the exact cause of your symptoms.

What you can do

While waiting to see a healthcare provider, here are some steps you can take:

Stay Hydrated: Drink plenty of water to help flush out your urinary system. This can be particularly helpful if kidney stones or a UTI are suspected.
Pain Management: Over-the-counter pain relievers like ibuprofen or acetaminophen may help alleviate some of the pain. However, consult with a healthcare provider before taking any new medication, especially if you are already taking fentanyl.
Monitor Symptoms: Keep track of your symptoms, including any changes in pain, urine color, or frequency. You can use the MDandMe app to journal your symptoms, track progress, and share insights with your healthcare provider.
Avoid Triggers: Try to identify and avoid movements or activities that exacerbate your pain.