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What does kidney pain feel like?

Where do you feel kidney pain?

Looking from the outside, the kidneys are located on the sides of the middle-lower back, under and partly below the lower ribs (Picture 1). Looking from the inside, kidneys lie deep in the upper abdomen, underneath the diaphragm on the either side of the spine (in the so-called retroperitoneal space, which means behind the peritoneal membrane). kidney pain location

Picture 1. Kidney pain appears where the kidneys are located
(the view from the back).

Where does kidney pain hurt:

  • In one or both flanks (loin pain) — in the area between the lower ribs and hips
  • Deeply in the upper abdomen on the left, right or both sides
  • Pain from the kidney stones that lodge in the ureter can radiate from the flanks toward the genitalia, groin and inner thighs.

What does kidney pain feel like?

Description of the kidney pain:

  • Sudden (acute) or persistent (chronic)
  • Mild or severe
  • Sharp, dull, throbbing or, rarely, cramping or colicky
  • One sided or both-sided.

Kidney pain is often, but not always, associated with tenderness in the kidney area.

Symptoms and Signs

Pain that originates in the kidneys is not very characteristic and can be easily confused with the pain arising from other abdominal organs (spleen, pancreas) abdominal aorta (aneurysm), lungs, back muscles, spine or spinal nerves. They are additional symptoms, which can speak for the kidney origin of the pain (1,3,4,7):

The sign that lower back pain arises from the kidneys: flanks may be tender to the touch, a doctor can provoke pain by tapping over the kidneys or by a slight punch to the kidney area.

Is kidney failure painful?

Neither acute or chronic kidney failure by itself is usually painful. Kidney failure means severe impairment of the kidney function, but the kidney as an organ is usually not damaged in the early phase of kidney failure. It is the cause of kidney failure, such as severe kidney infection or inflammation, that can cause pain, though. Symptoms of kidney failure are quite nonspecific and may include increased or decreased urination, fatigue, nausea, unintentional weight loss, pale and itchy skin, swollen ankles and hands, shortness of breath (16). Severe acute kidney failure may cause pain in the flank(s) (29).

Sudden (Acute), Severe Kidney Pain or Renal Colic

Kidney Stone Pain

Kidney stones (renal calculi) usually cause symptoms only when they lodge in the ureter and obstruct the urine flow. Symptoms often start at night or in the early morning and may include (2,4):

  • Sudden, sharp, severe, even extreme excruciating pain, in the right or left flank, which develops within 30 minutes to few hours to full intensity and can remain constant for up to 18 hours and then wears off in few hours; pain can radiate down to the lower abdomen, testicles or vulva (Picture 2). Urinary stone pain sometimes presents as an intermittent colic (spasm).
  • Blood and, eventually, one or more stones in the urine
  • Nausea, vomiting
  • No fever (except when infection occurs)

kidney stone pain location picture

Picture 2. Kidney stone pain
The pain from the kidney stones can be felt in the flank,
lower abdomen and genitalia

Other Causes

  • Obstruction of the ureteropelvic junction (UPJ) or pelvi-ureteric junction (PUJ), which most commonly occurs in children, is the obstruction of the upper part of the ureter due to congenital disorders, surgery or infection (2). Main characteristics are a palpable mass in the upper abdomen due to dilated kidney (hydronephrosis), occasional flank pain, especially after drinking large amount of fluid, like alcohol (25or caffeinated drinks, or after diuretics (26), and blood in the urine (2).
  • Acute hydronephrosis (swelling of the kidney due to filling with urine), mostly due to a stone in the ureter (7)
  • Blood clots in the ureter due to kidney injury or investigation, kidney tumors, sickle cell anemia, hemophilia (2)
  • Acute renal infarction due to embolism of renal artery or its branches in individuals older than 50 years: main symptoms are sudden flank pain on one side and blood in the urine (2)
  • Renal vein thrombosis (19)
  • Renal papillary necrosis due to diabetes, liver cirrhosis or analgesic abuse, mainly in women (2)
  • Loin pain hematuria syndrome (LPHS) in women who take oral contraceptives (23).

