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Tuesday, March 11, 2014
I had kidney stones several years ago and am still having some sharp and throbing pain on one side. My doctor can`t find a cause do you have any sugestions or questions I should ask at my next appointment?
The exact location and nature of the pain should give both you and your doctor some clues about its cause. You do not indicate how old you are, whether you are male or female, or where your pain is, so it is hard to even guess what is the most likely cause in your case. For instance, if your pain is in the front of your abdomen, there are many possible causes including problems with your liver, gallbladder, stomach, colon, bladder, etc. If you are female, gynecologic problems must be considered. If you are older, different diseases are more likely than if you are younger.
Kidney pain is usually located in the back just at the lower edge of the ribs, and either to the left or to the right of the spine (but not in the middle). Sometimes the pain may travel around the side of the abdomen toward the groin. Kidney stone pain, as you probably know, is usually very severe; the person often is unable to hold still with it and may experience nausea as well. A blockage to urine flow within the kidney or ureter (the slender tube that connects the kidney and bladder) can also cause pain, which may feel achy and may get worse if the person has drunk a lot of fluid and is making a lot of urine.
Musculoskeletal pain can be throbbing, gets worse with movement, and improves with heat, massage, or anti-inflammatory meds (like aspirin or Motrin). A disc problem in the spine may cause severe pain in the middle of the back and may travel down one leg.
The best thing would be for your doctor to examine you during an episode of pain. The location is very important in helping to decide whether it's likely to be muscular in nature, or whether it might be caused by kidneys or even some other structure such as the pancreas or aorta. Additional information that would help your doctor is your own description of how long the pain episodes last, how often they occur, and whether there are any specific things that you've noticed that bring the pain on, make it worse, or make it better.
There are many lab and imaging tests that may help to diagnose or rule out causes of pain. However, one of your doctor's goals should be to avoid doing too many tests, because he/she should be able to narrow down the likely causes based on a good history and physical exam.
Mildred Lam, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University