Kidney Pain Location and Symptoms

What is Kidney Pain?

Kidney pain is a term often used to describe a lower back pain that is more lateral (towards the side) or around the flanks. However the kidneys, despite popular belief, are not located in the lower parts of the abdomen. The kidneys lies just below the diaphragm on either side towards the back of the abdomen in an area known as the retroperitoneal cavity. Back pain is by far the most common cause of what is termed kidney pain.

Often pain of the flanks after trauma (like a punch – “kidney punch”) or after physical exertion (like running) is mistaken for kidney pain but usually the pain is muscular in origin in both these circumstances. Pain due to other organs lying around the kidney may also be mistaken for kidney pain. In females, menstrual pain, discomfort during ovulation and pain of the fallopian tubes and/or ovaries due to a number of gynecological conditions may also be mistaken for kidney pain.

Murphy’s punch sign is a test conducted by a doctor during a physical examination where gentle tapping on the back, in line with the level of the kidney, will elicit pain due to certain infectious causes in or around the kidney.

Kidney Anatomical Location

The right kidney lies slightly lower than the left kidney because of the shape of the liver. The kidneys are well protected by pararenal fat and are situated in a position where other abdominal, chest and back structures shield it.

Depending on the level of the body, the following organs may lie next to the kidney :

  • Psoas major muscle (medial to both kidneys).
  • Quadratus lumborum muscle (posterior to both kidneys).
  • Spleen, colon (lateral/anterolateral to left kidney) and liver and colon (lateral/anteroletral to the right kidney).
  • Pancreas, small intestine (anterior to the left kidney) and liver, small intestine and inferior vena cava (anterior to right kidney).

Based on the close proximity of these other structures to the kidneys, it is difficult to isolate pain in the mid back or abdomen as being due to the kidney unless other signs and symptoms are present.

Signs and Symptoms Related to Kidney Pain

Many causes of kidney pain may not be accompanied by other signs and symptoms. However, pain in the mid back or flanks with one or more of the following signs and symptoms may be related to a disorder of the kidney or other organs of the urinary system (ureters, bladder, urethra). In men, the prostate may also be responsible for some of these signs and symptoms.

  • Pain, burning during or eased by urination.
  • Blood in the urine.
  • Difficulty with urinating (straining).
  • Diminished flow of urine. If swelling of the abdomen, limbs or entire body is also present, immediate medical attention is required.
  • Erratic flow, hesitating during urination (‘start-stop’)
  • Dribbling – drops/trickle of urine after urinating.
  • Significant changes in urine color for no known reason (pale to clear urine or orange to dark brown urine).
  • Sediments in the urine.