A pain in your back can be hard to identify. It might follow lifting or an awkward movement, but pain from a kidney stone or infection can also be felt in the back. Location, accompanying symptoms, and how the pain behaves provide clues. None can confirm the cause on their own.
If you have fever, urinary changes, severe pain, or new weakness, pay attention to those symptoms rather than trying to decide whether the pain is “really” in your kidney.
For general information about everyday kidney health habits, you can explore the Kidney Coach program. New or severe pain needs a medical assessment; an educational program cannot diagnose its cause.
Where are the kidneys?
Your kidneys sit below your rib cage, one on each side of your spine. Pain associated with a kidney problem is often felt in the flank: the side of your back beneath the ribs. It may extend toward your abdomen or groin.
Ordinary back pain can occur in the same broad area. A muscle strain can hurt near the flank, and kidney stone pain can spread well beyond it. Location alone cannot reliably distinguish the two.
Kidney pain vs. back pain: clues at a glance
| Clue | May suggest a kidney or urinary problem | May suggest a muscle or spine problem |
|---|---|---|
| Location | Side of the back beneath the ribs; sometimes spreads to the lower abdomen or groin | Along the lower back or spine, or in nearby muscles; may spread into a leg |
| Onset | Can occur suddenly with a stone or develop with an infection | May follow lifting, twisting, exercise, or an awkward movement |
| Movement | May persist regardless of position | May worsen with certain movements or positions |
| Urination | Burning, frequent urination, blood in urine, or difficulty passing urine may occur | Usually no urinary symptoms |
| Other symptoms | Fever, chills, nausea, or vomiting may occur, especially with infection or a stone | Muscle tenderness or stiffness may occur |
These are clues, not a home diagnosis. Kidney pain does not always come with urinary symptoms, and a person can have back pain and a urinary problem at the same time.
What does pain from a kidney stone feel like?
A kidney stone may cause sharp pain in the back, side, lower abdomen, or groin. Other possible symptoms include blood in the urine, an urge to urinate often, pain while urinating, or passing very little urine. Some stones cause no symptoms until they move or obstruct urine flow.
The pattern matters, but you cannot confirm a stone from pain alone. A clinician may use your symptoms, urine tests, and imaging when needed to determine what is happening.
Get prompt medical help for severe pain, particularly if you also have fever, vomiting, or difficulty passing urine. An obstructed urinary tract with an infection can be serious.
What does a kidney infection feel like?
A kidney infection may cause pain in the back, side, or groin along with fever and chills. You may also have nausea, vomiting, frequent or painful urination, or urine that looks cloudy or bloody.
A kidney infection needs timely medical assessment and treatment. Do not assume that drinking more water, resting, or taking a supplement will treat it. If you feel very unwell or cannot keep fluids down, seek urgent care.
What does a muscle strain or common back pain feel like?
Back pain often follows a strain, such as lifting, twisting, or doing an unfamiliar activity. It may feel sore or stiff and change when you bend, turn, sit, or stand. Some back conditions also cause pain that travels down a leg.
Pain that changes with movement suggests a muscle or spine source, but it does not prove one. If your symptoms are unusual, worsening, or accompanied by fever or urinary changes, arrange a medical assessment.
Does pain mean you have chronic kidney disease?
Usually, pain is not how early CKD is discovered. Many people with early CKD have no symptoms. Blood and urine tests are needed to check kidney function and look for signs of kidney damage.
Likewise, having a normal-feeling back does not show that your kidneys are healthy. If you have diabetes, high blood pressure, or another kidney risk factor, ask whether you need tests such as eGFR and urine albumin.
For an explanation of these measurements, see how to increase GFR naturally: what your result means.
If you want to learn more about daily habits alongside your prescribed care, see the Kidney Coach program. Use blood and urine tests—not the presence or absence of back pain—to assess CKD with your clinician.
Can you have kidney pain without burning while urinating?
Yes. A stone or another kidney problem may cause pain without burning urination. Similarly, burning urination does not necessarily mean the kidneys are involved; the problem may be elsewhere in the urinary tract.
Tell a clinician about all your symptoms, including fever, blood in urine, changes in urine output, nausea, and where the pain travels. Those details are more useful than assigning yourself a diagnosis.
