DR FLO: I've had this pain for so long. Is it normal?
One of my doctors referred to it as lower right renal pain or something like that, but lab tests show that my kidneys are working well. PHOTO| FOTOSEARCH
Dr Flo, I am 25 years old and I have been hypertensive and on medication since August 2017. I was also treated for H. pylori last year. I feel pain on my right lower back when I bend.
I’ve had this pain since August last year. One of my doctors referred to it as lower right renal pain or something like that, but lab tests show that my kidneys are working well.
A back chest x-ray also showed that everything was okay, as did a bilateral renal Doppler ultrasound. Another doctor recently told me that the pain is related to strain and is nothing to worry about.
Is this pain normal and when will it go away? Mwass
Dear Mwass,
The pain on the right lower back is highly unlikely to be related to hypertension or Helicobacter pylori infection. It could have been due to a problem in the urinary tract, but the tests you did ruled that out.
The lower back supports the upper body and helps with movement of the lower part of the body. The lower back gets a lot of stress and strain and can easily get injured.
It can be mechanical pain i.e. pain in the muscles, joints or ligaments, that is triggered by movement, physical activity, poor posture or loading.
It can also be radicular pain i.e. pain that develops when a nerve is compressed or inflamed, causing pain in the back and/or in the thighs and legs. The pain may also be due to problems with the discs, arthritis, or from infections or tumours.
It would be advisable to visit an orthopaedic specialist for examination, and for x-ray or MRI scan, because you have had the pain for long.
To manage the pain, you can use medication, warm compresses, massage, lumbar support and physiotherapy. Avoid working while bending or lifting heavy things. Also maintain good posture at all times.
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I am 28 years old and I weigh 99 kilogrammes. I have severe pain in the lower part of my left ankle and it makes me restless all the time. I can't run or stand for long periods and I am always on painkillers. The other problem is that I occasionally feel itchy outside my anus. I have dewormed several times but the itch hasn't stopped. I have been to hospital for both problems but it didn't help. I have had these problems for a long time. What's the cause and possible treatment? Kevin
Dear Kevin,
The foot pain could be due to injury or overuse of the ankle, causing inflammation or wear and tear of the tissues in the joint.
It may also be due to plantar fasciitis, which means inflammation of the sheet of fibrous tissue (fascia) that connects the heel to the front of the foot, where the toes start.
The fascia supports the foot and helps us walk by acting as a shock absorber. It can easily get injured or torn due to too much pressure on the feet causing pain, usually felt when starting to walk after sitting or lying down for long, or after being on your feet for long.
It is more common in those who are overweight or obese, those who stand or walk for long, in long distance runners and those with flat feet or a high foot arch. Wearing shoes with poor arch support also contributes to the problem.
See an orthopaedic specialist for examination and tests, x-rays and/or scans and further management.
Pain and anti-inflammatory medication will help, as will physiotherapy and exercise. Wear shoes with good arch support and a cushioning sole e.g. thick rubber sole or sneakers or get heel cushions from the hospital, a pharmacy or the supermarket. Also avoid standing or walking for long.
Other treatments include steroid injection, using splints, plantar iontophoresis, extracorporeal shock wave therapy and surgery.
Itching around the anus (Pruritus ani) can be due to poor hygiene, haemorrhoids, skin tags, constipation, fungal infection, skin diseases like eczema or psoriasis, worm infection, sweating, and allergy/irritation caused by tissues, wipes, soaps or antiseptics.
Treatment depends on the cause. Ointments and suppositories can help relieve the itching.
Avoid scratching yourself, take lots of fluids and roughage to keep your stool soft, clean up with water and wipe gently, wear loose cotton underwear and avoid underwear when sleeping.
If you have noticed that some foods (e.g. pepper) worsen the itch, avoid them.
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