Right Flank Pain: When to Consult a Nephrologist

It is unclear whether this phenomenon is related to renal pathology?

Hello, I have been experiencing a dull ache and discomfort in my right lower back every morning upon waking up for the past week.
I do not have any urgency to urinate or any other urinary symptoms.
I'm unsure why this is happening and whether I should see a nephrologist.

Youxin, 30~39 year old female. Ask Date: 2013/12/28

Dr. Wang Weijie reply Internal Medicine

Dear You-Hsin,
Hello.
The causes of low back pain (also known as lumbago) are approximately 97% due to mechanical factors, including muscle strains, sprains, and spinal issues.
Among these, over 70% are due to lumbar sprains, 4% are due to herniated discs, and 1% are due to non-mechanical factors such as tumors, infections, and inflammatory arthritis.
Only about 2% are related to kidney issues, such as stones or pyelonephritis.
Patients with a high suspicion of kidney disorders can visit a nephrology clinic, where a physician will conduct a detailed physical examination, along with blood and urine tests and renal ultrasound.
Appropriate treatment will be provided based on the correct diagnosis.
Wishing you safety and health.
Sincerely,
Dr.
Wei-Chieh Wang
Chief of Nephrology
Taoyuan General Hospital, Ministry of Health and Welfare

Reply Date: 2013/12/28

More Info

Right flank pain can be a concerning symptom, especially when it persists over several days. Given your description of waking up each morning with a dull, aching pain in your right flank, it is important to consider several potential causes and when it might be appropriate to consult a nephrologist.

First, flank pain can arise from various sources, including musculoskeletal issues, kidney problems, or even gastrointestinal conditions. Since you mentioned that the pain is located in the right flank area, it could be related to the kidneys, which are located on either side of the spine in the lower back. However, without additional symptoms such as changes in urination, fever, or significant pain, it may not immediately indicate a serious kidney issue.

Here are some potential causes of right flank pain:
1. Musculoskeletal Issues: Strain or injury to the muscles or ligaments in the back can lead to localized pain. This is particularly common if you have engaged in physical activities that may have strained your back.

2. Kidney Stones: If the pain is severe and comes in waves, it could be a sign of kidney stones. However, you mentioned that you do not have any urinary urgency or changes, which makes this less likely.

3. Urinary Tract Infection (UTI): While UTIs typically present with urinary symptoms, they can sometimes cause flank pain, especially if the infection has reached the kidneys (pyelonephritis).
4. Kidney Issues: Conditions such as hydronephrosis (swelling of a kidney due to a build-up of urine) or kidney infections can cause flank pain.
5. Gastrointestinal Issues: Sometimes, conditions affecting the gastrointestinal tract, such as appendicitis or issues with the colon, can present as flank pain.

Given that your pain has persisted for a week, it would be prudent to consult a healthcare professional, particularly a nephrologist, if the pain continues or worsens. Here are some signs that would warrant a visit to a nephrologist:
- Persistent Pain: If the pain does not improve or worsens over time.

- Changes in Urination: Any changes in the frequency, color, or consistency of your urine.

- Fever or Chills: These could indicate an infection.

- Nausea or Vomiting: These symptoms can accompany kidney issues.

- Blood in Urine: This is a significant symptom that should be evaluated immediately.

When you consult a nephrologist, they may perform a physical examination and order tests such as blood tests to assess kidney function (including creatinine and blood urea nitrogen levels) and imaging studies like an ultrasound or CT scan to visualize the kidneys and surrounding structures.

In summary, while right flank pain can have various causes, the persistence of your symptoms over a week suggests that a consultation with a nephrologist is warranted. They can help determine the underlying cause of your pain and recommend appropriate treatment or management strategies. It is always better to err on the side of caution when it comes to potential kidney issues, so seeking medical advice is a wise decision.

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