[32F] With severe lower back and sharp right-sided abdominal pain

Patient Description

A 32-year-old female has been experiencing severe lower back pain for over a week, limiting mobility and requiring her to lie down with a heating pad most of the time. Today, she woke up with sharp pain in the lower right back and lower front abdomen. The abdominal pain started suddenly, is constant, and worsens with movement or pressure, rated as 6-7/10 in severity. She reports two bowel movements yesterday, not completely solid but not diarrhea. No nausea, vomiting, fever, chills, or changes in urine color, though urination is more frequent due to increased fluid intake. The back pain feels sharp, like something poking, and is aggravated by almost any activity. No blood in urine, no history of kidney stones, and no recent infections. Medical history includes acid reflux and a twisted small intestine identified over 10 years ago, not a major concern at the time. Allergic to tetracycline. Medications include Q-Lipta, citalopram, and buspirone, with occasional Tylenol for pain, without side effects.

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Arora's Assessment

What might be happening

Based on your symptoms, there are a few possibilities to consider:

  1. Kidney Stones: The sharp pain in your lower back and abdomen could be due to kidney stones. These can cause severe pain that comes on suddenly and may worsen with movement. Testing typically involves imaging like an ultrasound or CT scan, and treatment can range from pain management to procedures to remove the stones.

  2. Appendicitis: Although less common, sharp pain in the lower right abdomen could indicate appendicitis, especially if it worsens with movement. This is a medical emergency and requires immediate attention. Diagnosis is usually confirmed with imaging and blood tests, and treatment involves surgery.

  3. Muscle Strain or Injury: Given your limited mobility and back pain, a muscle strain or injury could be contributing to your symptoms. Rest, heat, and over-the-counter pain relief are typical treatments, but persistent or worsening pain should be evaluated by a healthcare provider.

What you can do

  • Seek Immediate Medical Attention: Given the severity and sudden onset of your symptoms, it's important to see a healthcare professional as soon as possible. If the pain worsens or you develop new symptoms like fever or vomiting, consider going to the emergency room.

  • Avoid Strenuous Activity: Rest as much as possible and avoid activities that worsen the pain.

  • Stay Hydrated: Continue drinking fluids, especially if kidney stones are a possibility.

  • Pain Management: Use over-the-counter pain relief like acetaminophen, but avoid NSAIDs like ibuprofen until a healthcare provider advises, as they can worsen certain conditions.

Please remember, this information is not a substitute for professional medical advice. It's important to consult with a healthcare provider for an accurate diagnosis and appropriate treatment. If your symptoms are severe, consider calling 911 or having someone take you to the hospital.

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2 mo ago

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 that radiates to the lower abdomen and groin, pain that comes in waves and fluctuates in intensity, frequent urination, and sometimes blood in the urine. Nausea and vomiting can also occur.

How can I differentiate between muscle strain and more serious conditions like appendicitis?

Muscle strain typically causes localized pain that worsens with movement and improves with rest, while appendicitis often presents with sharp pain in the lower right abdomen that worsens with movement and may be accompanied by fever, nausea, or vomiting. If in doubt, seek medical evaluation.

What are the risks of untreated appendicitis?

Untreated appendicitis can lead to a ruptured appendix, which can cause peritonitis, a serious infection of the abdominal cavity, and can be life-threatening. Immediate medical attention is crucial to prevent complications.

What are some effective ways to manage severe lower back pain at home?

To manage severe lower back pain at home, rest and avoid activities that exacerbate the pain, use heat therapy like a heating pad, and take over-the-counter pain relievers such as acetaminophen. If pain persists or worsens, consult a healthcare provider.

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