Lower Back Pain: When to Consult Urology or Nephrology

Q: Lower Back Pain: When to Consult Urology or Nephrology

Hello： If you are experiencing pain, you should seek medical attention, although the examination may still yield normal results. <br>Wishing you good health.

Continuation of the previous article on lower back pain issues?

Hello, doctor.
The day before yesterday, I asked about my left and right lower back pain online, and the doctor suggested that I first check for gynecological infections.
Yesterday, I visited an obstetrician-gynecologist who performed a pelvic exam and a gynecological ultrasound.
The doctor said there wasn't anything major, just that my private area is on the verge of inflammation but hasn't actually become inflamed yet.
I also asked if this could be related to my back pain, and the doctor said it wouldn't affect it.
Therefore, she recommended that I see a urologist or nephrologist to check for possible kidney stones.

Currently, my condition is as follows: on the first day, I experienced pain while walking, which made me walk very slowly, but it wasn't so severe that I couldn't walk at all.
On the second day, it improved a bit, but the doctor advised me to rule out any gynecological issues before seeing a urologist.
Today is the third day; if I don't move intentionally, I don't feel pain, but bending over does cause discomfort, more of an ache.
There isn't much pain when I tap on my lower back (just a little).
I'm wondering if I should go see the doctor? (But I have already made an appointment.)

Ling Er, 20~29 year old female. Ask Date: 2024/03/13

Dr. Du Shixi reply Urology

Hello: If you are experiencing pain, you should seek medical attention, although the examination may still yield normal results.
Wishing you good health.

Reply Date: 2024/03/13

More Info

Lower back pain can be a complex issue, and understanding when to consult a urologist or nephrologist is crucial for proper diagnosis and treatment. Based on your description, it seems you have already taken some important steps by consulting a gynecologist to rule out any gynecological issues. This is a wise approach, as many patients often overlook the potential overlap between pelvic and lower back pain.

From a medical perspective, lower back pain can arise from various causes, including musculoskeletal issues, nerve compression, kidney problems, or even referred pain from other organs. Given your symptoms—pain when walking, discomfort when bending, and mild pain upon percussion of the lower back—it is essential to consider both musculoskeletal and renal causes.

When to Consult Urology or Nephrology
1. Symptoms Suggestive of Kidney Issues: If you experience symptoms such as hematuria (blood in urine), changes in urination patterns (like frequency or urgency), or any signs of infection (fever, chills, nausea), it is advisable to consult a urologist or nephrologist. Kidney stones, for instance, can cause significant pain and may lead to complications if not addressed promptly.

2. Duration and Severity of Pain: Since your pain has persisted for three days and varies in intensity, it is essential to monitor its progression. If the pain worsens or becomes more persistent, seeking further evaluation is warranted. Chronic pain or pain that does not respond to over-the-counter medications should not be ignored.

3. Associated Symptoms: Pay attention to any additional symptoms that may develop. For example, if you start experiencing fever, chills, or changes in your urinary habits, these could indicate a urinary tract infection or kidney issue, necessitating a visit to a urologist.

4. Physical Examination Findings: The fact that you have some discomfort upon percussion of the lower back could indicate a potential issue with the kidneys or surrounding structures. A urologist can perform imaging studies, such as an ultrasound or CT scan, to evaluate for kidney stones or other abnormalities.

5. Previous Medical History: If you have a history of kidney stones or urinary tract infections, this increases the likelihood that your current symptoms could be related to these conditions. In such cases, consulting a urologist sooner rather than later is advisable.

Conclusion
In summary, while your current symptoms may not seem severe, the persistence of pain and the potential for underlying issues warrant further investigation. Since you have already made an appointment with a urologist, it would be prudent to keep that appointment. They can provide a thorough evaluation, including urine tests and imaging studies, to rule out any renal or urinary tract issues.

Additionally, if your pain continues or worsens, or if you develop any new symptoms, do not hesitate to seek immediate medical attention. Early intervention can often prevent complications and lead to more effective treatment outcomes. Remember, your health is paramount, and it is always better to err on the side of caution when it comes to unexplained pain.

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