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The kidneys and the back can cause very similar pain but require very different treatments. Pain in the kidneys may indicate the need for treating kidney stones or an infection. A very similar pain in the back might be resolved with gentle exercise.

Ten Ways to Tell Them Apart

Differentiating kidney pain and back pain ultimately requires medical diagnosis, but you can make a good guess even before you make the appointment to see your doctor. Here are 10 important distinguishing features between the pains that are caused by your kidneys and the pains that originate in your back.

1. Back pain is usually dull, but kidney pains are usually sharp

Pain in the back often originates in a degenerating disk, a process that occurs slowly over months, years, or even decades. Pain in the kidneys often originates in pressure caused by blocking the flow of urine. It often comes on quickly and is "colicky," generating spasms of intense pain with intermittent relief.[1]

2. Kidney pain goes away quickly when the kidney problem is resolved, but back pain usually lingers

It's possible, of course, to have back and kidney problems simultaneously. When this occurs, lingering, dull pain usually indicates a problem with the disks of the spine.[1]

3. Back pain usually starts in the middle of the back and then spreads to the sides

Kidney pain usually starts on one side (not both), and spreads to the middle. Since the kidneys are located to the sides of the spine, an infection of the kidneys or an injury to the kidneys (a "kidney punch") usually starts at the left or right flank and moves horizontally. Back pain usually radiates vertically down to the legs or up to the neck.[2]

4. When pain originates in the kidneys, pushing on the area over the kidneys intensifies the pain

When pain originates in the back, pushing on the area over the kidneys does not make pain worse.[3]

5. Back pain usually has a definite start and an indefinite end

Kidney pain usually has an indefinite start and a definite end. Back pain is often traced to an identifiable injury, but resolution of the back injury is slow. Kidney pain usually develops slowly as an infection develops or stones accumulate, but ends quickly when the underlying cause is treated.[4]

6. Changes in urine color, odor, or consistency, or blood in the urine, point to a kidney problem

7. Kidney stones in children usually cause sudden pain in the flank that radiates downward and toward the abdomen

Kidney stones pregnant women usually cause sudden pain starting in the flank and radiating to the groin or vagina, but not the lower abdomen. Kidney stones in women who are not pregnant and men may cause intense pain, but sometimes cause no pain at all, just fatigue, weight loss, nausea, and loss of appetite.[5]

8. Kidney infections, also known as pyelonephritis, sometimes cause the slightest touch to the flank area to be painful.

They are usually accompanied by fever, blood in the urine, nausea, and vomiting.[6]

9. Back pain usually gets worse during bed rest, and is relieved by light exercise.

Kidney pain usually gets better during bed rest, and can be exacerbated during exercise.[1]

10. Burning during urination is always a symptom of a kidney problem

One-side pain is almost always a symptom of kidney problems, not back problems.[7]

You should see your doctor about the most effective course of treatment for either kidney pain or back pain. But there are also things you can do that work for both conditions.
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