Left flank pain
introduction
Left flank pain describes pain in the left flank region. The flank region is located at the transition from the stomach to the back and occupies an area here that is both slightly above and below the costal arch. The lower ribs are located in the left flank region, below are the left kidney and adrenal gland, the spleen and some parts of the intestine.
Flank pain can come on suddenly or develop over a period of time. They can feel dull / oppressive or stinging.
Read more on the topic: Flank pain
Causes of Left Flank Pain
Flank pain on the left can originate either from the skin, from the musculoskeletal system (spine, ribs, nerves) or from internal organs on the left side of the upper abdomen.
1) Skin: Inflammation of the skin in the left flank area naturally causes pain. A classic disease is shingles (Herpes zoster) that presents with a vesicular rash.
2) Spine: Various diseases of the spine can cause pain in the left flank region. With increasing age, the joints between the vertebral bodies can wear out (osteoarthritis). It is possible to grow additional bone substance, which means that the exit holes for the nerve roots can be narrowed and the corresponding nerves can be irritated. Congenital misalignments of the spine, e.g. scoliosis can also trigger left flank pain
3) Incorrect posture and tension: If the body posture is incorrect, the muscles cramp up and are overloaded with this posture. This leads to painful tension.
4) Internal organs: Flank pain on the left can also be triggered by the abdominal organs on that side. These include the spleen, left kidney, stomach, pancreas and part of the colon.
Flatulence as the cause of left side flank pain
Flatulence affects the small and large intestines and occurs, for example, after the consumption of flatulent foods (beans, etc.) or in the context of an "upset" or infection of the digestive tract. This leads to a pronounced formation of digestive gases that cannot leave the intestine as quickly as they arise. Result: the stomach puffs up, the stomach feels full. Pain in the stomach and large intestine can also radiate into the left flank region. Left flank pain is not a typical symptom of flatulence.
You might also be interested in: Oberbach pain and flatulence - that's behind it
Tension as the cause of left side flank pain
The left flank is in close proximity to the spine. The so-called autochthonous back muscles, which are responsible for stabilizing the trunk, run alongside the spine.
If the spine or pelvis is misaligned or if you have learned (accustomed) to incorrect posture of the upper body, some muscles are stressed beyond the usual level. They cramp and harden, what we call "tension". If these muscles are in the area of the left flank, the result is flank pain on the left.
Diagnosis of left flank pain
"Left flank pain" is not a diagnosis, but a symptom. This symptom, together with other accompanying symptoms, can provide an indication of the causal disease. To make a diagnosis, the doctor wants to know the following things:
1) When did the pain start?
2) How do you feel?
3) How bad is the pain?
4) Is the pain radiating?
5) What makes the pain better or worse?
The doctor will then do a physical examination and, depending on the suspicion, e.g. do a blood draw or ultrasound scan.
Where is the flank pain exactly?
Flank pain does not describe an exact organ area, but only a diffuse orientation of the pain. Accordingly, flank pain can extend over the lateral abdominal cavity and the costal arch to the lateral back areas.
The type and location of the complaints can vary and can be perceived specifically over an anatomical structure or diffusely over the entire flank. Important anatomical structures that can cause flank pain on the left side are the left kidney, the lungs, the spleen, the stomach and the left side of the intestine.
Accompanying symptoms with flank pain
The accompanying symptoms of left flank pain vary depending on the cause. With inflammation of the skin as the cause of the flank pain on the left, itching, swelling and redness can occur as accompanying symptoms.
In addition to pain, diseases of the spine also lead to restricted mobility or to pain that increases under strain (e.g. standing for long periods, carrying heavy things).
Pain may also be present in other parts of the musculoskeletal system. When there is tension, you can feel the hardened back muscles in the area of the left flank region.
If the flank pain on the left is triggered by an inflammation of the kidney pelvis, fever, pain in the lower abdomen, nausea, vomiting and a general feeling of illness occur.
In glomerulonephritis (inflammation of the kidneys), the flank pain often occurs on both sides. In infections that lead to an enlarged spleen and thus to flank pain on the left, fever and a general feeling of illness also occur.
If a ruptured spleen is the cause of the left-sided flank pain, it can lead to circulatory weakness up to circulatory failure and shock.
Treatment of left flank pain
Treatment of left flank pain also depends on the cause:
1) Skin: Inflammations of the skin are treated locally with creams or ointments, if bacterial causes antibiotics. Shingles is treated with pain relievers and acyclovir, an antiviral drug.
2) Musculoskeletal system: Therapy for flank pain on the left caused by the spine is carried out by an orthopedic surgeon. Vertebral joint arthrosis is treated with painkillers and sufficient exercise, while scoliosis is treated with corset therapy and possibly surgical procedures. Tension caused by poor posture is countered with posture therapy, e.g. can be achieved through physiotherapy.
