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Flank Pain – Causes, Symptoms, Treatment

Updated on October 3, 2013

Flank pain is usually felt on one side of the body, between the top part of the abdomen and the lower back. The most common cause of flank pain is renal colic, which indicates a problem with the kidneys. The term ‘renal colic’ does not correctly define flank pain, because colic implies ‘repeated’ while flank pain tends to be constant. Severe flank pain can spread from the back to the groin and may cause vomiting or nausea. If these symptoms are apparent, then it is possible that the patient is suffering from renal colic. This kidney-related problem usually occurs due to obstruction in the urethra or the pelvis. The obstruction is usually in the form of kidney stones called renal calculi. The stones may also cause symptoms like dysuria (painful urination), nausea and even vomiting.

There are other reasons why a patient may have flank pain, and these are as follows:

  1. Herpes Zoster

This will cause the patient to experience a burning sever pain around the flank. The pain usually comes before any changes to the skin appear. Thereafter, the vesicles will be seen in the affected area and the doctor will make an easy diagnosis. However, the flank pain associated with herpes zoster is somewhat different from that caused by renal colic. The treatment of herpes zoster is predominantly by using analgesics for the pain, and antiviral for the herpes virus.

  1. Abdominal Aortic Aneurysms

Abdominal Aortic Aneurysms (AAAs) have been misdiagnosed as renal colic in about 10% of the patients since it presents symptoms that are very similar to those of renal colic. AAAs come due to injury to the nerve plexus that surrounds the celiac axis. They can also be due injury to aortic arterial branches serving the nerves for the kidneys. AAAs can be found next to the urethra, causing inflammation of the area, leading to flank pain. The urethra may shift laterally, especially on the left side. The diagnosis for AAAs is through the use of computer tomography or ultrasonography. Patients who are over the age of 50 usually get tested for AAAs when they get flank pain.

  1. Papillary necrosis

Papillary necrosis brings about acute obstruction of the urethra. The cause of the obstruction is the sloughed papilla. This can come about due to the abuse of analgesics, diabetes or liver cirrhosis. Women are more affected by this problem than men. Vascular ischemia is responsible for the sloughing off of the papilla. This leads to coagulative necrosis of the renal medullary pyramids.

Other causes of papillary necrosis are urinary tract obstruction, sickle cells disease tuberculosis, renal transplant rejection, and systemic vasculitis. The best treatment for this condition is a nephrotomy which bypasses the obstruction thereby relieving the pain.

  1. Kidney Tumors

Kidney Tumors also cause flank pain, and this is usually because of stretching of the renal capsule. If the patient has tumors that have broken off due to necrosis, then they can cause renal obstruction. The obstruction of the urethra leads to inflammation which causes the pain. The extension of the tumor can also cause the pain, although this occurs slowly and the patient hardly exhibits any pain.

  1. Radiculitis

When the lumbar or lower thoracic nerve roots are injured the patient will experience flank pain. The pain is usually centered around the 10th to 12th ribs. The distribution of this pain resembles that of renal colic. However, while the pain associated with renal colic is deep and throbbing, the pain associated with radiculitis is stabbing and sharp. Any movement makes the pain worse and it can spread anteriorly or inferiorly. If any of the transverse processes are injured in this area, the patient will also experience flank pain. This problem usually affects women, and in most cases is related to arthritis, prior open renal surgery and a history of broken ribs. The pain in most cases comes from scarring and injury to the intercostal nerve. This is the most common cause of flank pain that is not related to the renal system.

If the patient has normal urinalysis and imaging test results, then radiculitis should be suspected. The treatment of radiculitis is through the use of analgesics. If ribs’ fractures are the cause then the patient should rest until the ribs are healed. Any damage to the nerves should be refereed to a neurologist for further examination and treatment.

There are several other causes of flank pain and each of them has its own unique treatments, which have been mentioned. Once you realize that you have flank pain, do not simply buy analgesics since the cause may be very serious. Any problems with the kidneys should be attended to. It may be simply because you stretched the muscle, but it may also indicate a serious underlying problem with you renal system.

Flank pain on the right side and left side

Typically, right side flank pain is linked to kidney problems, urinary tract infections and bladder issues. People who have diabetes can also suffr from the pain. In women, ovarian cyst formation can cause flank pain on the right side. Sometimes, the ache can be due to a simple muscle pull.

Flank pain to the left side can be due to kidney problems, urinary tract infections, gastrointestinal disorders and diverticulitis. A muscle pull or any injury can also cause the problem. Some people may experience left flank pain immediately after having food. If the pain is too much to bear, it can be an issue with the organs like gallbladder, liver, pancreas and appendix. Irregular pain in the area is also evident in people with Irritable Bowel Syndrome.


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