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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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sharp pain lower left rear abdomen . Not spinal. comes

Answered by
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Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 3129 Questions

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Posted on Wed, 3 Apr 2019 in Abdominal Pain
Question: sharp pain lower left rear abdomen . Not spinal. comes and goes , mostly comes now. Seems to be related to similar pain in left calf muscle
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Answered by Dr. Bonnie Berger-Durnbaugh 32 minutes later
Brief Answer:
Questions so that I can be more specific in the information I provide.

Detailed Answer:
Hello Mr. Polkowski,

I am confused by the location of the pain you describe. You write "lower left rear abdomen". The abdomen is at the front of the body. Do you mean back? Is the pain in the flanks, just above the hips, because that is the location of the kidney and it may be a problem with the kidney such as a stone. However, if the area is tender to touch or increases with use of certain muscles, such as with changing position, then it may be a muscle strain.

Can you please clarify the location and if it changes with position?

Can you tell me more about what is going on in the calf muscle? Does the pain radiate (travel) from the low back to the calf?

Also, how long has this been going on (days, weeks, months) and did it follow a particular activity?
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Bonnie Berger-Durnbaugh 2 hours later
The pain originates somewhat deep in the area you mention as the kidney. I do have a history of calcium based gout. The pain in the calf, just below the knee, has been persistent for about a month while the back pain started within the last week. Moving about does change the pain intensity. It is not tender to the touch. There has been no event that I can recall to indicate a muscle strain. Pain is most intense in the mornings on rising.
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Answered by Dr. Bonnie Berger-Durnbaugh 23 minutes later
Brief Answer:
Thoughts on this

Detailed Answer:
If the pain isn't radiating from the back or leg down to the calm, it's possible that the two (the flank area pain and the calf pain) are separate problems.

I gather that there was no specific event before the back/flank pain started, making a muscle strain less likely, but there can still be musculoskeletal pain from spinal arthritis or a pinched nerve. That pain is most intense in the morning when you start to move around would go more with a musculoskeletal problem than a urinary tract system problem. However, I can't completely rule that out, particularly given the location and that it "comes and goes" (kidney stone pain typically comes in waves).

I do think, given the location of the pain, and that it is becoming more frequent, that this warrants evaluation. You can either go to your family doctor if you can get in to see him or her soon, or go to a good quality urgent care clinic, and ask to see a physician and not a physician's assistant or nurse practitioner.

The doctor should do an abdominal and back exam, to try to localize the pain. Depending on this, it would likely be a good idea to get urinalysis (to look for microscopic blood, infection, inflammation) and depending on the exam and urinalysis, either an Xray that shows the kidneys, ureters, bladder ("KUB"), or an xray of the lumbar spine if the doctor thinks it is more likely to be musculoskeletal. That's where I would start.

I did note that you have a history of pseudogout, and when you go in, it would be important to let the doctor know that if they don't already. The problem with deposits of calcium pyrophosphate dihydrate (CPPD) that people with pseudogout have, can be genetic, but can sometimes be from a metabolic disorder (these include hyperparathyroidism, hypomagnesemia, hypophosphatasia, hypothyroidism, and hemochromatosis). Something to keep in mind as you get evaluated.

I hope this information gives you a starting place from which to proceed. I also hope you are feeling better soon! Please let me know if I can provide further information.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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