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What Causes Bi-lateral Kidney Pain And Flank Pain After Discontinuing Dilaudid And Topamax?
Question: I got back from Germany a week ago & while there was at a Natural Praxix clinc. I was stopped all medications I was on while there (i.e. methadone, Dilaudid, Topamax) since I am now in remission from my CRPS (complex regional pain syndrome). This threw me into withdrawal and all the symptoms that comes with it. 3 day in I started having kidney pain (bi-lateral) and flank pain. As the weeks went on it intensified. In Germany my Creatine levels were high and "global Diagnostic" showed the kidneys and adrenals as being impaired and having high toxin levels.
We arrived home and I was seen at the ER. My urinalysis came back clean -no blood. Blood work showed Creatine at 0.89. I was told this was good. Renal ultrasound was normal. I was sent home with continued pain between 7-8/10.
Now a week later the kidney pain persists. It is bilateral. If there is pressure on my back oner the kidney area it increases the pain/discomfort. Laying on either side is uncomfortable.
Any suggestions or input?
We arrived home and I was seen at the ER. My urinalysis came back clean -no blood. Blood work showed Creatine at 0.89. I was told this was good. Renal ultrasound was normal. I was sent home with continued pain between 7-8/10.
Now a week later the kidney pain persists. It is bilateral. If there is pressure on my back oner the kidney area it increases the pain/discomfort. Laying on either side is uncomfortable.
Any suggestions or input?
Brief Answer:
first on the kidney issue....
Detailed Answer:
It's a bit tricky without directly being there. An ultrasound and a urinalysis without blood would certainly exclude most serious conditions (and a creatinine of < 1 indicates entirely negative kidney function). Kidney stones, tumor, kidney infection, kidney blockage, autoimmune inflammation of them really does not seem possible if the inflammatory signs are not there.
Several points. How is something "kidney pain"? certainly one can have pain in the back, but what makes it kidney? and if it is both, then it is not a condition that would affect one side or one spot (everything from stones to punches to cancer.. one side not both). One can have urinary symptoms like pain with urination. These occur from a problem anywhere along the urinary tract and often the pain travels in a broad area involving the kidney when the kidneys are not the source. Testicular pain as one of many examples. But back pain is not generally kidney pain.
How is CRPS in remission but someone has pain? I can see someone having CRPS and then having pain or having it in remission and not having pain.
Indeed, it is very common for someone to have back pain and CRPS and not have kidney problems. Most people with CRPS don't have kidney problems. Back pain occurs literally in everyone. Serious back problems such as disk disease won't involve the kidney and won't have abnormalities in kidney tests and will not show up in ultrasounds even if one were trying to find disk disease, ultrasound doesn't get a good look.
first on the kidney issue....
Detailed Answer:
It's a bit tricky without directly being there. An ultrasound and a urinalysis without blood would certainly exclude most serious conditions (and a creatinine of < 1 indicates entirely negative kidney function). Kidney stones, tumor, kidney infection, kidney blockage, autoimmune inflammation of them really does not seem possible if the inflammatory signs are not there.
Several points. How is something "kidney pain"? certainly one can have pain in the back, but what makes it kidney? and if it is both, then it is not a condition that would affect one side or one spot (everything from stones to punches to cancer.. one side not both). One can have urinary symptoms like pain with urination. These occur from a problem anywhere along the urinary tract and often the pain travels in a broad area involving the kidney when the kidneys are not the source. Testicular pain as one of many examples. But back pain is not generally kidney pain.
How is CRPS in remission but someone has pain? I can see someone having CRPS and then having pain or having it in remission and not having pain.
Indeed, it is very common for someone to have back pain and CRPS and not have kidney problems. Most people with CRPS don't have kidney problems. Back pain occurs literally in everyone. Serious back problems such as disk disease won't involve the kidney and won't have abnormalities in kidney tests and will not show up in ultrasounds even if one were trying to find disk disease, ultrasound doesn't get a good look.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I had a manual exam while in Frankfurt, Germany and it was determined that it was my kidneys. At the time I was there my Creatine levels were 1.8.
