How to control severe back pain in a dialysis patient who is in her early sixties?

Question

Hello doctor,

My mother who is in her early sixties is under dialysis for the past four years. She is getting severe back pain during dialysis and at other times also. Please suggest any medication.

Answer 1

Hello,

Welcome to icliniq.com.

Thank you for your query.

You have not mentioned whether the patient is on hemodialysis or peritoneal dialysis. Back pain in peritoneal dialysis is commonly due to increased abdominal pressure which can be managed by reducing dialysate volume under a doctor's supervision. In general, whether on hemodialysis or peritoneal dialysis, back pain is seen in a lot of patients due to many reasons like muscle weakness, vertebral bone weakness due to parathyroid disease in CKD (chronic kidney disease) patients, and also infections to vertebral bone particularly common in diabetic CKD patients on dialysis. I would like to know whether the patient has any associated weakness in her legs and any associated fever. She needs to be evaluated with imaging of her spine, MRI (magnetic resonance imaging) preferably, or X-ray for screening and serum PTH (parathyroid hormone), calcium, phosphate, and potassium levels. Meanwhile, while we await the reports if the pain is severe she can take tablet Acetaminophen or Tramadol (available as tablet Ultracet). Use only when there is pain and be cautious of its abuse as the patient may get dependent on this pain killer.

Kindly consult a specialist, talk to them, and take medications with their consent.

I hope this has helped you.

Thank you.