[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.

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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:

  1. 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.

  2. 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.

  3. 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.

  4. Avoid Triggers: Try to identify and avoid movements or activities that exacerbate your pain.

What you should look out for

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

  • Fever or chills, which could indicate an infection
  • Blood in your urine
  • Severe or worsening pain
  • Inability to urinate or significant changes in urination patterns

Remember, it's important to consult with a healthcare professional to receive a proper diagnosis and treatment plan.

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29 d ago

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People Also Ask


What are the common symptoms of kidney stones?

Common symptoms of kidney stones include severe pain in the side and back, below the ribs, pain that radiates to the lower abdomen and groin, pain that comes in waves and fluctuates in intensity, painful urination, discolored or smelly urine, and nausea or vomiting.


How can a urinary tract infection affect urine appearance?

A urinary tract infection can cause urine to appear cloudy, dark, or have a strong odor. This is due to the presence of bacteria, white blood cells, or blood in the urine, which can alter its appearance and smell.


What are some potential causes of sharp pain under the rib cage?

Sharp pain under the rib cage can be caused by several conditions, including kidney stones, musculoskeletal issues like muscle strain, or even gastrointestinal problems. It's important to consult a healthcare provider for an accurate diagnosis.


What steps can I take at home to manage severe back pain?

To manage severe back pain at home, you can stay hydrated, use over-the-counter pain relievers like ibuprofen or acetaminophen, avoid movements that trigger pain, and keep track of your symptoms to share with your healthcare provider.


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