Yes, it was good to see the Creatine drop to a normal level when checked at ER.
CRPS pain is different than this. Yes, it is possible to be in remission from CRPS and have this type of pain. I have consulted with my pain management doc just prior to leaving Germany and he felt it was perhaps a strain put on the kidneys and adrenals from detoxing. He was the person who requested I go back on the Topamax and taper it down.
Yet, it has caught me off guard that it is lasting this long. I am very aware of the spine, lumbar area, etc. I went through two Spinal Cord Stimulators prior to having the last one removed in 2010 due to a buildup of scar tissue on the Dura.
I get the feeling from your response that without seeing a patient it is not possible to assist with this. Am I correct?
I will follow up with my own doctor at the beginning of the week then.
Yes, it was good to see the Creatine drop to a normal level when checked at ER.
CRPS pain is different than this. Yes, it is possible to be in remission from CRPS and have this type of pain. I have consulted with my pain management doc just prior to leaving Germany and he felt it was perhaps a strain put on the kidneys and adrenals from detoxing. He was the person who requested I go back on the Topamax and taper it down.
Yet, it has caught me off guard that it is lasting this long. I am very aware of the spine, lumbar area, etc. I went through two Spinal Cord Stimulators prior to having the last one removed in 2010 due to a buildup of scar tissue on the Dura.
I get the feeling from your response that without seeing a patient it is not possible to assist with this. Am I correct?
I will follow up with my own doctor at the beginning of the week then.
Brief Answer:
information is often helpful
Detailed Answer:
Going to have to check up on kidney irritation.... I am quite dubious about it existing EXCEPT when the kidneys are irritated .. which is quite common. BUT if kidneys are irritated:
red cells in urine
white cells in urine (always).
and....maybe other problems due to dysfunction of the kidneys. So... it would have to be irritation of the kidneys BUT not the physical stuff of the kidneys. If the nerves or covering of the kidneys get irritated, then, yes, makes sense. AND... treatment is totally different if it is pain from an irritated nerve from everything else. Anti-epileptic drugs (topamax, but it is the weakest for pain; gabapentin and pregabalin are much more used) and lidocaine like drugs (lidocaine and amitryptiline) and spinal blocking drugs (amitryptiline and to a lesser extent cymbalta) are all good for nerve pain but only nerves for most of them. The covering of the kidney can be irritated. Likely to have some soreness on pressing on them if that is the source of pain. Anti-inflammtories would be good. Steroids are.... interesting.... and getting a level of the steroid hormones if someone has adrenal issues would be a very very important thing.
so.... how to think about and test for causes. what the best treatment is based on the causes. most important test for adrenal issue would be cortisone level first thing in the AM and the pituitary hormone that stimulates the adrenal gland ACTH.
There, just info, but pretty good covering the issue.
information is often helpful
Detailed Answer:
Going to have to check up on kidney irritation.... I am quite dubious about it existing EXCEPT when the kidneys are irritated .. which is quite common. BUT if kidneys are irritated:
red cells in urine
white cells in urine (always).
and....maybe other problems due to dysfunction of the kidneys. So... it would have to be irritation of the kidneys BUT not the physical stuff of the kidneys. If the nerves or covering of the kidneys get irritated, then, yes, makes sense. AND... treatment is totally different if it is pain from an irritated nerve from everything else. Anti-epileptic drugs (topamax, but it is the weakest for pain; gabapentin and pregabalin are much more used) and lidocaine like drugs (lidocaine and amitryptiline) and spinal blocking drugs (amitryptiline and to a lesser extent cymbalta) are all good for nerve pain but only nerves for most of them. The covering of the kidney can be irritated. Likely to have some soreness on pressing on them if that is the source of pain. Anti-inflammtories would be good. Steroids are.... interesting.... and getting a level of the steroid hormones if someone has adrenal issues would be a very very important thing.
so.... how to think about and test for causes. what the best treatment is based on the causes. most important test for adrenal issue would be cortisone level first thing in the AM and the pituitary hormone that stimulates the adrenal gland ACTH.
There, just info, but pretty good covering the issue.
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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