Can back pain be caused by something other than the kidneys or muscles?
Yes. Several conditions can cause pain in the back or side. A clinician considers your medical history, examination, and other symptoms before deciding whether you need urine tests, blood tests, imaging, or another assessment.
This is why a comparison chart cannot give a definite answer. Two people with pain in the same place may need very different treatment.
What can you safely do while arranging an assessment?
If the pain is new, note:
- When it began and whether it followed an injury or movement.
- Whether it is on one side or both.
- Whether it spreads to your abdomen, groin, or leg.
- Whether you have measured a fever.
- Any burning, blood in urine, or change in urine output.
- Any nausea, vomiting, numbness, or weakness.
- Which medicines you have taken.
If you have CKD, ask a clinician or pharmacist before taking an over-the-counter pain medicine. Nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen and naproxen, can pose kidney risks, especially during dehydration or illness.
Do not force large amounts of water to “flush” a suspected stone if you have a fluid restriction or are vomiting. Follow your usual fluid instructions until a clinician advises you.
For more on why fluid advice varies, read how much water a kidney patient should drink.
When should you seek urgent help?
Seek prompt medical assessment if you have back or side pain with:
- Fever or chills.
- Blood in your urine.
- Persistent vomiting or inability to keep fluids down.
- Difficulty urinating or much less urine than usual.
- Severe pain, especially if it is new or worsening.
Seek emergency care immediately for back pain with new loss of bladder or bowel control, numbness around the genitals or anus, or new serious leg weakness. These can be signs of a spinal nerve emergency.
Do not wait to work out whether the pain is muscular or renal when these symptoms are present.
How will a clinician tell the difference?
A clinician may ask about your pain and other symptoms, examine your back and abdomen, and check for signs of infection or nerve problems. Depending on what they find, they may recommend:
- A urine test for blood or signs of infection.
- Blood tests to assess kidney function or other concerns.
- Imaging if a stone, obstruction, or another condition is suspected.
Not everyone needs every test. The assessment is based on the whole picture, rather than a single feature such as which side hurts.
Frequently asked questions
Is kidney pain always on one side?
No. Pain may be felt on one side or both, depending on its cause. The number of sides involved cannot diagnose the problem.
If pressing the area hurts, is it definitely muscular?
No. Tenderness may provide a clue during an examination, but it cannot reliably rule out a kidney or urinary problem by itself.
Can a kidney stone cause pain in the lower abdomen or groin?
Yes. Stone pain can be felt in the back, side, lower abdomen, or groin. Blood in the urine or urinary symptoms may also occur.
Can I have CKD without kidney pain?
Yes. Early CKD often has no symptoms. Blood and urine tests are the way to check for it.
Should I take ibuprofen for back pain if I have CKD?
Ask your clinician or pharmacist which pain medicine is suitable for you. NSAIDs such as ibuprofen can be risky for people with kidney disease, particularly during dehydration.
The takeaway
Kidney-related pain and ordinary back pain can overlap. Pain beneath the ribs toward one side, especially with fever, vomiting, blood in urine, or urinary changes, deserves medical attention. Pain that follows a movement and varies with position may suggest a muscle or spine problem, but it does not prove one.
Use the pattern as a guide to what details to report—not as a substitute for diagnosis. Seek urgent help for severe symptoms, and remember that CKD can exist without any kidney pain.
For broader education on habits that may support kidney health, explore the Kidney Coach program. If you have current pain, fever, or urinary symptoms, get medical advice rather than relying on a general program.
Resources
- National Institute of Diabetes and Digestive and Kidney Diseases: Your Kidneys and How They Work
- National Institute of Diabetes and Digestive and Kidney Diseases: Symptoms and Causes of Kidney Stones
- National Institute of Diabetes and Digestive and Kidney Diseases: Symptoms and Causes of Kidney Infection
- National Institute of Diabetes and Digestive and Kidney Diseases: What Is Chronic Kidney Disease in Adults?
- National Institute of Diabetes and Digestive and Kidney Diseases: Keeping Kidneys Safe: Smart Choices About Medicines
- NHS: Back Pain
- Oxford University Hospitals NHS Foundation Trust: Cauda Equina Syndrome Awareness