Kidney Pain

Most people are born with two kidneys which are bean-shaped organs on each side of the middle back. In the medical field kidney pain is usually called flank pain because it is noted most in the middle back or flank area.

The kidney is a filter for the blood and works to remove waste materials. Aside from filtration the kidneys also helps with hormone and electrolyte control. Kidney pain is not in itself a diagnosis and could be a symptom of various issues.

What do the Kidneys do in our body?

Kidney is considered as one of the major organs of the body. This is because of its important role in various functions that keep us in healthy condition. The major functions of it include the following.

  • Maintenance of fluid volume within the body.
  • Maintenance of acid-base equilibrium within the body.
  • Blood is purified of waste products, chemicals and toxins by the kidneys.
  • Electrolytes such as Sodium, potassium and chloride are kept in the required amount in body with the help of the kidneys.
  • Kidneys are also known to produce hormones and chemicals required for information transmission through nerves. (18)

This article will discuss a bit more about the anatomy of the kidney as well as possible causes for kidney pain.

Kidney Location – Where are your kidneys located ?

As mentioned above most people have one kidney on each side of the posterior abdominal area. The specific location of the kidneys sometimes causes the pain sensation to be confused with other types of pain such as liver or back pain. It is very important to understand the exact location and sensation of kidney pain.

The picture below shows a drawing each kidney in the area where they are located. Flank pain is specifically found in this area. If movement of the muscle or massage does not relieve pain in this area you may be experiencing kidney pain.

Flank pain which is sharp or doesn’t change upon movement is most likely kidney pain and not muscular pain.

Surface of the kidney location anatomy

Picture 1 : Surface of the kidney location (back side of the abdomen)
Image source :

Where are your kidneys located exactly?

where are your kidneys located - kidney location


Check out this video for the 3D view : Location and Relations of Kidneys


Kidney Pain Location and Sensation

There is usually a feeling of a stabbing pain in the upper back just below the ribs. It may also be a dull ache depending on the diagnosis. At times kidney pain may be felt in the upper abdominal area. In this case it is often confused for digestive issues. Pain can radiate to the back as well as to the groin region.

kidney location in abdomen pain


Picture 2 : Kidney pain located in the Right and Left Upper Quadrants
Image source : HealthHype

Kidney Pain vs Muscular (back pain)

The flank area is an area of the back that is commonly injured in normal every day movements or during exercise. There are a few good ways to know the difference between kidney pain and muscular back pain.

If you answer yes to any of the following questions you could be experiencing kidney pain.

  • Assess your body to see if you have any other symptoms such as fever, or difficulty with urination?
  • Does the pain increase or decrease associated with  your urination?

If you answer yes to any of the following questions you may be experiencing back pain.

  • Does the pain get better or worse with stretching or movement?
  • Is pain relieved with regular over the counter pain medications?

Causes of Kidney Pain

Generally, kidney pain can occur when there is an infection or disease of the tract through which urine passes. This includes the kidneys, ureters, urinary bladder and the urethra. Obstruction of the tract by renal stones, especially in the kidneys or ureters can lead to flank pain. However, obstruction in the bladder and urethra can lead to lower abdominal pain. Malignant growth and congenital deformities of the urinary tract can also lead to similar pain.  (19)(20)(21)

Renal Stones

One of the most common reasons for flank pain is kidney stones. This is basically a build up calcium residue which creates tiny stones. Although the stones are very small they have to move through the kidneys filtering system.

The pain can be quite debilitating and difficult to treat. Usually kidney stones do not need treatment and “pass” on their own, but in some cases different measures are taken to help “break up” larger stones to help them pass. Along with the pain, the person may have nausea, vomiting or hematuria (passing of blood in urine).

How to relate (identify) kidney stone location with pain location:

Anatomical locationRadiated location of pain
Stone in renal pelvis or Proximal pelvis of the kidney.Flank and groin
Middle of Ureterlower flank towards the anterior section
Ureterovesical junctionRadiates to scrotal skin and in lower flank.
Usually noted sensation of needing to urinate frequently.

kidney pain referred pain

FAQs :

Passing a 4mm kidney stone ?

Kidney stone less than 4mm stone 1 to 2 weeks
Kidney stone more than 4mm 2 to 3 weeks

also note : if stone is bigger than 10 mm and looking big, then surgical or medical treatment is needed.


4mm kidney stone actual size


Polycystic kidney

Polycystic kidney disorder is a hereditary condition causing multiple cysts in the kidney. The cysts can cause enlarged kidneys and lead to flank or abdominal pain.

On examination of the person’s abdomen, palpable mass may be felt in the kidney region on both the sides. It is usually seen that people with polycystic kidneys are prone to frequent urinary tract infections. (22)

Kidney Infection

Kidney infection is usually caused by untreated bladder infections. When both kidneys are infected the diagnosis is pyelonephritis. Immediate medical attention is needed to prevent kidney damage. Generally the patients with pyelonephritis may complain of dull aching pain in either sides or both. They may also have nausea and vomiting (23).

Renal Vascular Issues

Arteriosclerosis of the renal artery may bring about renal pain. It may also be accompanied by a number of other problems due decreased blood flow to and through the kidney.


Hydronephrosis is when the urine that should be flowing through the ureters and into the bladder, are for some reason blocked. This blockage could be caused by various reasons such as obstruction by stones. Hydronephrosis can be very dangerous and has a potential to cause kidney damage. This must be treated immediately under medical supervision. They usually present with pain in the upper back or flanks (24).

