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What Causes Chronic Right Abdominal And Lower Back Pain?

Posted on Thu, 21 May 2015

Question: I have had chronic right side low back and abdominal pain for the past 2 years. I have had MRIs, CT scans, gal stone test, sonograms, blood teens, etc. NOTHING. The pain is constant, sometimes worse than others. I have been to many different specialists - and they have found nothing. Chiropractor says that its not a muscle or bone issue since its been persistent for two years.

Answered by Dr. T Chandrakant (15 minutes later)

Brief Answer:
Detailed history please.

Detailed Answer:
Hi.
Thanks for your query.
To recapitulate:Female/41- wants to find the reason.

Read and understood your problem of chronic right abdominal and low pain for which you have seen many specialists and done all investigations, nothing positive is found.

Chiropractor also says negative about muscles or bones- says not related.

A detailed history alone can help us to solve the problem. May I please know the following?
- Since when have you got this problem?
- Type of pain - dull / twisting/ throbbing/ cutting/Burning / any other sensation?
- Relation to food? Relieving factors?
- Enhancing factors?
- Nausea?
- Vomiting?
- Bloating?
- Loose stool / constipation?
- Any back pain?
- Radiation to back / shoulder/ to private parts or leg?
- MRI of the spine done?
- Any information you would like to share.
- Any relation to menstrual periods?
- Any history of trauma like an accident / Surgery?

If the history is very detailed and coherent, 90 % of the diagnosis can be made.

Please tell me the details and share all the history even though you may feel it not to be related to the present problems. This way we can try to find out the reasons.

Many a times a Diagnostic Laparoscopy can help to find and even treat the reason.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. T Chandrakant (4 minutes later)

Pain started May 2013. I was seeing a nurologist at the time for kidney infection, he thought the pain would go away when the infection did, but it has never gone away. Pain medication does not work either.

Pain is on lower right side of back and on lower right side, under the lower rib. It feels like someone is grabbing me at my side 24/7.

Nausea, and chronic fatigue.

Answered by Dr. T Chandrakant (1 hour later)

Brief Answer:
Clinical Examination by a General Surgeon - MRI of spine.

Detailed Answer:
Thanks for your feedback.
- It is almost 2 years.
- feels like someone is grabbing at the side 24/7
- You must have been seeing the Urologist, I suppose - for kidney infection.
- Pain medication does not work
- lower right side of back and on lower right side, under the lower rib

I would think of the following:
-Root compression of the nerve supplying this area of pain_ MRI of the thoracic spine can diagnose this.
- Intravenous pyelography to see the ureters and kidneys. This may show a partially blocked Ureter.
- Retro-cecal Appendicitis that caused fibrosis as a sequel
- Abscess / spasm if the ilio-psoas muscles.
- Retro-peritoneal fibrosis
* These condition can be diagnosed on MRI or CT scan, if the radiologist knows your symptoms and he also knows what to see for.

The following medicines may be tried in consultation of your Doctor as you need a valid prescription:
Gabapentin for pain relief and to see whether it helps or not. It it helps the theory of Neurological pain can be established.
Clinical / actual physical examination by a General Surgeon.

Please discuss there points with your Doctor to get further investigations and getting an early treatment.

If there is a pain, there has to be a reason.

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar