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Coachrobmd
Coachrobmd, Internal Medicine MD
Category: Medical
Satisfied Customers: 1785
Experience:  •Fmr. Dir. Hep. C Clinic. •Fmr. Dir. Head Trauma Rehab Ctr.
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Flank pain. How do you tell if it its muscle related or i

Resolved Question:

Flank pain. How do you tell if it its muscle related or internal?
Submitted: 2 years ago.
Category: Medical
Expert:  Coachrobmd replied 2 years ago.

Coachrobmd :

Hi, I'm Doctor Robert, a Medical Internist (MD) who deals with diseases of all organ systems. All my education has been completed in the US.

Coachrobmd :

The views expressed here are for educational purposes only and do not establish a physician-patient relationship. It is NOT intended to replace your own physician's advice or diagnosis. If this is an emergency, stop now and please call 9-1-1 or go to the nearest Emergency Room.

Coachrobmd :

Are you there? If so, NOW is the time to chime in so we can chat.

Coachrobmd :

Because I can NOT see, touch, speak with or examine you, nor do I have access to your complete medical history, labs, scans or medications, I will NOT be able to give you an exact diagnosis. If that's what you are expecting from me here, STOP READING NOW. Otherwise you may possibly give me a negative I BAD/POOR SERVICE rating, which is not helpful. There are limits to what can be done across the internet. PLEASE keep this in mind as you read my responses.

Coachrobmd :

Flank pain can be due to

Coachrobmd :

1. kidney stones

Coachrobmd :

2. muscle strain

Coachrobmd :

3. Urinary Tract Infection (UTI) with spread to the kidneys

Coachrobmd :

Those are the big three of flank pain.

Coachrobmd :

They are differentiated by

Coachrobmd :

1. Urinalysis (U/A)- Of a UTI it will show one thing, another for kidney stones, and nothing for muscle strains

Coachrobmd :

2. CT scan will show kidney stones

Coachrobmd :

If you have fever, pain radiating from the lower ribs down the back toward the pelvis, this speaks of kidney stones

Coachrobmd :

If it hurts more when twisting or bending, this is more likely muscle spasms

Coachrobmd :

If it hurts to urinate, such as burning pain, that most likely is a Urinary Tract Infection (UTI).

Coachrobmd :

Please realize this: I am limited to the information that I glean from your posts, as I can't see, talk to, or touch you. I can only give you my approach to the evaluation of your symptoms if you were in my office. That puts me at a disadvantage compared to your doctor who actually sees your body right there in the office. This is just the nature of advising across the internet. A specific diagnosis under these conditions is VERY difficult.

Coachrobmd :

These are all differentiated by simple testing an a clinical exam, which I obviously can't do on you through the internet. If you were expecting that, I'm sorry to disappoint.

Customer:

Yes

Coachrobmd :

If the pain persists, and you develop ANY fever or burning, you need to be seen for a UTI or kidney infection as they can be serious.

Coachrobmd :

There is no way for YOU to tell simply because you can't analyze the urine.

Coachrobmd :

but your primary care physician (PCP) or general practitioner can do that for you.

Customer:

Hurts when bending or getting up.

Customer:

How long does it take to get over spasms?

Coachrobmd :

If the pain becomes INTENSE and radiates down the back, then you should head off to the ER because this is likely a stone and you're going to need pain medications pretty shortly.

Coachrobmd :

Spasm take a few days with heat and rest.

Customer:

No. only on flank Not down back

Customer:

Not intense, but been 3 weeks

Coachrobmd :

But by rest, i do NOT mean laying in bed. Only the first 24 hours should be spent that way. After that, gently walking and sitting in a chair.

Coachrobmd :

If not spreading down, it could still be a stone in the kidney pole.

Customer:

Right flank only.

Coachrobmd :

A Urinalysis (U/A) will show blood in the urine.

Coachrobmd :

You need a Urinalysis (U/A) to be honest. I can't differentiate without seeing you.

Customer:

No visible bllod in urine seems normal

Customer:

blood

Coachrobmd :

No, you don't see blood in the urine with stones. It is microscopic.

Coachrobmd :

If I had to guess, I'd say this was a muscle strain.

Coachrobmd :

And that responds to heat, Non-steroidal anti-inflammatory drugs (NSAIDs) and not exerting yourself.

Coachrobmd :

Some people also prefer a firm bed.

Customer:

I would agree but the time seems longer than normal to get over,.

Customer:

How long could a severe strain take?

Coachrobmd :

Not if you keep exerting yourself it isn't.

Coachrobmd :

A SEVERE strain in the back can take weeks.

Coachrobmd :

That's because you're always using your back when you walk and stand and it nEVER gets a rest.

Customer:

OK I will give a few more weeks, then see a doctor.

Coachrobmd :

That's why backs take so long to heal.

Coachrobmd :

Are you satisfied with all my advice today? Yes or No? If not, what else can I answer for you?

Customer:

Stones would be possible even if I have no history of them?

Coachrobmd :

Absolutely.

Coachrobmd :

There is ALWAYS a first stone before others occur.

Customer:

Pushing in area brings no severe pain. Pressure

Coachrobmd :

but this sounds more muscular to me.

Customer:

OK I am satisfied with your advice

Coachrobmd :

Stone are not made worse by pressure.

Coachrobmd :

============= Please remember to only rate my answer when you are 100% satisfied. If you feel the urge to leave a NEGATIVE rating of "BAD" or "POOR" service (or ONE or TWO STARS, depending upon your screen), please stop and reply to me via the CONTINUE CONVERSATION button. I will be happy to do everything I can to provide you with the service you seek. Selecting from the RIGHTMOST 2 faces/stars is how I receive compensation for all the years of training that went into assisting you today. It would be most appreciated.

Customer:

ok I was just wondering if there would be pressure pain by pushing on it Theres not

Coachrobmd :

No, not with stones. It would not increase the pain and may make it feel better actually.

Coachrobmd :

That is not a way to differentiate between these three disorders.

Customer:

Ok. I will give it 2 more weeks max, then go in

Customer:

What over the counter?

Coachrobmd :

I wouldn't wait that long.

Customer:

I have to

Coachrobmd :

over the counter (OTC) medications include motrin, aleve, naproxyn, and tylenol.

Coachrobmd :

It's your decision.

Customer:

OK thanks will rate your answers now.

Customer:

Bye.

Coachrobmd :

Thank you.

Coachrobmd :

Bye.

Coachrobmd, Internal Medicine MD
Category: Medical
Satisfied Customers: 1785
Experience: •Fmr. Dir. Hep. C Clinic. •Fmr. Dir. Head Trauma Rehab Ctr.
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