Back Pain or Kidney Pain? Find Out What Hurts

Kidney pain or back pain? Sometimes it can be tough to tell, but each will provide their own clues. Here’s what you need to know.

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Trying to understand why your back hurts can feel exhausting. Most cases of back pain go away on their own. But if the soreness or irritation lingers it can suggest a more substantial health concern – possibly one associated with the kidneys.

Back pain or kidney painKidney pain or back pain? Sometimes it's hard to tell the difference.

Healthy kidneys help eliminate waste from the body, regulate blood pressure, make red blood cells, and perform other essential jobs all day every day. You’ll find these bean-shaped organs below your ribs, close to the middle of your back. That’s why kidney problems—stones, infection, chronic kidney diseases—can easily be mistaken for mid-or upper back pain

Here’s the thing, though. “People with kidney disease sometimes have ‘pain’ caused by their kidney disease,” says Alan Charney, MD, a nephrologist at NYU Langone Health and clinical professor at the Department of Medicine at NYU Grossman School of Medicine. “Remarkably, though, the kidney itself has no pain receptors!”

Back Pain or Kidney Stone?

What gives?

According to Dr. Charney, if you’re feeling kidney “pain,” it’s probably coming from one of two places (or both): Either because of distension of the ureter or capsule that surrounds the kidneys.

The ureters—tubes attached to each kidney—transport urine from the kidneys to the bladder. All that urine contains salts and minerals, and if the minerals clump together and block one of the ureters, you’ve got yourself a dreaded, infamously painful kidney stone.

“[The] ureter [contracts] because there is a stone blocking it,” says Dr. Charney. Not only that, he says, but “when there is a blockage due to the stone in the ureter, the urine may back up into the kidney and that may expand the capsule of the kidney and cause pain.”

Back pain or kidney pain illustrationKidney stones (artist's rendering)

When it comes to where the pain is located, it is typically just on one side. It is routinely categorized as a dull ache. Dr. Charney adds that the pain “is always there…more or less bothering you.” Sound familiar? That’s because chronic back pain, especially the kind caused by nerve compression, is usually on just one side too (think sciatica).

However, when it comes time to pass a stone, you’ll know it.

“Stone ache can just be faint pain unless that stone is trying to pass,” says Dr. Charney. “Then it can be severe and last for several minutes before it goes away.” Whenever the pain is too excruciating to bear—and really, any time you suspect a kidney stone—head to the emergency room. Treatment is available and of course, better safe than sorry.

“And it is important to collect the stone when it passes,” says Dr. Charney. “Analyzing the kidney stone will help direct treatment to prevent the next kidney stone which unfortunately will occur in about 50% of patients within five years.”

Back Pain or Kidney Infection?

Another type of pain is caused by a kidney infection.  How does it feel? You guessed it: A dull throb that may feel like mid- or upper back pain.

A kidney infection is usually caused by bacteria. These real-life risk factors greatly increase your chances of developing one. For example: a kidney stone whether or not it obstructs the ureter, nerve or spinal damage that impairs bladder emptying or a lower urinary tract infection (UTI) called cystitis. But older people, 70’s on up, sometimes develop kidney infections without any other predisposing factor.

The signs and symptoms linked to this include back, side and/or groin pain as well as one or the combination of factors listed:

  • Fever
  • Chills
  • Burning sensation when you urinate
  • Sense of urgency—you really gotta go
  • Vomiting
  • Nausea 

As with a kidney stone, a kidney infection can turn into an emergency.

Kidney stone and infection are the most common forms of kidney pain, Dr. Charney says, but points out that rare genetic diseases such as polycystic kidney disease and Fabry disease can cause kidney pain that can be mistaken for back pain.

Back Pan vs Kidney Pain: How to Tell the Difference

There’s usually no easy way to differentiate between back pain and kidney pain, especially for the constant ache of a kidney stone that’s not demanding to be passed. Passing a kidney stone is a different story since it hurts so badly, and kidney infections provide clues in the form of other symptoms.

Unsurprisingly, your best bet is to see a doctor for a formal diagnosis. Be prepared for a physical exam, providing your family and medical history and undergoing tests. The tests can include urine analysis or culture as well as a plain abdominal X-ray, CT scan or MRI.

“There is no cure or quick fix for getting rid of kidney stone pain, as people who have experienced the excruciating pain know.” Dr. Charney said. The only solution is to have a physician prescribe pain medications and sometimes fluids while just giving yourself time to pass the stone. However, there are antibiotics for kidney infections as well as home remedies. The home remedies include using heat to the area where you have discomfort, keeping yourself hydrated and taking over the counter pain meds when needed.

Overall, the best advice to keep kidneys healthy is to exercise, keep hydrated especially in warm weather or when exercising, maintain a healthy weight, and quit smoking. And the best part? That advice works for back pain as well.

 

Updated on: 10/30/20
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Alan Charney, MD
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