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What Causes Pain In The Right Side Of The Back?

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Posted on Sat, 15 Oct 2016
Question: Hello.
For the last 4 days I have had a 'severe' pain in the right side/back feels about between my pelvis and rib-case, it is very painful to lay on and have to get up and walk around to relieve, which it doesn't really do, when I do eventually get to sleep I will be woken up with the severe pain, once up and about the pain all but reduces, however if I sit down for a while (probably badly) the pain will return but not as severely and moving around will relieve it, sometime when crouching the standing it will give a sharp pain like a hard punch, generally walking around and working the pain is much in the background.
Regards
XXXX

Note.
About 2 month ago I had a flexible ????(Dyno-rod) Lower intestine inspection due to several months of 'soft stools' and multiple visits to the toilet 6 / 7 per day, no problem was found however since then the problem seems to be slowly improving some days loo visits normal once maybe twice for a few days then 2 /3 bad days but generally I feel on the mend.
doctor
Answered by Dr. Shuba Hariprasad (3 hours later)
Brief Answer:
Kidney stones, cholecystitis to be ruled out

Detailed Answer:
Hello Sir,
Thank you for your query.
I'm Dr. Shuba Hariprasad and will be answering your query today.

Your symptoms would lead me to primarily rule out kidney stones and cholecystitis.
Would you please clarify a few things for me?
-is this the first time you have experienced a pain like this?
- is the pain localized to your right side only? Does it radiate else where (your groin, for instance)?
-do you have any fever? And discomfort while urinating?
-do you smoke or consume alcohol?
-do you have any other medical issues or take any medications?
-what is you daily level of activity?
-any change in stools now?

I recommend :
- a physician consult right away.
-ultrasound whole abdomen. CT scan if required.
-blood tests (complete blood count, liver function tests, kidney function tests, amylase & lipase levels, ESR and CRP - inflammatory markers)
-urine analysis

The above tests may not all be necessary and will depend on the results of your clinical examination and other parameters (temperature, pulse rate, blood pressure)

As the pain seems quite severe, I urge you to consult a physician asap or visit the ER if that's not possible.

Either scenario (stones or cholecystitis) needs to be investigated for its severity and treated accordingly.

Hope this helps.
Please let me know if there is anything else I can help you with

Wish you good health.
Regards,
Dr. Shuba Hariprasad
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Shuba Hariprasad (6 hours later)
Hello.
I am not sure if I operated this procedure and am wondewring if you received my reply to your questions
Kind Regards
XXXX
doctor
Answered by Dr. Shuba Hariprasad (1 hour later)
Brief Answer:
Didn't receive reply

Detailed Answer:
Hello XXXXXXX
Sorry but I did not receive the reply to my earlier questions.
Please get back to me with those details.

Hope you are feeling better.

Regards,
Dr. Shuba Hariprasad
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Shuba Hariprasad (1 hour later)
Thank you for your reply, answers to your questions as follows:

1, this is the first time that I have had a pain like this in this area. it fells like trapped air but in the wrong place.

2, The pain in only on the right-hand side but moves around towards the back, not to the groin area.

3, I body felt warmer for a period but I put it down to the warmer temperature, no discomfort when urinating although I do have a slight incontinence problem.

4, Don't smoke, don't drink as such just 250ml Larger with the Sunday lunch.

5, I take medications as follows:
Aspirin 2 X 75 mg
candesartan 1 X 32mg
Omeprazole 1 X 10 mg
Simvastatin 1 X 20mg. (I do have a twice yearly check-up for liver & kidney function)
Previously 18 years ago had a Radical prostatectomy and have 6 monthly PSA checks.
also have diverticular disease, and recently have biopsies taken from my power colon, other than this recent problem I'm, "as fit as the butcher dog".6, I am 'semi' retired, am involved in electronics design, domestic stuff, go out 3/4 times a week. drive, attend Art classes and also paint Plus attend to the garden when needed.

7, Stools and frequency tend to vary from day to day, on a good day 1/2 visits stools more or less normal, a bad day 3/4 visits, stools usually soft average, sometimes very soft.

Kind Regards
XXXX
doctor
Answered by Dr. Shuba Hariprasad (14 hours later)
Brief Answer:
Please see below

Detailed Answer:
Hello Mr. XXXXXXX

Thank you for the follow up and the clarifications.

