Jan has been researching and writing about health and nutrition for several years.
It is easy to confuse kidney and lower back pain. Lower back pain can be dull, like an ache, and/or continuous. Kidney pain generally occurs in waves and will be accompanied by other symptoms, including painful urination or fever. The kidneys are part of the urinary system, so if there is an infection or other issue, urinating will become uncomfortable or difficult. When troubleshooting symptoms with your doctor, it's helpful to know what could be the case based on your current symptoms. Jot down the symptoms you experience regularly along with the conditions that match them. Have a conversation with your doctor about what's possible and what isn't.
Kidneys, Back Muscles, or Spine?
Kidney pain usually appears in the flank, or side, between the ribs and hips. Sometimes it is felt in the upper abdomen. Pain from kidney stones, for example, can appear on your side or in the lower left or right abdomen. Pain in the kidneys is not significantly affected by body movements, but in disorders, such as a kidney infection, applying pressure to the affected kidney can be painful.
Lower back pain can appear due to a disorder or injury to the spinal column. If the spinal nerves are involved, the pain may radiate into the buttocks, the back or side of the legs, or even the feet. If the issue is with the lower back muscles, the pain can appear anywhere in the lower back. Both spinal and muscle pain can be greatly affected by body position.
Kidney Pain vs. Lower Back Pain Chart
|Symptom||Kidney Disorder?||Alternative Issue|
Muscle strain, a "stitch," or pneumonia
Rarely (inner thigh pain if urinary stones)
Often (kidney stones, infection, nephritis)
Multiple myeloma (rare)
Blood in urine
Often (kidney stones, injury, cancer)
Muscle damage (rare)
Often (kidney stones, infection)
Sometimes (kidney infection or cancer)
Cancer of the spine (rare)
Causes of Sudden Kidney Pain
- Hydronephrosis is distention of the kidneys due to obstruction. A kidney stone in the ureter can block the flow of urine and result in flank pain of the urine flow caused by a kidney stone lodged in the ureter can result in flank pain and swollen kidneys that may be felt from the outside.
- Kidney infection (Pyelonephritis) causes pain in the flank, usually on one side, cloudy urine, burning urination, nausea, vomiting, high fever, and diarrhea.
- Kidney stones rarely cause symptoms, but stones in the ureter (the tubes that deliver urine from the kidneys to the bladder) can cause sudden, sharp pain. Usually, the pain is on one side of the flank or lower abdomen and can last for several hours. The pain may radiate toward the groin, genitalia, or inner thighs. The presence of kidney stones will make the urine cloudy. Eventually, there will be blood in the urine and urination will cause burning urination. Passing a kidney stone with urine can cause nausea and vomiting. There is usually no fever.
- Loin Pain Hematuria Syndrome can cause flank pain (sometimes on both sides) and blood in the urine of women who take oral contraceptives. This syndrome is incredibly rare.
- Obstruction of the ureteropelvic junction is generally a congenital disorder that appears in children or after kidney surgery. The pain is throbbing and felt in the flank area, especially after drinking a large amount of fluid.
Causes of Chronic Kidney Pain
Often, even with advanced kidney disease, there are no symptoms, only mild or general sensations such as feeling unwell. Kidney disease with or without symptoms can be confirmed by blood and urine tests.
- Berger’s Disease causes dark urine and spasms in the flanks after a respiratory or other infection.
- Polycystic Kidney Disease causes dull pain on both sides of the back.
- Chronic Hydronephrosis or kidney distention due to gradual blockage of the ureter, usually causes pain on one side and a palpable kidney (meaning it can be felt from the outside).
- Inflammation of the Kidneys leads to pain on both sides, cloudy urine, and a low-grade fever.
- Kidney Cysts or Cancer causes gradually building side pain and eventually blood in the urine.
Abdominal Causes of Lower Back Pain
These conditions are often accompanied by upper-middle abdominal pain (and possibly lower-middle back pain).
- Aneurysm or dissection of the abdominal aorta (upper-left abdominal pain and possibly lower-left back pain).
- Appendicitis nausea, vomiting, anorexia, abdominal tenderness.
- Cholecystitis due to gallbladder inflammation, and gallstones (tenderness below the right rib cage, pain can radiate into the lower right back, right shoulder blade or shoulder).