Throbbing Kidney Pain

Throbbing, pulsating pain in the kidney area, which can radiate up or down the back and may last for several seconds to minutes, can be caused by:

  • Blockage of the urine flow due to ureteropelvic junction (UPJ) obstruction, stricture after surgery or ureteral stone (17)
  • IgA nephropathy or Berger’s disease (a type of kidney inflammation — glomerulonephritis): brown, cola- or tea-colored urine and spasms in the flanks within 72 hours after the onset of respiratory infection or gastroenteritis (10,18)
  • Renal vein thrombosis (21)
  • Cystinuria (11)
  • Loin pain hematuria syndrome (LPHS): persistent or recurrent burning or throbbing loin pain on one or both sides, which may be triggered by movement or exercise; blood in the urine (not always), sometimes fever or nausea. Symptom episodes may last from hours to months (12).

Dull Kidney Pain

Kidney Infection (Pyelonephritis) Pain and Associated Symptoms

Symptoms of urinary tract infection (UTI) that involves kidneys (pyelonephritis) develop in few hours or days and may include (1,2,3):

  • Mild, dull ache, discomfort and tenderness in the left, right or both flanks
  • Nausea, vomiting
  • High fever and chills (not always)
  • Occasional symptoms: loss of appetite, diarrhea, stiff neck
  • Symptoms of the associated bladder infection (cystitis) or infection of the urethra (urethritis): cloudy and foul smelling urine, blood in the urine, frequent urination, urge to urinate, burning pain during urination.

Kidney infections are much more common in women than in men.

Other Causes

  • Renal abscess is a localized collection of pus within a kidney — it usually occurs as a complication of infection. A doctor may detect a palpable mass in the loin (2).
  • Fungal bezoars may occur after kidney transplantation or in diabetes or during long-term antibiotic treatment (2,8)
  • IgA nephropathy or Berger’s disease (a type of kidney inflammation or glomerulonephritis): brown, cola-colored or red urine and dull flank pain within 48 hours after onset of a respiratory or gastrointestinal infection; symptoms may last for up to 3 days (10,18).
  • Polycystic kidney disease (13)
  • Chronic hydronephrosis due to gradual blockage of the urinary tract, for example, due to ureteral stricture after ureteroscopy, kidney stone, radiation or kidney surgery (5,7)
  • Kidney cyst, tumor or cancer: gradual development of flank pain, blood in the urine (9)
  • Narrowing of the kidney artery–renal artery stenosis–due to atherosclerosis with clot formation or ischemia, steady ache in the flank, blood in the urine, high blood pressure (20)
  • Nutcracker syndrome (compression of the left renal vein): left flank pain, blood in the urine (22)
  • Idiopathic loin pain haematuria syndrome (LPHS) (12)
  • Retroperitoneal fibrosis — development of scar tissue in the area around the kidneys, mostly from an unknown cause (2).

Bilateral Kidney Pain  (in Both Flanks)

Disorders that can cause kidney pain on both sides at the same time:

  • Kidney infection (pyelonephritis) (6)
  • Kidney inflammation:
    • Nephritis
    • Glomerulonephritis, such as IgA nephropathy(6), post-streptococcal glomerulonephritis after strep throat (sore throat followed by flank pain, malaise, blood in urine) (28)
  • Polycystic kidney disease; flank pain, blood in the urine, recurring urinary tract infections (13)
  • Nephrocalcinosis: symptoms are caused by kidney stones (14)
  • Bilateral hydronephrosis (15)
  • Loin pain hematuria syndrome (LPHS) (12)
  • Renal vasculitis: polyarteritis nodosa, Henoch-Schönlein purpura, essential mixed cryoglobulinemia, microscopic polyangiitis, Wegener’s granulomatosis (6,27)
  • Retroperitoneal fibrosis (6)
  • Other causes (6): X-ray contrast toxicity, ethylene glycol poisoning (ingestion), arsine gas poisoning, Haff disease after eating Buffalo fish, blood hemolysis, such as in sickle cell anemia, myoglobinuria after muscle breakdown (rhabdomyolysis), paroxysmal cold hemoglobinuria, anaphylactic reaction, transfusion reaction, serum sickness.

Published on July 8th 2013 by  under Symptoms.
Article was last reviewed on 2nd December 2014.

12 Responses to What does kidney pain feel like?

  1. Justin Tasoulas says:

    i have itchy redness lump in my back ribs right where the kidney is caused from a car accident in march 1st 2005

    • Jan Modric says:

      Justin, my first thought was a blood collection (hematoma) under the skin that became fibrous (like an internal adhesion or scar). I strongly suggest you to get that checked to exclude more serious causes, like a tumor. An ultrasonography, for example, is a quick, cheep and quite informative investigation.

