Loin Pain

Loin pain is a common reason why patients come to a urologist.

Causes

The potential underlying causes are extensive (seebelow-list not exhaustive). The most common include UTI, renal or ureteric stones and musculoskeletal problems.

Urinary tract causes:

  • UTI including Pyelonephritis
  • Renal calculus
  • Renal tumour
  • Glomerulonephritis (rare)
  • Polycystic kidney disease (rare)

Other causes:

  • Muscular strain
  • Thoracic/lumbar spine nerve root pain
  • Rib fracture
  • Shingles
  • Retroperitoneal fibrosis
  • Pulmonary embolism
  • Pneumonia
  • Diverticulitis
  • Cholecystitis
  • Pancreatitis
  • Duodenal ulcer with perforation
  • Aortic aneurysm rupture
  • Myocardial Infarction/ heart attack

Tests

The urologist is likely to arrive at a clinical diagnosis after examination but may ask for further tests like urine routine test, blood test including creatinine (to assess renal function), ultrasound/CT scan of the abdomen.

Based on the diagnosis appropriate treatment will be recommended by the urologist.

UTI

The loin pain occurs in UTI usually due to spread of infection from bladder to kidneys or can happen due to primary kidney infection itself. Stone or structural abnormalities of urinary tract itself are primary causes of spread of infection to kidneys. If obstruction to urinary tract occurs along with the infection then investigation and treatment are indicated urgently according to the cause.

Stones

Stones can be a source of infection. Patients get recurrent infections or more seriously infection can occur in an obstructed kidney due to stones which needs to be dealt with urgently.

Persistent infection in urine can cause a stone to form called phosphate stones (CAMP or triple phosphate stones) and can take the form of staghorn stones. If these stones are not treated immediately, then they can enlarge rapidly and destroy the kidney and the infection will not go away unless the stone is cleared completely.

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