How to distinguish kidney pain from back pain
The kidneys are located higher than is commonly thought: they are covered by the lower ribs, so their pain is felt in the side and in the upper part of the lower back, closer to the costovertebral angle. It is deep, dull or, conversely, cramping, often extends down to the groin and genitals, and is not associated with movement. Muscular and spinal pain, on the contrary, clearly changes when bending and turning, increases after exercise and decreases at rest, and when palpated, a painful point is located. Kidney pain is often accompanied by changes in urination, fever and nausea.
- Kidney pain - deep in the side, under the ribs
- Gives to the groin, thigh, genitals
- Does not depend on posture and movements
- Accompanied by changes in urine, temperature, nausea
- Muscle pain changes with bending and applying pressure
Main reasons
The most common cause of acute unilateral pain is a stone that blocks the outflow of urine and causes renal colic. The pelvis is stretched, and wave-like pain appears with restlessness, nausea and vomiting. Acute pyelonephritis causes constant pain in the side with high fever, chills and cloudy urine. Large cysts, tumors and obstruction of the outflow due to narrowing of the ureter stretch the kidney capsule and cause dull, arching pain. Separately, there are lower back injuries, as well as situations where kidney pain is imitated by diseases of the spine, gall bladder, intestines and pelvic organs.
- Kidney and ureteral stones, renal colic
- Acute and chronic pyelonephritis
- Impaired urine outflow, hydronephrosis
- Kidney cyst or tumor
- Lumbar injury
- Diseases of the spine and muscles that mimic kidney pain
Associated symptoms
The accompanying symptoms help to understand the nature of the pain. Pain when urinating, frequent urge and cloudy urine indicate a urinary tract infection. Visible blood in the urine is characteristic of a stone, injury, or tumor. High fever with chills accompanied by pain in the side is a sign of kidney inflammation that requires prompt treatment. Swelling under the eyes in the morning, foamy urine and high blood pressure most likely indicate a disease of the glomeruli of the kidneys, which is dealt with by a nephrologist. Nausea and vomiting during colic occur reflexively and do not mean poisoning.
- Pain and frequent urge to urinate
- Cloudy urine with an unpleasant odor
- Blood in urine
- Temperature with chills
- Facial swelling and high blood pressure
- Nausea and vomiting with colic
What examinations are needed
The basic set is simple: a general urine test shows leukocytes, red blood cells, protein and salts, and an ultrasound of the kidneys and bladder reveals stones, dilation of the collecting system and cysts. Blood creatinine with calculation of glomerular filtration rate evaluates kidney function. If an infection is suspected, a urine culture is performed to determine sensitivity to antibiotics. The most accurate method for urolithiasis is considered to be computed tomography of the urinary tract without contrast: it finds even small stones that are invisible on ultrasound. For pregnant women, radiation methods are replaced by ultrasound.
- General urine test
- Ultrasound of the kidneys and bladder
- Blood creatinine with GFR calculation
- Urine culture for suspected infection
- MSCT of the kidneys and urinary tract
- Excretory urography according to indications
What to do and how to treat it
In case of sudden severe pain in the side, especially with fever, vomiting or blood in the urine, you need to call an ambulance by calling 103 - the combination of colic and fever is dangerous and should be treated in a hospital. You should not apply heat to the lower back before examining a doctor: in case of purulent inflammation, this worsens the course. Further tactics depend on the findings. Small stones often pass away on their own with pain relief and sufficient fluids; large stones are crushed or removed endoscopically. Pyelonephritis is treated with antibiotics; if the outflow of urine is impaired, the outflow is first restored. For prevention, it is important to drink enough water, especially in the heat.
- For severe pain with fever, call 103
- Do not warm up your lower back until examined by a doctor
- Pain relief and drinking regimen as prescribed by a doctor
- Antibacterial therapy for pyelonephritis
- Crushing or removing stone
- Drink enough water and examine the composition of the stones after passage