  2. Google says:

    Very good article. I am experiencing some of these issues as well..

  3. Tina says:

    I have a horrible kidney and bladder infection. My doctor has neglected this, it has worsened, hydronephrosis,let to go home though anti biotics were not working and not feeling well at all. Vomiting, 6 pd weight loss,severe sweats,abnormal confusion, my other complex health issues are worsening and nothing I can do for help. I am traumatized by going to the ER and how I’ve been treated over and over, so won’t go back. This is a very sad situation.

    • Jan Modric says:

      Tina, urinary tract infection is confirmed by urine culture test on basis of which a doctor can prescribe exact antibiotics, and if those do not work, some other antibiotics. If you really have an UTI, please go back to the doctor.

  4. Celina says:

    I’m getting spasms under the bottom part of my rib cage. (Left side )It seriously feels like someone squeezing on it . Then eases up and goes away for a mi then comes back .
    I noticed last month my husband and I went out for drinks and I woke up feeling like someone punched me in the ribs (both sides) and I got up to get water and the pain went away about ten 15 mins later…

    • Jan Modric says:

      If the pain is in the front, it may be from the gas in the part of the colon that runs horizontally below the rib cage. I cannot say if it is this or not, but if it is, it may be managed by observing which foods trigger the pain and remove them from the diet.

  5. rita owens says:

    I have stage lll kidney, 73 year old female and have started having pain in my RIGHT lower back and hip, right groin and right shin bone mostly when sitting for about a month. My kidney function labs have been stable and pretty good for over 6 months then this pain started. Could it be related to ckd or something else. What kind of doctor should I see. I have a medical dr., kidney specialist, neurologist, endrocrinologist and obgyn. Where do I start.Please help.

  6. Stephani says:

    I had a UTI a few months back that woke me up with severe kidney pain. Felt like someone took a baseball bat to my back. I took antibiotics and the UTI went away. I returned to the doc after my kidney pain persisted and tested negative for UTI. It’s been about three months and my kidneys still hurt. It’s more of a full, achy pain that comes and goes every few days and it will last for anywhere from one to three days. Today, after intercourse, I noticed some blood on the toilet tissue after using the bathroom. Should I be concerned about kidney disease at this point? I’m uninsured and worried about where to go considering my doctor hasn’t been very helpful so far.

    • Jan Modric says:

      Pain in the kidney area and blood on the tissue (if it is from the urine) suggest a kidney disease. Pain from stretched lower back muscles is more superficial and changes with the body movement and position, but kidney pain is less likely affected by the body position. The kidney inflammation or cancer could be suspected from changes in the simple blood tests, for example elevated white blood cells and sedimentation rate, but to get exact diagnosis, some imaging investigation (CT?) would be needed.

      I strongly recommend you to try to have at least some simple blood and urine tests done (a primary doctor can order them). I also strongly recommend you to check for ALL possible options for affordable insurance. If you are not very confident about your doctor, try to get in touch with some other doctor for a brief consultation, just to get the second opinion. A good doctor should be able to tell something on the basis of a physical examination and few non-expensive blood and urine tests.

  7. joan says:

    I am a 36 year old breast cancer patient who has had 8 rounds of chemo, surgery am currently undertaking my 6th & final week of radiation and have Herceptin through my Port every 3 weeks (my last being on Thursday last week). About 3 weeks ago I had a UTI which lead to thrush – it took 3 rounds of antibiotics & thrush treatment (first lot didn’t appear to work so was given a different type and then advised through further urine tests that my urine was ‘clear of infection’ and white cell count was good in bloods. Last Thursday evening I felt discomfort through my abdomen and right side which lead to the back. It is now early Monday morning and I still have a dull ache around the right kidney area which feels heavily bruised (and slightly hard) when touched. my urine appears normal with no cloudiness or discolour. I am urinating normal and my temperature is normal. I no longer have any UTI symptoms. I feel well accept for this sensation in my back. I will try to see my doctor again today but can you suggest what this may be?

    • Jan Modric says:

      Swelling around the kidney certainly suggests a problem in the kidney or surrounding tissues. An ultrasound, blood and other tests may reveal more.

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