<p>I am a healthy 23-year-old woman who just had a clean physical only two weeks ago. </p>
<p>Then, two days ago, I was suddenly stricken with horrible lower back pain, including spasms so bad I’ve been in tears. I can’t sleep and I certainly can’t work. The only activity I can do comfortably is sitting, although today while I was eating lunch, the spasms were unpredictable and excruciating (so, they are getting worse rather than better)</p>
<p>Today, I went to an urgent care facility because my PCP couldn’t see me. The doctor ruled out a kidney infection–suspected because I had a low-grade fever-- and decided that it was not likely to be a slipped disc or pinched nerve. He did not do any x-rays or imaging. Basically, he sent me home with no diagnosis, no pain medication, and a referral for physical therapy.</p>
<p>My question for all you helpful parents: I have an appointment with my primary care doctor tomorrow morning (made as a backup if I couldn’t get to the urgent care place). What questions should I ask? What tests might I suggest? Anything to help me be a better advocate for my own care in this instance? And any hints for being more comfortable in the meantime?</p>
<p>I am not asking for any medical advice whatsoever, as I have doctors for that I am only asking for personal anecdotes or any ideas that might be helpful. Thanks in advance.</p>
<p>If it were me, or my children, I would plunk myself (or my kid and me) down in my doctor’s office first thing in the morning. I would not leave until the doctor saw me. I would also be calling my insurance carrier, from the waiting room, demanding an out of network doctor.</p>
<p>Ask about kidney stones. While you are young for these, young people DO get them. They often begin as the kind of pain you describe. This is different from a kidney infection. I’ve had 3 so unfortunately I’m familiar with this.</p>
<p>What were you doing when you were stricken with this pain? As someone with 4 herniated discs, 3 of them in the low back, I’m surprised to hear you are comfortable sitting. Sitting is always the most uncomfortable position for me, which may be why your doctor didn’t feel this was a disc problem.</p>
<p>You definitely need follow up if you are in so much pain that you can’t sleep. The fact that you are having low grade fever is a concern. Could you have a kidney stone? There are a lot of things that could be causing this, and I don’t blame you a bit for wanting to know what it is. Just sending you home without further investigation seems ridiculous. Muscle spasm is one thing, but the fact that you have a fever is certainly a reason to rule out other disease processes vs. just assuming it is a muscle injury.</p>
<p>Good luck and please check back in after you see your PCP.</p>
<p>If your urinalysis (UA) was normal without blood it’s very unlikely you have renal stones. Most likely a simple muscle spasm or strain. Its unlikely that your PCP will find anything different, and in the absence of trauma or other alarm signs (weight loss, significant fever, accompanying abdominal pain, weakness, bowel or bladder incontinence) there is no need for any other testing. A muscle relaxant or antiinflammatory is sometimes helpful.</p>
<p>I agree that it could be kidney stones. The pain from them is worse than childbirth pain. They can’t be definitively diagnosed without some type of imaging. I truly feel for you if this is what it turns out to be.</p>
<p>Blood is not always present in the urine when you have kidney stones. I’ve had them more than a dozen times and have never had blood the urine.</p>
<p>Ellebud, my doctor was leaving early for a meeting today, so that’s why she wouldn’t see me. I’m pretty tired of dealing with the office, and as soon as I get around to it, I’ll find a different practice. I have an HMO, though, so I couldn’t have just gone to a different general practitioner. I really miss being on my dad’s PPO! After I left the urgent care place, and the pain got worse, I was actually contemplating an ER visit. However, my insurance, like many others, will reject a claim if it rules the situation was not really an emergency. So, as long as I can sit up and think and speak, I think I’ll stay out of the ER. I’m not staying out of my doctor’s hair anymore though!</p>
<p>Curiouser, thanks for the suggestion! From your description, I’m surprised kidney stones didn’t cross the doctor’s mind today, and I will definitely ask at my appointment tomorrow.</p>
<p>Nrdsb4, it first happened when I was sleeping on Tuesday night. At some point in the night, I just couldn’t sleep anymore. On my sides and my stomach, the pain was unbearable. Lying on my back, it was merely tolerable. If I am upright and perfectly still, I am okay. If I breathe, horrible, sharp pain. If I sneeze, if I cough, if I laugh, if I bend, if I turn to either side…well, I think you get the idea. Today, when I was sitting on the exam table, the doctor had me stretch both legs out and pushed them up while fully extended. It caused me zero pain, so that’s why he ruled out a slipped disc or a nerve issue.</p>
