What kidney pain feels like and how to tell it from back pain

Where the kidneys are

The kidneys sit deep at the back of the abdomen, on either side of the spine, roughly level with the two lowest ribs. Each one is about the size of a fist. The right kidney usually sits a little lower because the liver is above it.

That is why kidney pain is felt at the side, in the angle between the lowest rib and the spine. Pain low in the back, over the sacrum, rarely comes from the kidneys.

Other organs can hurt in the same area too: the bowel, the gallbladder, the pancreas and, in women, the pelvic organs. The location of the pain alone can’t tell you the cause.

What kidney pain feels like

Renal colic happens when a stone blocks the flow of urine. The pain comes on suddenly, is very severe, comes in waves and spreads to the groin, lower abdomen or genitals. People can’t find a comfortable position, often feel sick or vomit, and there may be blood in the urine.

With a kidney infection (pyelonephritis), the pain is dull, aching and constant. It usually comes with a fever, chills and weakness, and the urine becomes cloudy and smells bad. A kidney infection often follows a bladder infection, so think back to whether you first had cystitis symptoms: frequent, painful urges and burning.

Many kidney diseases, especially chronic ones, don’t hurt at all. Signs can include puffiness of the face in the morning or swollen legs, high blood pressure, foamy urine or a change in its color. That is why doctors advise people with diabetes, high blood pressure or a family history of kidney disease to have regular urine and blood tests, even when nothing hurts.

Kidneys or back: how to tell

Back pain most often comes from muscles, ligaments and the spine. These signs point to it:

• the pain started after lifting something heavy, an awkward movement or sitting for a long time;
• it gets worse when you bend or twist and eases when you lie down;
• it hurts in the middle of the back or along both sides of the spine;
• it spreads to the buttock or leg;
• your temperature is normal and your urine looks as usual.

It looks more like the kidneys when:

• it hurts on one side under the ribs, and changing position makes little difference;
• you have a fever, chills or nausea;
• your urine is cloudy, reddish or strong-smelling;
• you urinate often or it hurts to urinate;
• the pain comes in waves and spreads to the groin.

These signs help you get your bearings, but only a doctor can say for sure whether the kidneys are the cause, after an exam and tests.

What to do about lower back pain and when to call an ambulance

If you have a fever, don’t put heat on your lower back or take a hot bath: a doctor needs to find out what is causing the pain first.

A painkiller can dull the pain for a while, but don’t take it for several days in a row without seeing a doctor. Some painkillers can harm the kidneys when taken for a long time. And pain that goes away after a tablet doesn’t mean its cause has gone.

While you wait for your appointment, write down when the pain started, where it spreads, what your temperature was and whether your urine has changed. These details will help the doctor find the cause faster.

Call an ambulance (103) if:

• the pain is very severe and won’t let up, especially with vomiting;
• you are passing very little urine or none at all;
• lower back pain comes with a high temperature, severe weakness or confusion;
• an attack of renal colic comes with a fever or chills, or you have only one kidney.

See a doctor the same day if lower back pain comes with a fever and chills, you notice blood in your urine or you are pregnant.

Which tests the doctor orders

The urologist will ask where and how it hurts, examine you and gently tap your lower back on each side with the edge of the hand. Bring any previous test and ultrasound results, and the doctor will take them into account. The doctor usually orders:

• a urinalysis;
• a urine culture, if there are signs of infection;
• blood tests, including creatinine, which shows how well the kidneys work;
• an ultrasound of the kidneys and bladder.

At Viva Clinic in Slavuta you can have all of these on site. Kidney and bladder ultrasound is done at the polyclinic at 27a Sobornosti St, and urine and blood tests are processed at the Diagnost-Lab laboratory at 32 Sobornosti St. If you have signed a declaration with a Viva Clinic family doctor, a urinalysis with their referral is free.

The urologist sees patients at 27a Sobornosti St or 3 Danyla Halytskoho St, and the exact address is confirmed when you book. You can book a urology consultation at Viva Clinic by phone or on Viber. If the tests show that the problem is your back, the doctor will tell you which specialist to see.