chronic flank pain

[spondy14]

24 yo with chronic flank pain due to several UPJ obstructions, s/p stents. I have no experience with this, anyone have any ideas in regards to pumps, or stimulator, or neurolysis? He does not want narcs, patches roll up, and kidney docs are out of suggestions....

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[drusso]

24 yo with chronic flank pain due to several UPJ obstructions, s/p stents. I have no experience with this, anyone have any ideas in regards to pumps, or stimulator, or neurolysis? He does not want narcs, patches roll up, and kidney docs are out of suggestions....

Have you tried a lumbar sympathetic block? Does she have hematuria/loin syndrome?

 

[Tenesma]

Flank pain: i get this all the time from the Nephros and Urologists...

it drives me nuts - occasionally it turns out to be upper lumbar facet w/ referred pain and that responds relatively well to the occasional lumbar facet block...

in one patient it was a lymphoma in the lower thoracic spine

some respond to TENS units, i have heard of some responding to LSB (but in my hands i have NEVER seen that work for this type of pain)...

i always wonder if chronic scar tissue in the ureter can be a source of chronic pain?...

however in these young patients who get frequent exposure to short-acting opioids for their stones, there seems to a very FREQUENT incidence of substance abuse....

 

[Ligament]

Could try a far lateral stim with high frequency 1000-1500Hz...might help, crap shoot.