Kidney Pain vs Back Pain? Detailed Guide to Spotting the Difference

You probably already know that kidney pain feels different from muscle pain, but what about lower back pain? When you feel stabbing pain in your lower back or flank, how can you tell if it's a pulled muscle or kidney pain? Understanding kidney pain vs back pain is important! It could be a sign of an infection you need immediate medical attention for or muscle strain that physical therapy can fix.

Kidney pain vs back pain can feel very similar which is why it's important to take note of what type of pain it is (aching vs stabbing), what other symptoms you are experiencing, and how it responds to movement. We breakdown everything you need to know about kidney infection symptoms vs mechanical back pain signs below.

Location of Back Pain and Kidney Pain

Before we dive into symptoms, it's useful to understand where your kidneys are located. They are bean-shaped organs located deep in your abdominal cavity on both sides of your spine, underneath the rib cage between your 12th thoracic vertebra and your 3rd lumbar vertebra.

One landmark to know is your iliac crest or the top of your hip bone you can feel when you place your hands on your hips. Kidney pain occurs above your iliac crest in your flank region, while muscular pain is felt lower in your lumbar spine region and may radiate below your iliac crest.

Kidneys are retroperitoneal (located behind the abdominal cavity) organs, so kidney pain will have more of an "inside your body pain" feel. You will notice this distinction since kidney pain does not improve with palpation or massage like muscular pain does.

Symptoms of Kidney Pain

Costovertebral Angle Tenderness aka "thump test"

If you have kidney infection symptoms you will experience pain along your costovertebral angle (CVA), which is where your lowest rib meets your spine. If you receive a sharp blow to your CVA you will feel intense stabbing pain that radiates through your kidney if you have an infection. Since your kidneys sit right underneath your CVA, when inflammation occurs they will be extremely tender.

Abnormal urine color/frequency

Symptoms of kidney pain will typically include:

• Cloudy or foul smelling urine from bacteria/pus in your urine
• Dark urine or blood in your urine from inflammation/damage to your kidneys
• Painful urination as the infection spreads to your bladder
• Feeling like you need to pee frequently with little to no urine coming out from bladder irritation/inflammation
• Trouble urinating to begin with due to inflammation/swelling

Keep track of any changes when you urinate along with back pain, since this is not a symptom you will experience with muscular pain.

Fever and chills

If you develop fevers or chills with back pain this is a huge sign that you have kidney pain, and not back pain. High fevers (101°F or higher), along with chills, sweating, nausea and fatigue are typical signs of kidney infection. These symptoms will not resolve with rest or positional changes like back pain will since they are caused by your infection.

Symptoms of Back Pain

Activities that cause your back pain to flare up can help identify mechanical back pain signs. Pain is worse with:

• Poor posture: Sitting for long periods
• Certain movements: Lifting heavy objects, twisting your torso
• Morning pain: Pain when you first wake up

If your pain fluctuates with movement and activities this is mechanical back pain.

Improvement with rest or position change

Common things that improve mechanical back pain include:

• Resting (lying down)
• Heat application
• Certain positions such as sleeping on your side with a pillow under your knees
• Stretching
• Posture corrections such as improved seating or adding lumbar support

If you find your pain stays constant regardless of what position you are in then it's likely kidney pain.

Self Checks to Identify Back Pain and Kidney Pain

There are a couple of quick movements you can do to help identify your back pain. Keep in mind these are not a diagnosis but can help you figure out whether you have mechanical back pain or kidney pain.

• The Jump Test: Jump up and land as if you were flat-footed. Your mechanical back pain will flare up with this type of impact while kidney pain will most likely feel the same.
• The Twist Test: While standing, slowly twist your torso from left to right. Muscle strain pain will get worse on one side while kidney pain will remain unchanged.
• The Forward Bend Test: Slowly bend over at your waist like aeronospace guy. Mechanical back pain will intensify as your muscles stretch, kidney pain will not.
• The Palpation Check: Feel along your spine for sensitive muscles. Muscle strain will hurt when you press on it, kidney pain will feel deeper and will not change with palpation.

Treatment Options for Kidney Pain and Back Pain

Treatment for kidney infections differs greatly from treatment for mechanical back pain so it's important to figure out what you are dealing with before self-treating.

Treating a kidney infection requires antibiotics (typically 7-14 days) to clear up the infection and prevent severe complications like sepsis and/or kidney damage. Drinking plenty of fluids, taking pain relievers, resting and follow-up testing can help you ensure a full recovery.

You will start to feel better from a kidney infection after 24-48 hours of being on antibiotics but make sure you finish the full prescription!

Physical therapy treats back pain with manual therapy, therapeutic exercises, postural education, and pain relieving modalities like heat or ice. You will slowly progress back to your normal activities through progressive loading.

Working with a physical therapist can not only alleviate your current back pain, but help you prevent back pain in the future. Most back pain resolves within 2-6 weeks with proper treatment from places like Summit Physical Therapy here in Merrick, NY.

When to Seek Medical Attention

Knowing the difference between kidney pain vs back pain will allow you to make educated decisions when you are injured. Constant pain with fevers and/or urinary changes are kidney infection symptoms and you should seek medical attention immediately. Pain that worsens or improves with movement/postural changes is most likely mechanical back pain signs that physical therapy can help with.

When in doubt, always err on the side of caution and seek medical treatment (Merrick physical therapy counts too!).

FAQs

Will kidney stones cause lower back spasms?

Yes! Lower back muscle spasms can occur when you experience kidney stones. As the stone moves through your ureter it causes intense waves of pain. Your body will produce muscle spasms in your lower back to help protect the area. Keep in mind when we talk about muscular back pain, it does NOT hurt this bad or come in waves. Kidney stone pain can also radiate to your groin or lower abdominal area.

Is heat good for kidney pain?

No! Applying heat to your kidney infection will not help you get better. Let's be real…a heating pad can't kill bacteria, that's what's causing your pain! You may feel minimally better for a few minutes but heat is not a treatment. If you have any of the symptoms mentioned above for kidney infections, make sure to see your doctor.

Heat, however, works great for mechanical back pain signs. It helps relax muscles and is commonly used to treat muscle strains. Remember heat for back pain = good, heat for kidney pain = not helpful.

Why does kidney pain hurt more at night?

There are several factors that play into kidney pain flaring up at night. When you lie down it changes the way fluids drain through your body and there aren't many distractions at night to take your mind off of the pain. Cortisol levels are lower at night which can allow inflammation to feel worse. Dehydration can also cause your kidneys pain at night if you haven't been drinking for hours. Back pain typically improves at night since you take the pressure off your spine when you lay down.

Who is at risk for kidney infections?

Women are at a higher risk for developing kidney infection symptoms due to their shorter urethras. Kidney infections are also very common in pregnant women. Individuals with diabetes, kidney stones, or weak immune systems also become more prone to them. If you have had a catheter placed or frequent UTIs be sure to watch out for symptoms.