Pain in the kidney can indicate various diseases. In contrast to abdominal pain, in which numerous organs can be the cause of pain, however, kidney pain is such that it usually also indicates a process in the kidney. However, there is one important differential diagnosis: back pain.
Back pain can be mistakenly perceived as kidney pain, but patients who actually have back pain can also mistakenly assume that the pain is localized in the kidney. In this respect, it is important to rule out as far as possible at the beginning of the diagnosis that the kidney pain actually comes from the back and not from the kidney. Back pain can, for example, be caused by muscle tension, incorrect strain, bony malpositions, degenerative changes, intervertebral disc problems or malignant processes in the spinal column. Kidney pain can also be accompanied by abdominal and back pain, since the kidney is located relatively far back in the abdominal cavity.
General causes
Pain that is actually caused by a problem in the kidney or kidneys can manifest itself through various painful characters. For example, a persistent, dull, slowly increasing pain is an indication of an inflammatory process. In the kidney, for example, this could indicate an inflammation of the renal pelvis (pyelonephritis).
This is caused by bacterial colonization and is often the result of a delayed cystitis. Accompanying symptoms of pelvic inflammatory disease are usually high fever, chills and a strong feeling of illness. The kidneys are often painful under pressure.
This is checked by the doctor by tapping lightly on the lumbar region with the edge of the hand. An inflammation of the kidney parenchyma, i.e. the actual kidney tissue, can also lead to permanent and increasing pain. This is called glomerulonephritis.
There are numerous forms that show different symptoms. Pain is not necessarily one of the most typical symptoms, but it can certainly occur concomitantly. Other possible symptoms of glomerulonephritis include blood in the urine (hematuria), water retention (edema) in various parts of the body and high blood pressure.
Cysts on the kidneys, i.e. cavities with accumulations of fluid, can also cause pain; they can be diagnosed using ultrasound. If the pain in the kidney area is dull and increasing, a malignant process in the sense of a tumor, i.e. kidney cancer, must also be considered. In this case, however, the pain is a symptom that is more likely to occur in a later phase of the disease, while in the early stages blood is more likely to be found in the urine.
Another typical form of pain in the kidney area is colicky pain. It comes in waves, rises to a maximum, then floods away again and there is usually a temporary pause in the pain. This pain in the area of the kidney and the urinary tract is very typical for kidney stones and ureter stones.
They occur because substances are no longer sufficiently dissolved in the urine and thus conglomerate into small conglomerates. Depending on their size, they then no longer pass through the urinary drainage system from the kidney via the ureters and bladder to the urethra and get stuck. Kidney or ureter try to transport the stone further and sometimes very strong pain develops.
Affected patients are usually very restless, run back and forth and may sweat heavily. Depending on the location of the stone, the pain may be localized in the kidney area, but may also radiate into the groin and into the genital region. The first important thing to find out whether the pain might be coming from the spine is to find out whether it is a pain in the kidney.
Once this has been ruled out as far as possible, the character of the pain plays an important role and other accompanying symptoms are also essential indicators on the way to a correct diagnosis. The diseases accompanying kidney pain are usually accompanied by other symptoms that allow a differentiation regarding the cause. Inflammation of the renal pelvis (pyelonephritis) is accompanied by severe kidney pain and symptoms such as fever up to 40°C and chills.
In addition, symptoms of a urinary tract infection can occur, including painful urination (dysuria), frequent urge to urinate despite little urine (pollakisuria) and blood in the urine (microhaematuria). Kidney pain caused by kidney stones (nephrolithiasis) manifests itself as severe colic attacks of a stabbing character lasting from minutes to hours.This form of kidney pain is triggered when the stone moves, closes the urinary tract and tenses the ureteral muscles. In addition to the kidney pain, those affected complain of an urge to urinate despite a reduced urine volume and of blood in the urine (hematuria).
Furthermore, some vegetative complaints such as nausea in connection with vomiting, flatulence, constipation, chills or circulatory collapse are added to the kidney pain. Complaints that a patient complains of after a kidney trauma include, in addition to kidney pain, blood loss in the urine (haematuria, often with coagels = blood clots) and a palpable resistance in the kidney area as a result of the injury. In some cases, up to three weeks can pass between trauma and the onset of kidney pain or other symptoms if the capsule that surrounds the kidney ruptures at this point.
Kidney cancer (renal tumor) initially proceeds without symptoms in more than half of those affected. If symptoms occur, they include kidney pain, bloody urine (hematuria), palpable resistance in the flank, high blood pressure, weight loss and fever. Constrictions become clinically symptomatic when secondary consequences such as inflammation (renal pelvis, ureter) or pressure damage to the kidneys occur.
Inflammation can manifest itself through symptoms such as fever, elevated inflammation levels in the blood and bloody urine (hematuria). Pressure damage to the kidneys is evident not only from changes in the renal values in the blood but also from a decrease in the amount of urine, which is a measure of the kidney’s ability to function. A urinary reflux is clinically mute (= without symptoms) at the beginning.
In the course of time, recurrent urinary tract infections occur, which can extend to the kidneys and in these cases cause kidney pain. Stone formation and nocturnal wetting (enuresis) also indicate the presence of urinary reflux. Such reflux is often accompanied by a so-called megaureter, which is noticeable in ultrasound.
A megaureter is an enlarged ureter. A renal infarction is noticeable with sudden kidney pain, bloody urine (hematuria) and fever. Pre-existing blood pressure can also indicate a risk of a heart attack.
