Lower Back Pain: When to Seek Medical Attention

Q: Lower Back Pain: When to Seek Medical Attention

Dear Miss Peggy： Your symptoms appear to be indicative of acute pyelonephritis, which is characterized by fever, flank pain, dysuria, burning sensation, and increased urinary frequency. <br>Symptoms can vary from person to person, and a correct diagnosis requires urine analysis a

Pain in the lower back, noticeable when turning over and walking?

Two days ago, while I was sleeping, I turned over and felt a sharp pain in my lower back.
I initially thought it was due to sitting too long at work during the day.
However, the next morning, the pain persisted, and by the afternoon, I developed a fever (38.2°C) along with body aches.
I went to a general gastroenterology clinic to get checked and informed the doctor of my symptoms.
After an ultrasound, he said my kidneys appeared normal, but based on my description, he suspected a possible kidney inflammation.
After taking medication, my fever subsided, and the pain slightly decreased, but I still feel discomfort in my lower back.
I do not have issues with frequent urination or urinary tract infections, and my daily routine has been normal.
The only change is that I have been taking green tea extract tablets and calcium supplements for the past two days.
Is it possible that this could have caused kidney stones? What should I do next? Should I monitor my symptoms or go to a major hospital for further examination? If I need to get checked, should I see a urologist or a nephrologist?

peggy, 30~39 year old female. Ask Date: 2008/06/21

Dr. Wang Weijie reply Internal Medicine

Dear Miss Peggy: Your symptoms appear to be indicative of acute pyelonephritis, which is characterized by fever, flank pain, dysuria, burning sensation, and increased urinary frequency.
Symptoms can vary from person to person, and a correct diagnosis requires urine analysis and urine culture results.
Treatment can be effectively achieved with antibiotics.
The flank pain associated with pyelonephritis may persist for one to two weeks.
If your symptoms have improved, maintaining good daily health practices is advisable.
It is recommended to take precautions to avoid urinary tract infections, such as drinking plenty of water, not holding in urine, and practicing good hygiene.
If you have concerns, you may return to your original healthcare facility for follow-up.
Regarding the use of green tea extract tablets and calcium supplements, if you have an acidic body constitution, taking them together may increase the risk of kidney stones.
To avoid stone formation, it is advisable to take them separately, with a gap of 2-3 hours between the two.
Wishing you peace and health.
Sincerely, Dr.
Wang Wei-Jie, Chief of Nephrology, Taoyuan Hospital, Department of Health.

Reply Date: 2008/06/21

More Info

Lower back pain can be a complex issue, and understanding when to seek medical attention is crucial for effective management. Based on your description, it seems that your pain began suddenly during sleep and was accompanied by fever and generalized body aches. This combination of symptoms raises several considerations.

Firstly, the acute onset of lower back pain, especially when associated with fever, could indicate an underlying infection or inflammatory process. While your initial evaluation by a gastroenterologist ruled out kidney issues via ultrasound, the possibility of a kidney infection (pyelonephritis) or other inflammatory conditions should not be dismissed entirely. The fact that your fever responded to medication suggests that there might have been an infectious component, but the persistence of discomfort in your lower back warrants further investigation.

Regarding your question about whether the green tea extract and calcium supplements could lead to kidney stones, it is possible but not very common. Green tea is generally considered safe, but excessive consumption of calcium can contribute to stone formation, particularly if you are predisposed to them. However, the symptoms you are experiencing—especially the fever—are more indicative of an infection rather than stone-related pain.

Given your current symptoms, it is advisable to seek further medical evaluation. If your discomfort persists or worsens, you should consider visiting a larger medical facility where you can receive comprehensive care. In terms of which specialty to consult, both urology and nephrology could be relevant. Urologists specialize in urinary tract issues, including kidney stones and infections, while nephrologists focus on kidney function and diseases. If you suspect an infection, starting with a urologist may be more appropriate, as they can perform necessary tests such as urinalysis and imaging studies to rule out urinary tract infections or stones.

In the meantime, monitoring your symptoms is essential. If you experience any of the following, seek immediate medical attention:
- Worsening pain or fever
- Changes in urination (such as increased frequency, urgency, or blood in urine)
- Nausea or vomiting
- Any new symptoms that concern you
In summary, while your symptoms may have improved somewhat, the persistence of lower back discomfort and the initial fever suggest that further evaluation is warranted. It is crucial to address these symptoms promptly to rule out any serious conditions and to ensure appropriate treatment. Always prioritize your health and do not hesitate to seek medical attention if you feel it is necessary.

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