[32F] Experiencing persistent back pain with additional symptoms

Question

Pain has now moved to left flank/lower abdomen

Patient Description

A 32-year-old female has been experiencing persistent back pain for about a month, which has gradually worsened and sometimes presents as sharp pain. The pain is exacerbated by standing for more than 10 minutes, and no relief has been found. In addition to back pain, the patient reports nausea over the past few days and intermittent knee pain in the left knee. There is also some back pain associated with urination, but no blood in the urine. The patient experiences occasional diarrhea and has had a loss of appetite for the last few days. There is no history of fever, chills, recent travel, or family history of kidney disease or urinary issues. The patient's medical history includes a diagnosis of polycystic ovary syndrome (PCOS) approximately 5-6 years ago. Current medications include Metformin 40 mg once daily and Lexapro 10 mg once daily. There are no known drug allergies.

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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: Your back pain, especially when urinating, along with nausea and intermittent diarrhea, could suggest kidney stones. These are hard deposits made of minerals and salts that form inside your kidneys. They can cause severe pain, especially when passing through the urinary tract.

    • Typical treatment involves pain management, staying hydrated, and sometimes medications to help pass the stone. In some cases, medical procedures may be necessary to remove larger stones.
  • Urinary Tract Infection (UTI): Although you haven't noticed blood in your urine, the back pain and discomfort during urination could indicate a UTI, which can sometimes cause nausea and changes in bowel habits.

    • UTIs are usually treated with antibiotics, and it's important to drink plenty of fluids to help flush out the bacteria.
  • Musculoskeletal Issues: Given the chronic nature of your back pain, it could also be related to musculoskeletal problems, such as muscle strain or a herniated disc, especially if the pain worsens with standing.

    • Treatment often includes physical therapy, pain management, and sometimes imaging tests to better understand the cause.

What you can do

While it's important to consult a healthcare professional for a formal diagnosis, here are some steps you can take in the meantime:

  1. Stay Hydrated: Drink plenty of water to help flush your urinary system, especially if kidney stones or a UTI are suspected.
  2. Pain Management: Over-the-counter pain relievers like ibuprofen may help alleviate some of the discomfort, but be sure to follow the recommended dosage.
  3. Monitor Symptoms: Keep track of your symptoms, including any changes in pain, urination, or bowel habits. Using MDandMe to journal these can provide valuable insights and help you share detailed information with your healthcare provider.
  4. Rest and Gentle Movement: While rest is important, gentle stretching or walking can sometimes help alleviate musculoskeletal pain.

What you should look out for

Seek medical attention if you experience any of the following:

  • Severe or worsening pain, especially if it becomes unbearable
  • Fever or chills, which could indicate an infection
  • Blood in your urine or significant changes in urination
  • Persistent nausea or vomiting

Remember, while these suggestions can help manage your symptoms, it's crucial to consult a healthcare professional for a proper diagnosis and treatment plan.

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3 mo ago

Top picked over-the-counter products for Urinary Incontinence: Best Evidence for At-Home Management

People Also Ask


What are the common symptoms of kidney stones?

Common symptoms of kidney stones include severe pain in the back or side, pain during urination, nausea, vomiting, and sometimes blood in the urine. The pain can be sharp and may come in waves as the stone moves through the urinary tract.


How can I differentiate between a UTI and kidney stones?

While both conditions can cause back pain and discomfort during urination, kidney stones often cause severe, sharp pain and may lead to nausea and vomiting. UTIs typically cause a burning sensation during urination, frequent urges to urinate, and cloudy or strong-smelling urine. A healthcare provider can perform tests to accurately diagnose the condition.


What are some effective ways to manage chronic back pain?

Effective ways to manage chronic back pain include physical therapy, regular exercise, maintaining good posture, using ergonomic furniture, and over-the-counter pain relievers. In some cases, imaging tests or professional medical advice may be necessary to address underlying issues.


Can PCOS contribute to back pain or urinary issues?

PCOS itself does not directly cause back pain or urinary issues, but it can lead to hormonal imbalances that might contribute to other health problems. It's important to discuss any new or worsening symptoms with a healthcare provider to determine if they are related to PCOS or another condition.


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3 Comments


Arora (Bot)#28060

3 mo ago

I'm sorry to hear that you're going through such discomfort. It sounds like a really challenging situation, and it's understandable to be concerned with these symptoms. You've done a great job in listing all the details, which will be very helpful for any healthcare professional you consult.

In the meantime, trying to stay hydrated and carefully managing your pain with over-the-counter options, as suggested, might help provide some relief. It's also a good idea to keep a close eye on any changes in your symptoms, especially if they worsen or new ones appear.

Do make sure to reach out to a healthcare provider soon. They can offer a thorough examination and determine the best course of action for you. Hang in there, and I hope you find some relief soon!

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Anonymous#4896

3 mo ago

Hang in there, my cousin just went through passing a kidney stone while he was visiting us, very much was trying to get him to drink as much water as possible.

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Arora (Bot)#28060

3 mo ago

It sounds like your cousin was going through a really tough time! Kidney stones can be incredibly painful, but staying hydrated is definitely key to helping pass them more easily. It's great that you were there to support and encourage him. I hope he's feeling much better now. If you or anyone else has similar symptoms, it's always a good idea to check in with a healthcare professional. Take care!

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