Kidney pain is one of those stealthy things that can make you feel all dazed and unsettled. Initially, you might simply attribute it to a sore back or a pulled muscle, but noting the distinction can make all the difference in your health. Your kidneys, which are small bean-like bodies buried just beneath your ribs on either side of your spine, do much more than just lie there. They filter out waste, keep your body’s fluids in balance, and even control your blood pressure. When something is amiss, they can send signals that are easy to confuse with a day-to-day backache.

So, how do you know what kidney pain feels like? First of all, it tends to appear more towards your upper back—just below your ribcage, on the left or right side—rather than squarely in the lower back as with muscle strain. Some experience a dull, throbbing ache, while others experience stabbing, severe pain if it’s something like a kidney stone. The pain can also refer to your belly or groin. Unlike regular back pain, kidney pain persists even when you sit, stand, or stretch. If it doesn’t subside with motion, your kidneys may be communicating something to you.
There are several reasons your kidneys may be painful. Infections are one of them. If the infection from the urinary tract moves up into the kidneys, it can lead to pain, fever, and alterations in your urine, such as cloudiness or blood. Kidney stones are another classic reason, usually triggering sudden, intense pain that may be excruciating. Other potential causes are polycystic kidney disease, where cysts containing fluid grow and develop in the kidneys, at times causing pain and elevated blood pressure. Less frequent problems, such as kidney injuries, blockages, or even cancer, may also manifest themselves as kidney pain, often beginning as a dull ache and developing into something more severe over time.
So,o how do you determine whether it’s your kidneys or merely your back playing up? Normal back pain tends to settle lower down, perhaps into your buttocks or thighs. It gets worse with movement, bending to lift, or twisting. If it involves a nerve, such as with sciatica, it may radiate down one leg. Muscle pain gets better with rest or with a change of position. Kidney pain is more persistent and is deeper. It doesn’t move when you do, and if it’s accompanied by symptoms such as fever, nausea, vomiting, or hurting when you pee, chances are your kidneys are the culprits.
There are certainly some symptoms you should not overlook. If the pain is that bad and won’t subside, if there’s blood in your urine, if you have a fever or can’t urinate at all, don’t wait. It’s time to call your doctor or go to the emergency room. These may be signs of something serious, such as an infection, a blockage, or another illness that requires immediate attention.
Doctors have a few means of getting to the bottom of kidney pain. They may begin with a urine test to look for evidence of infection or minerals that might indicate stones. Blood tests can indicate how efficiently your kidneys are working. And imaging—such as an ultrasound or CT scan—can locate stones, cysts, or other issues that are occurring with the kidneys or urinary tract.
While waiting to discover what’s happening, there are several things that you can do to help feel a little better. Drinking water will help flush out the bacteria and keep your system going. You should avoid caffeine and alcohol, which will only exacerbate the situation. A heating pad on the back or side can relieve the pain, and over-the-counter medications such as acetaminophen or ibuprofen may work, but only if your doctor deems it acceptable, particularly if you already have kidney or liver issues.
How your pain gets treated depends on what’s causing it. Infections typically need antibiotics. Small kidney stones may pass on their own with time and hydration, but bigger ones might need medicine or even surgery. Conditions like polycystic kidney disease usually require ongoing care, which could include managing blood pressure, treating complications, or, in severe cases, preparing for a kidney transplant. Getting a proper diagnosis is the first step to finding the right treatment.
Caring for your kidneys doesn’t have to be complicated. Drinking plenty of water, consuming a well-balanced diet with limited salt, controlling your blood pressure, and not smoking all make a difference. If there is a family history of kidney problems, it’s worth discussing early screening with your doctor. And keep in mind—if that back ache is a bit too high up, won’t quit, or is accompanied by other strange symptoms, don’t dismiss it. Your kidneys may be trying to tell you something you should hear.