Severe Left Lower Back Pain: Possible Causes and Concerns

Severe pain in the lower left flank?

Hello Dr.
Yang, my symptoms are as follows: About a week ago, I started experiencing a dull pain in the lower left side of my back (approximately above my left hip) while I was sleeping.
This pain then began to come in waves, becoming increasingly intense, and it radiates to the left side of my lower abdomen or my entire abdomen, accompanied by a feeling of bloating.
As a result, I feel the urge to have a bowel movement, but I am unable to pass stool.
There is no pain when urinating, and there is no visible blood.
(I have been constipated for about one to two years.) After about two days, one day after lunch, the same area started hurting again, and the symptoms were almost identical, to the point where I couldn't do anything.
Even after taking painkillers, the pain persisted.
Although I haven't had an episode today, the same area still has a dull ache.
Could this be a symptom of some kind of internal organ stone? I am really worried.
I hope you can take the time to answer my concerns.
Thank you.

Jiang Xiaojie, 30~39 year old female. Ask Date: 2006/07/08

Dr. Yang Zhangzhi reply Urology

Hello Miss Jiang, the symptoms you mentioned could potentially be renal colic caused by urinary tract stones.
However, we cannot rule out other abdominal issues.
Kidney stones can be confirmed through imaging studies such as X-rays or ultrasound.
Therefore, I recommend that you visit a hospital for a thorough examination to determine the underlying cause.
Thank you for your inquiry, and I wish you good health.

Reply Date: 2006/07/08

More Info

Dear Patient,
Thank you for sharing your symptoms and concerns regarding the severe pain in your left lower back, which radiates to your abdomen and is accompanied by a feeling of bloating and constipation. Based on your description, there are several potential causes for your symptoms, and I will outline them below, along with recommendations for further evaluation and management.

Possible Causes
1. Musculoskeletal Issues: Given that your pain is localized to the lower back, it could be related to musculoskeletal problems such as muscle strain, ligament sprain, or even a herniated disc. These conditions can cause referred pain to the abdomen and may also contribute to discomfort during bowel movements.

2. Kidney Stones: The pain you describe could potentially be related to kidney stones, especially if it radiates towards the lower abdomen. Kidney stones can cause severe pain that may come in waves, and while you mentioned no blood in your urine, it’s important to rule this out with imaging studies.

3. Gastrointestinal Issues: Your history of constipation is significant. Chronic constipation can lead to abdominal pain and discomfort, and in some cases, it can cause a condition known as fecal impaction, where hardened stool blocks the intestines. This could explain the bloating and the urge to have a bowel movement without success.

4. Reproductive System Concerns: In females, left lower abdominal pain can sometimes be related to gynecological issues such as ovarian cysts or other reproductive system disorders. If you are female, this should be considered, and a gynecological evaluation may be warranted.

5. Nerve Compression: Conditions such as sciatica or other forms of nerve compression in the lumbar spine can also cause pain that radiates to the lower abdomen. This is less common but still a possibility.

Recommendations
1. Medical Evaluation: It is crucial to seek medical attention for a thorough evaluation. A healthcare provider will likely perform a physical examination and may order imaging studies such as an X-ray or MRI of the lumbar spine, as well as an abdominal ultrasound or CT scan to assess for kidney stones or other abdominal issues.

2. Management of Constipation: Since you have a history of constipation, it may be beneficial to address this issue. Increasing dietary fiber, staying hydrated, and possibly using over-the-counter laxatives or stool softeners could help alleviate your symptoms. However, consult with a healthcare provider before starting any new medications.

3. Pain Management: Over-the-counter pain relievers such as ibuprofen or acetaminophen may help manage your pain. However, if the pain persists or worsens, it is essential to follow up with a healthcare provider.

4. Avoid Strain: Until you have a clearer understanding of the cause of your pain, it is advisable to avoid heavy lifting or strenuous activities that could exacerbate your symptoms.

5. Follow-Up: If your symptoms do not improve or if you experience additional symptoms such as fever, changes in urinary habits, or worsening abdominal pain, seek immediate medical attention.

Conclusion
Your symptoms warrant a thorough evaluation to determine the underlying cause and appropriate treatment. While there are several potential explanations for your pain, only a healthcare professional can provide a definitive diagnosis and treatment plan. Please do not hesitate to reach out to a physician for further assistance.

Wishing you a speedy recovery and relief from your symptoms.

Best regards.

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