- Diverticulosis or diverticulitis (upper right abdominal pain (and possibly lower right back pain).
- Enlarged liver due to congestive heart failure, hepatitis, leukemia, or lymphoma (palpable mass below the right rib cage).
- Pancreatitis (acute or chronic).
- Peptic ulcer.
- Spleen enlargement in infectious mononucleosis, lymphoma, and leukemia with a palpable mass in the left flank (lower left abdominal pain (and possibly lower left back pain).
Spinal and Muscle Causes and Cancer
While this list is intimidating, it's important to talk to your doctor before suspecting you're afflicted with one of the following ailments. This article is intended to provide you with the tools to understand possibilities and strengthen your self-advocacy in your relationship with your doctor.
- Ankylosing spondylitis is a form of arthritis that affects mainly the spine. The joint inflammation causes chronic pain and stiffness in the lower back, especially in the sacrum, and occasionally in other joints, such as hips or knees. Acute painful episodes (flares) that come and go are typical for the disorder.
- Bad posture, including sleeping on an excessively hard or soft mattress, prolonged sitting with a bent back or neck, carrying heavy bags on the back or in the hands, forced body position or movements during work or inappropriate shoes, can cause various vague upper or lower backaches, often without other physical symptoms.
- Blunt trauma to the muscles usually results in localized pain, tenderness and bruise. Blunt trauma to the kidneys may result in blood in the urine.
- Discus hernia is protruding discs in the spine. When a discus hernia touches the sciatic nerve, pain may be felt in the back (more prominent on the affected side) and pain, numbness, and tingling in the buttocks, legs, or feet on one or both sides. The pain, commonly called sciatica, is usually aggravated by bending, prolonged lying down, sitting, or standing and is relieved by walking.
- Fractured vertebra can cause pain in the spine and surrounding muscles, and numbness or paralysis in the legs. Small vertebral fractures may cause little or no symptoms and can be sometimes discovered only by X-ray or CT scan.
- Metastases of cancers can cause pain in the spine and fever.
- Multiple myeloma is a rare blood cancer that can affect one or more vertebrae and cause pain in the spine and cloudy urine.
- Osteoarthritis is a degenerative disorder of the spine and joints due to wear and tear. The pain in the spine is aggravated by walking.
- Osteomyelitis is an infection of the vertebra that can cause localized pain and tenderness over the spine and fever.
- Osteoporosis can cause collapse or fracture of the vertebra with pain in the spine and eventual pains in the legs due to pinched spinal nerves.
- Pinched spinal nerves can cause pain in the back, and pain, numbness, or tingling in the buttocks, legs or feet.
- Scoliosis (curvature of the spine) in most cases does not cause pain but it can sometimes cause chest or back pain. Signs of scoliosis include uneven shoulders, shoulder blades, rib cage and hips, and left or right curvature of the spine. It is a doctor, preferably an orthopedician, who can make a diagnosis of spinal deformities.
- Shingles An inflammation of one or more spinal nerves caused by Herpes zoster virus can cause burning pain and itch in the flank, usually on one side. The pain is usually, but not always, followed by rash along the course of the nerve.
- Side stitch Pain below the right or left rib cage during exercise (a side stitch) can resemble kidney pain. A side stitch is transitional and goes away during or shortly after exercise.
- Strained muscles usually do not result in bruising, but in lower-back and buttocks tenderness and pain, usually aggravated by activity, bending and lying on the affected side.
- Stress can cause pain in the lower back without other physical symptoms.
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
Comments - Ask a question or share your experience
Nikhil on February 12, 2020:
We has a back pain full spinal cord when we have stress what I can do
Samuil Hippi from Samoah on September 12, 2014:
You did an awesome job presenting data in an interesting and easy-to-digest manner. I don`t usually like reading long articles so I loved the "Kidney Pain vs Lower Back Pain" chart you`ve made! Keep up the good work!
Steve Mitchell from Cambridgeshire on January 13, 2014:
Very interesting article. I have been diagnosed with a Bosniak II F cyst in my left kidney and it causes discomfort most of the time. It also causes blood in urine. With this there is a 1 in 4 chance of it turning into kidney cancer. My medics are following up regularly.