Introduction
The kidneys are bean-shaped organs that are located against the back muscles in the upper abdominal area. They sit opposite to each other on both sides of the body; the right kidney, however, sits a little lower than the left to accommodate the size of the liver.
Kidneys are located inside the lower abdomen, on each side of your spine. Pain on the sides or middle to upper back could be coming from kidneys. However, having pain in your back or sides does not necessarily mean there is something wrong with your kidneys. It is possible to have pain on only one side if only one kidney has a problem, or both sides if both kidneys are affected.
Signs & symptoms
- fever
- painful urination
- flank pain
- pain on the back and abdomen. (Kidney pain can be on the left, right, or both sides.)
- Blood in urine
- Nausea & vomiting
- Dizziness
- Constipation or diarrhoea
- Rash
- Fatigue
- Kidney pain or flank pain which is acute, relatively constant, and sharp, called as “renal colic.” This happens due to a kidney stone.
If the kidney function is increasingly compromised, there will be:
- Metallic taste in mouth,
- Bad breath,
- swelling and shortness of breath.
Causes
- Urinary tract infections
- trauma that can result in a “lacerated kidney.”
- Urinary bladder infection(cystitis)
- Kidney infections (pyelonephritis)
- Hydronephrosis
- Kidney stones (nephrolithiasis and/or ureterolithiasis)
- Carcinoma of kidney
- Anything that compresses the kidney (for example, a large tumour or cyst)
- Glomerulonephritis
- Blood clots in the kidneys (renal vein thrombosis)
- Polycystic kidney disease (congenital)
- Congenital malformations in the renal system
- Drugs or toxins that harm kidney tissue (for example, pesticide exposure or chronic use of medications such as ibuprofen)
Pathophysiology
Pathophysiology solely depends upon the cause of kidney pain.
Coming to kidney pain pathophysiology, obstruction happens first, most commonly from a stone. But blood clots can also be the cause.
Urine is unable to travel from kidney to the bladder and as a result builds up and stretches the proximal – closest to the kidney – ureter and renal collecting system. This stretch activates nociceptive nerve fibres within an entire neuronal network located submucosally in the renal pelvis, calyces, capsule and ureter.
These fibres then transmit afferent signals to the T11 – L1 spinal cord which the body interprets as pain at the corresponding level of neuronal activation. As the stone migrates from the kidney down the ureter and towards the bladder, pain usually shifts downward as well. It is commonly sensed as high as the upper flank when the stone is lodged in the proximal ureter and as low as the labia/testicle when down near the uretero-vesical junction at the entry to the bladder.
Patients passing stones may experience other symptoms in addition to pain. Many of the nerves involved in the process of obstruction are intimately linked to innervation of adjacent organs, for example the gastrointestinal tract. Cross activation of these associated nerve fibres has been proposed as an explanation for the nausea and vomiting which so often occurs in the setting of an acute episode of renal colic.
In rare instances patients may even have alternative symptoms without any pain at all. In some cases, particularly when the stone is at the uretero-vesical junction, urinary symptoms predominate and the only appreciable symptoms are urinary frequency, urgency and discomfort while voiding. These symptoms mimic urinary infection and often result in temporary mis-treatment with antibiotics until the correct diagnosis is made.
Diagnosis
physical examination and history taking
Complete Blood Count (CBC),
Renal function test
Urine examination and cultures.
CT scan
Renal Ultrasound
Abdominal X-ray
MRI
Kidney pain itself is a symptom that may happen due to problems or diseases of the kidney or its associated structures, including the ureters or bladder. However, other diseases may mimic kidney pain, but are not actually due to the kidneys, for example,
- muscle sprains, especially in the back,
- spinal problems,
- rib pain,
- pleuritis
- retroperitoneal fibrosis,
- aortic abdominal aneurysm,
- gynaecological problems like PCOD, endometriosis etc
Treatments
The treatment for kidney pain depends on the cause.
- Kidney infections and kidney stones that cause pain are often treated with ibuprofen, ketorolac (Toradol), acetaminophen (Tylenol and others), or occasionally with small amounts of morphine (in severe cases). However, these agents do only pain management and do not address the cause(s) of pain.