<p>I’ll keep monitoring this thread through the evening and before my appointment tomorrow morning, so keep the comments coming!</p>
<p>If your doctor rules out kidney stones, then I would ask about interstitial cystitis.</p>
<p>I had the exact symptoms as you about two years ago. To make a long story short, the second urologist I saw (after seeing a primary care doctor and a different urologist) finally diagnosed interstitial cystitis. The problem was resolved through a strict diet that eliminated acidic foods.</p>
<p>The pain was excruciating. I couldn’t sleep or sit down. The only way I could cope with the pain was to lie in a hot bath for hours. The urologist explained that interstitial cystitis pain is the same pain as that of a kidney stone, as the pain in both instances is caused by spasms of the ureter. During my bout with interstitial cystitis, I also had bladder spasms. </p>
<p>Interstitial cystitis is usually diagnosed through the process of elimination. If your doctor rules out other causes, then I encourage you to research interstitial cystitis. A diet that eliminates acidic foods is usually the first line of defense. You can find the diet at multiple sites on the internet.</p>
<p>Wow. It’s a shame your insurance is so…well, anyway. The pain you’re describing would sure send me to the ER. Your pain tolerance is impressive.</p>
<p>It is true that renal stones can show up without hematuria but its unusual. But its often only visible microscopically. Perhaps that’s why you’ve never seen blood before. If you’ve had 12 kidney stones and no hematuria, not even microscopic hematuria, your MD needs to find a better lab.</p>
<p>The fact that your pain is worse with a deep breath, cough etc suggests that its muscular in origin. When you rotate from side to side you use the large muscles along the spine to perform that action. These are the ones that are typically strained or in spasm. I would be more concerned with a renal source of pain if you had pain with urination, had a slow urine stream, tea colored urine. It would also help if you took your temperature- body temp peaks at about 99.5 around 8 PM in most folks and drops to around 97.5 between 4-6 PM. Good luck!</p>
<p>My diagnosis, based on a few lines in a post, is kidney stones. I’m not a doctor so my diagnosis isn’t of much value but a kidney stone would cause the symptom you’re seeing. Of course, you need to see a doctor for it and it needs to be sooner rather than later - ideally right now (urgent care, ER). If it turns out to be a kidney stone you’ll likely have to just bear with it until it passes but they can give you some pain meds that won’t really help the pain much but can help it pass more easily.</p>
<p>Of course it could be other things as well. When it comes to ‘excrutiating pain’ it’s time to see a doc right away.</p>
<p>Not sure how low on your back the pain is but it could be your gall bladder. I have an history of kidney problems including surgery as a child. I went through a period about 10 yrs ago that I was convinced was a bladder infection. I was annoyed that my primary Dr at the time would not just write me a prescription. I could not get into him and I was in terrible pain that I found a new Dr. Right away he guessed gallstones. Went right over to the radiology group and had an ultrasound. The pain was below my bra line just on my back. I had no pain on my front side. The pain was beyond anything I had experienced in childbirth. With gallstones the pain will worsen after eating any food that contains fat.</p>
<p>My H also had some muscle spasm intense pain that ended up being a inflamed muscle on his rib cage.</p>
<p>^^^^I had gallstones, too. Though I felt pain in the front and back. I agree that it can be just excruciating. I remember thinking, “at least during labor, you get little breaks between contractions.” I was laying on the bed, just rocking to and fro, thinking that would help. It got to the point where even eating a salad with low fat dressing would set me off. So glad to be done with that particular internal organ.</p>
<p>But my pain was all high, not low as the OP describes. But everything else was similar. </p>
<p>That’s why it’s important for the OP to be completely evaluated by a physician. We can’t diagnose you online, OP. Most of us are not qualified. Even a doctor can’t adequately assess you online. He/she needs to see you in person.</p>
<p>I hope tonight goes well, without any unbearable pain. Get some sleep!</p>
I am only asking for personal anecdotes or any ideas that might be helpful. Thanks in advance.</p>