3) Kidney: Kidney inflammation is given with antipyretic drugs and antibiotics, which are taken via the vein or as a tablet, depending on the age of the patient and the severity of the disease. In most cases, kidney stones find their way into the urinary bladder on their own and can be eliminated from there. Therefore, for kidney stones, anticonvulsant pain relievers are given until the stone or stones have been eliminated in the urine. If the stones cannot be eliminated, urologists treat kidney stones with ESWL (extracorporeal shock wave lithotripsy), in which the stones are shattered into small pieces from the outside with the help of shock waves (high-energy sound waves). Kidney tumors are usually treated with surgery; in advanced stages, radiation and chemotherapy may be necessary.
4) Infections: An enlarged spleen from malaria responds well to treatment with specific anti-malarial drugs. If a viral disease (Epstein-Barr virus, cytomegalovirus) is the cause, symptomatic treatment is usually given. In special cases, the cytomegalovirus can be fought with ganciclovir.
When do I have to see a doctor with flank pain?
Many of the causes of flank pain are harmless and temporary. These are to be differentiated from serious causes and serious illnesses. The first criterion for a doctor to clarify the symptoms is the severity of the symptoms. If the pain is unbearably bad, has lasted for several days without interruption or keeps recurring, a medical diagnosis should be carried out. On the other hand, slight pain can recede within a few days and often do not give rise to a medical consultation.
Which doctor treats flank pain?
Flank pain can usually first be diagnosed and treated by a general practitioner or internist. Organic diseases are rarely the underlying trigger behind the pain, which requires further treatment by a specialist.
If necessary, there must be an extended diagnosis by a radiologist, as well as an accompaniment of the treatment by liver, lung or kidney specialists and, if necessary, surgeons. The general practitioner first initiates the first therapy and can, if necessary, issue a referral to a specialist doctor.
Duration of flank pain
No general statement can be made about the duration of left flank pain. They can appear very briefly, for example due to a wrong movement, or they can be present for a longer period of time, for example in the case of vertebral joint arthrosis or tension.
Prognosis of left flank pain
The prognosis for left flank pain is good because most of the underlying causes are harmless and treatable. However, in the case of flank pain caused by osteoarthritis, the therapy can include the long-term use of painkillers because the cause (osteoarthritis) is difficult to treat.
Kidney tumors as a serious cause of left flank pain are quite rare. Only 2% of all cancers affect the kidneys.
Left flank pain when lying down
Flank pain, which only occurs after lying down for a long time, typically comes from the spine, which is excessively stressed by staying in one position for a long time and reacts with a painful stimulus. This can be remedied by regularly changing the lying position. If this is unsuccessful, an examination of the spine is advisable.
Read more on the topic: Abdominal pain when lying down
Left and right flank pain
Flank pain on both sides is a typical symptom of glomerulonephritis, an inflammation of the kidneys. Affected patients have severe pain in the left and right flanks. Inflammation of the pancreas is also possible; the pain is not only found on the flanks, but also on the upper abdomen. Diseases of the spine and back muscles can also be the cause of bilateral flank pain.
Learn more about the causes and therapy bilateral flank pain.
Left back flank pain
Left rear flank pain can have the same causes as left side flank pain in general. Due to the close proximity to the spine with the vertebral bodies and exiting nerves, these structures are a common cause of left rear flank pain.
Many reasons are conceivable: Age-related wear and tear (osteoarthritis) of the joints between the vertebral bodies, a broken vertebral body after a fall, rheumatic diseases, (congenital) misalignments or poor posture of the spine.
Flank pain from the spleen
The spleen is located in the left upper abdomen and is a maximum of 14 x 5 x 8 centimeters in adults. Flank pain on the left can be caused by an enlarged spleen, because this puts tension on the organ capsule.
This is the case, for example, with glandular fever, infection with the cytomegalovirus or malaria.
Blood disorders can also lead to an enlarged spleen, but the pain then only occurs after a long time.
Left flank pain after an accident with blunt abdominal trauma (severe contusion of the abdomen) can be an indication of a ruptured spleen.
You might also be interested in: Glandular Pfeiffer fever
Flank pain from pancreas
The pancreas is about 15-20 centimeters long and is located in the upper abdomen, reaching across the spine.
Inflammation of the pancreas is painful and causes a ring-shaped pain in the upper abdomen that radiates to the left and / or right flank.
Flank pain due to kidney disease
Kidney and urinary tract disorders are a common cause of left side flank pain.
Inflammation of the kidney pelvis on the left side causes severe, aching left flank pain, fever, and a general feeling of illness. It usually arises from a cystitis.
Glomerulonephritis (inflammation of the kidneys) is less likely to cause left flank pain because it often occurs on both sides.
Sudden pains in the left flank that radiate into the lower abdomen and the genital region and wave-like shape suggest kidney stones as the cause of the pain.
Kidney tumors can also cause pain in the left flank, but the pain does not appear until a later stage as a dull, pressing pain.
Read more on the topic: Pelvic inflammation
Flank pain from exercise
Especially with a ball sport it can e.g. a bruise on the left flank due to a collision with a teammate, a bruise occurs and causes pain. If one or more ribs were severely injured, it would also be conceivable.
A very unfortunate accident while playing sports can also lead to damage to the internal organs (kidneys, spleen, pancreas).
Flank pain on the left after exercise is usually harmless and can indicate an overload of the back and trunk muscles (sore muscles) caused by tension or nerve irritation.