Kidney Cancer

The carcinoma of the kidney usually causes pain in the flank region along with painless blood loss via urine.

Kidney Pain and Alcohol Abuse

Although the kidneys do not directly filter alcohol, problems associated with the kidneys may be related to the alcohol abuse. Alcohol can affect certain renal hormones such as anti-diuretic hormone and result in dehydration. Alcohol may also raises the risk of atherosclerosis and cause clot formation in the kidneys.

Associated Symptoms of Kidney Pain

Any disease or a disorder related to the kidneys may be accompanied by a number of other symptoms. They usually represent a problem in the urinary tract.

Urinary tract symptoms

  • Oliguria- Decreased urine output.
  • Polyuria- Increased frequency of passing urine
  • Anuria- Absolutely no urine output.
  • Hematuria- Blood in urine.
  • Color may also be changed sometimes.
  • Urinary urgency and frequency
  • Painful urination

Other symptoms not related directly to the urinary tract may be:

  • Nausea and vomiting.
  • Edema of the face, hands, legs, feet or even whole body
  • Loss of appetite
  • Weakness
  • Fever
  • Weight loss or gain
  • Joint pain
  • Painful menstruation
  • Hypertension (High blood pressure)
  • Nail Abnormalities

If you are suffering from the above mentioned symptoms, then you are most likely having a kidney issues and should seek medical attention.

Diagnosis of Kidney Pain

As stated above if you are experiencing any of the symptoms noted above it is always important to get medical advice. Your doctor will go through a process of checks and tests in order to decide if you in fact are suffering from kidney pain.

Full blood Count

A full blood count will determine the number of bloods cells in a certain amount of your blood. They will particularly be looking at the white blood cells because they will alert to infection.

Blood cultures and Urine Culture Test

These determine the causative agent behind infection in case there is a suspicion of renal or urinary tract infection.


A urinalysis can show various important clues helpful for detecting the main cause of an infection.

Intravenous pyelogram (IVP)

It is the X-ray specially designed for kidney and urinary tract. It is used to detect the size, position and shape of the kidney, urinary tract and ureters. It can also help to locate the stone.

Abdominal X-ray (KUB)

This type of x-ray gives a portrait of the kidneys, the urinary bladder, and the ureters. This may be helpful in finding stones and deciding the size and location of the kidneys. Other tests that help to detect the pain in the kidney include CT scan and ultrasound of the kidneys.

Differential Diagnosis of Kidney Pain

While diagnosing a pain which could probably be due to the kidneys or urinary tract, it should also be kept in mind that similar pain can occur due to various other problems. Let us look at a few causes of pain that resembles kidney pain. (25)(26)(27)(28)(29)

Acute Appendicitis

The pain due to appendicitis is usually felt around the umbilicus and radiates towards the right lower quadrant of the abdomen. It may also be associated with nausea, vomiting and tenderness in the area. Clinical examination with ultrasonography of the abdomen can help in excluding the diagnosis.


It is a condition of the colon due to inflamed pouch formation in their walls. The abdominal pain associated with diverticulitis is usually felt in the left or right lower quadrant of the abdomen.


Endometriosis associated pain is also felt in the lower abdominal quadrants, right or left. The condition can show  dysmenorrhoea (painful menstrual periods), menorrhagia (heavy menstrual periods) , nausea, vomiting, dyspareunia (painful sexual intercourse) and infertility.

Infectious colitis

Abdominal pain in this condition can be felt as being in the whole abdomen, but sometimes it may be localized to right or left lower quadrants of the abdomen. General features such as fever and chills with diarrhoea may also be seen.

Low back ache

Kidney pain may occasionally be felt as pain in the back region just below the ribs. One of the common causes for low back ache can be muscular or bony pain due to positional or stress related causes. This can also be confused the renal pain.

Appropriate investigations can be employed to include or exclude any of these differential causes by a medical expert. The wide range of causes presenting with similar symptoms makes it mandatory for a doctor to examine and come to conclusions regarding the cause of the pain.

Treatment for Kidney pain

Diet Modification

There are various calcium oxalate containing foods which may increase kidney stone formation such as:

  • Chickpeas
  • Cauliflower
  • Carrots
  • Turnips

Foods that may help prevent kidney stones and may help with general kidney issues are those containing large amounts of water or vitamin C such as:

  • Watermelon
  • Grapes
  • Organs
  • Cranberries juice
  • Grapefruits

Medical Treatment

Infections require antibiotics while other treatment is symptomatic. Over the counter pain killers can help but they should be avoided.

Surgical Treatment

Kidney stones have to be removed surgically or by breaking it into bits, in case it does not pass through the urine.

Treatment is basically given according to the cause of the kidney pain. Avoid alcohol and factors that aggravate your pain.

References :

  20. Kidney pain. American Kidney Fund. Accessed Jan. 14, 2017
  21. Steinman TI, et al. Pain syndromes in autosomal dominate polycystic kidney disease. Accessed Jan. 14, 2017
  22. Diagnosis and management of chronic kidney disease; Scottish Intercollegiate Guidelines Network – SIGN (June 2008)
Kidney Pain
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Published on by under Pain Management.
Article was last reviewed on January 23rd, 2018.

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