*why did you have the radical prostatectomy done?
* when you had the soft stools, did you notice any discoloration or mucus in it?
*based on your medications, you have high blood pressure, cholesterol, and possibly heart disease. (or at least a risk of it). Please correct me if I am wrong
*has the diverticular disease caused you any problems so far?
*why were the biopsies taken from your colon? Did they find anything suspicious.? When will the results be back.
*this pain that you currently feel, does it go along the same level to your back on go to the right shoulder or scapula?

Based on your query and clarifications I still believe that cholecystitis and kidney stones need to be ruled out.
As suggested earlier, I recommend :
- A physician/gastroenterologist consult
-an ultrasound abdomen to look for these.
Blood tests as mentioned earlier?

How is the pain now? Please monitor your temperature and pulse rate (at the wrist). Anything above 100f (temperature) and 100 beats per minute (pulse rate) is significant and indicates and active infection
Please see a doctor to at the earliest to prevemt complications..

Hope I've helped.
I'd be happy to help you with any other queries you may have.

Wish the pain gets resolved soon.
Regards,
Dr. Shuba Hariprasad


Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar
doctor
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Follow up: Dr. Shuba Hariprasad (19 days later)
Hello Dr. Shuba XXXXXXX

XXXX©
Thank you for following up on the consultation.

Following our recent consultation I was about to go on holiday and have now returned,
The problem I think started with a feeling of 'Trapped Wind' Which I couldn't release (I did not connect at the time to the problem ?).
I then was woken at night with a severe pain in the right-hand side of my back between the pelvis and rib cage (a similar pain experienced many years ago when I fell off the roof and cracked 3 ribs) the only release that I got from this pain was to walk around and finally sleep upright in an armchair, after about a week the pain lessened and I would wake up with the lesser pain other that the pain waking me up, the situation at the moment is that the pain albeit much less than previously takes longer to show, meaning that when I wake up at say 2 am no pain or discomfort but at say 4 am the pain is present and so on but at the same time I get the 'trapped Wind' feeling which I try to release, I anticipate that the night time pain and discomfort will fade away in the next week or so, I will have to wait and see.
However I do wonder how and why it occurred in the first place, During this period I did take Paracetamol also used a 'local Analgesic cream' but to no apparent effect.

Kind Regards
XXXX
doctor
Answered by Dr. Shuba Hariprasad (18 hours later)
Brief Answer:
Please have a physician consult & ultrasound done

Detailed Answer:
Hello Mr. XXXXXXX
Hope you had a pleasant trip.

I've gone through our discussion so far. I believe there is an inflammatory condition, probably of the gall bladder.
It is possible for there to be a waning phase before it exacerbates again.
I urge you to consider my earlier recommendations and have an ultrasound done to rule out kidney stones and gall bladder disease.
Trapped wind can cause similar pain but will not be persistent. It may be severe and Intermittent and gets relieved by walking, burping or passing gas.

If you get back to me with clarifications to my other questions, I could have a better idea.

Hope this helps.
Please let me know if there is anything else I can help you with.

Regards,
Dr. Shuba Hariprasad
Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar
doctor
Answered by
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Dr. Shuba Hariprasad

General & Family Physician

Practicing since :2002

Answered : 1087 Questions

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What Causes Pain In The Right Side Of The Back?

Brief Answer: Kidney stones, cholecystitis to be ruled out Detailed Answer: Hello Sir, Thank you for your query. I'm Dr. Shuba Hariprasad and will be answering your query today. Your symptoms would lead me to primarily rule out kidney stones and cholecystitis. Would you please clarify a few things for me? -is this the first time you have experienced a pain like this? - is the pain localized to your right side only? Does it radiate else where (your groin, for instance)? -do you have any fever? And discomfort while urinating? -do you smoke or consume alcohol? -do you have any other medical issues or take any medications? -what is you daily level of activity? -any change in stools now? I recommend : - a physician consult right away. -ultrasound whole abdomen. CT scan if required. -blood tests (complete blood count, liver function tests, kidney function tests, amylase & lipase levels, ESR and CRP - inflammatory markers) -urine analysis The above tests may not all be necessary and will depend on the results of your clinical examination and other parameters (temperature, pulse rate, blood pressure) As the pain seems quite severe, I urge you to consult a physician asap or visit the ER if that's not possible. Either scenario (stones or cholecystitis) needs to be investigated for its severity and treated accordingly. Hope this helps. Please let me know if there is anything else I can help you with Wish you good health. Regards, Dr. Shuba Hariprasad