[57F] Experiencing sharp and achy back pain with abdominal discomfort

Patient Description

A 57-year-old female has been experiencing sharp and achy pain in the right flank area of her back for three weeks, with no relief from any activities or treatments. Additionally, she reports sharp and crampy abdominal pain in the flank area, radiating to the side and upper abdomen, starting three days ago, with a severity rating of 8 out of 10. The patient also experiences nausea but no fever, chills, changes in bowel movements, or urine. She is currently taking Oxycodone 20mg three times a day and a muscle relaxer (Tizanidine 8mg three times a day) for pain management. There's no recent history of injury, and she has no significant past medical history.

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Arora's Assessment

What might be happening

Based on the information provided, here are a few possibilities:

  • Kidney Stones: These are hard deposits made of minerals and salts that form inside your kidneys. They often cause severe pain in the back or side, below the ribs, and the pain can radiate to the lower abdomen and groin. The pain may come in waves and fluctuate in intensity.

    • Treatment often involves pain relievers and drinking lots of water to help pass the stone. Medical procedures may be needed to remove or break up larger stones.
  • Musculoskeletal Strain: This happens when muscles or ligaments in the back are stretched or torn, often due to overuse or injury. However, you mentioned no recent injuries.

    • Treatment typically involves rest, physical therapy, and pain relievers.
  • Pyelonephritis: This is a kidney infection usually caused by bacteria that have traveled up from the bladder. It can cause back pain, fever, and nausea, but you mentioned no fever.

    • Treatment typically involves antibiotics.
  • Gallbladder Issues: Problems like gallstones or cholecystitis can cause pain in the upper right abdomen, and sometimes in the right shoulder or back. However, these conditions often cause severe and sudden pain, which doesn't quite match your symptoms.

    • Treatment can range from dietary changes to surgery, depending on the severity and cause.

What you can do

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

  1. Schedule an appointment with your healthcare provider as soon as possible.
  2. Continue to take your prescribed medications as directed.
  3. Keep track of your symptoms and any changes. This will be helpful information for your healthcare provider.

What you should look out for

Please seek immediate medical attention if you experience any of the following:

  • Severe pain that prevents you from sitting still or finding a comfortable position
  • Blood in your urine
  • Fever and chills
  • Vomiting

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for accurate information.

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7 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, below the ribs, pain that radiates to the lower abdomen and groin, pain that comes in waves and fluctuates in intensity, nausea, and sometimes blood in the urine.


How can musculoskeletal strain be differentiated from other causes of back pain?

Musculoskeletal strain typically involves pain that is localized to the muscles or ligaments, often due to overuse or injury. It usually does not involve systemic symptoms like fever or nausea, which can help differentiate it from other causes like infections or kidney stones.


What are the typical symptoms of a kidney infection (pyelonephritis)?

Typical symptoms of a kidney infection include back pain, fever, chills, nausea, and sometimes painful urination or blood in the urine. It is important to seek medical attention if these symptoms are present.


What are the signs that gallbladder issues might be causing abdominal pain?

Signs that gallbladder issues might be causing abdominal pain include sudden and severe pain in the upper right abdomen, pain that may radiate to the right shoulder or back, nausea, and sometimes vomiting. These symptoms often occur after eating a fatty meal.


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Billy#3955

7 mo ago

Was it a kidney stone that you were prescribed the oxycodone for?

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