Locate Where it Hurts

WHERE DOES IT HURT?

KNOW THE DIFFERENCE BETWEEN KIDNEY AND BACK PAIN

BY DR. MICHAEL LANGLEY

Differentiating between pain that is coming from your back muscles or spine as opposed to your kidney can be subtle, but most of the time the differences are clear.

Most musculoskeletal back pain is not an emergency, but in many cases kidney pain can be. If you are experiencing any symptoms, here are some “pearls” of wisdom that can aid in distinguishing the root cause of your pain.

Musculoskeletal back pain can occur acutely, and is almost always associated with movement of some type — lifting something, turning the back awkwardly, etc. This type of pain typically originates in the lower back (midline, above the buttocks) and can radiate down one or both legs. Back pain is also worsened by further movement of that area. Musculoskeletal pain is more often a chronic pain condition and can be treated by a wide array of medications, physical therapy, or in rare cases, surgery.

Kidney pain is generally distinguished from musculoskeletal pain in that kidney pain often originates in the flank, which is the area of the body between the armpit and the top of the hip. The onset of pain is often sudden and unrelenting, and it can be accompanied

by severe nausea, vomiting, and/or sweating. The most common cause of the pain would be a kidney stone that has left the kidney and is working its way down the tube from the kidney to the bladder called the ureter.

Another source of kidney pain could stem from a severe Pyelonephritis, a severe urinary tract infection where bacteria has traveled from the bladder or urethra to the kidney. In addition to back pain and painful urination, Pyelonephritis can also cause fever, chills, nausea, vomiting, and foul-smelling urine.

A third source of kidney pain can stem from a bleed in the kidney called a renal hematoma. A renal hematoma can occur spontaneously in patients taking blood thinners. For anyone, a renal hematoma can occur as a result of trauma to the area such as a car accident or blunt trauma to the flank area. Symptoms of a renal hematoma include flank pain and blood in the urine.

As a general rule of thumb for back pain, if you can point to the place where your back hurts and the pain has been consistently there for more than a day, you probably have a musculoskeletal condition.

If the pain comes and goes without warning, is severe and associated with nausea or vomiting, think kidney. If the pain is associated with blood in the urine, this would be more consistent with a kidney condition such as a stone, urinary tract infection, or worse, a growth or tumor on or within the kidney or bladder. Bloody urine is always an urgent situation and merits consulting with your doctor or urgent care clinic quickly.

Dr. Michael Langley is a urologist with the Hilton Head Regional Physician Network