- If small kidney stones (usually less than about 6 mm in diameter) are passed in the flow of urine, and pain will be relieved.
- Infections like urinary tract infections and pyelonephritis usually require antibiotic treatments in addition to pain medications.
- Kidney stones more than 6mm diameter, need surg.
- Other underlying causes of flank pain may need similar pain management and concurrent treatments. However, patients with known kidney problems (kidney disease) should not be treated with pain medications that are either filtered (removed) through the kidneys and/or may cause further renal damage.
Prognosis
The prognosis of kidney pain depends upon the cause, and the majority of patients can have a good outcome when treated quickly and appropriately.
Complications
- Abscess formation
- Serious infection of the kidney that diminishes renal function
- Urinary fistula formation
- Ureteral scarring and stenosis
- Ureteral perforation
- Extravasation
- Urosepsis
- Renal loss due to long-standing obstruction
- Complete ureteral obstruction
Infected hydronephrosis is the deadliest complication with chance of rapidly progressive sepsis and death.
A ureteral stone associated with obstruction and upper UTI is a true urologic emergency.
Disease & Ayurveda
Kidney pain -Pakwasayagata vaata/Mootraghata
Nidana
Diet and behaviour causing Vaata vitiation
Purvaaroopa
Not mentioned
Samprapti
Due to the causative factors including obstruction by a calculi, Vitiated vaata gets obstructed & goes into abnormal pathways causing pain.
Lakshana
Soola – abdominal pain
Aanaha – Distension of abdomen
Antrakujana – Abnormal pesristaltic sounds
Malarodha – Constipation
Asma – Calculi in kidney/ureter/urinary bladder
Varddha – Cysts or growths in lower abdomen, especially excretory/reproductive organs
Arsas – Piles
Thrika-Prishtha-Kateegraha – Pain & stiffness in coccygeal region, Lower back and hip area.
Divisions
Not mentioned
Prognosis
Kricchrasadhya/Yaapya
Chikithsa
Samana
Abhyangam
Pichu
Kateevasti
Sodhana
Avapeedakasnehapanam
Vastikarma
Commonly used medicines
Bruhathyadi kashayam
Chandraprabhagulika
Brands available
AVS Kottakal
AVP Coimbatore
Vaidyaratnam oushadhasala
SNA Oushadhasala
Home remedies
For some people who have had many kidney stones, home care may be appropriate. When passing a kidney stone, drinking lots of fluid is important. In fact, this is the most important home care measure. Medications may help control the pain temporarily.
Diet
- To be avoided
Hot, spicy and pungent food items
Pickles, processed and tinned masala items.
Heavy meals and difficult to digest foods – cause indigestion.
Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
Carbonated drinks – makes the stomach more acidic and disturbed digestion
Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)
Curd – causes vidaaha and thereby many other diseases
- To be added
Light meals and easily digestible foods
Green gram, soups, fresh juices, Indian sarsaparilla, tender coconut water, sugar cane, and arrowroot.
Freshly cooked and warm food processed with coriander seeds, cumin seeds, ginger, ajwain etc
Behaviour:
Drink enough water and void urine frequently.
Maintain personal hygiene, especially private parts. Avoid using public toilets, using wet undergarments etc.
Protect yourself from dehydration and exposure to heat.
Better to avoid exposure to excessive sunlight, wind, rain or dust.
Maintain a regular food and sleep schedule.
Avoid holding or forcing the urges like urine, faeces, cough, sneeze etc.
Yoga
In persons with fever, severe pain and severe urinary tract infections, physical exercises are not recommended.
Regular exercise after regaining normal health helps improve bioavailability of the food ingested and leads to positive health.
Nadisudhi pranayama
All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.
Research articles
https://www.ncbi.nlm.nih.gov/books/NBK292/
Author information
The post Kidney pain- Ayurvedic Treatment, Diet, Exercises, Research Papers, Yoga & Pranayama appeared first on Ayurvedaforall UK Blog.
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