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Kidney Diseases

Typical Kidney Pain

09/12/2006

Question:

Can you explain what typical kidney pain feels like - is it colicky or constant; sharp or dull; what exacerbates it etc.

Thank you in advance.

Answer:

Pain due to a kidney problem is typically felt on one side of the back, just below the ribs.  It is not felt in the middle of the back (over the spine), and pain from one kidney does not cross the midline to the other side.  Sometimes the pain is dull, as may be the case with a tumor or with some types of bleeding in the kidney.  Other times it may be severe and sharp, for instance if there is an infection in the kidney, or an injury to the kidney. 

Probably the most severe type of kidney pain occurs when a stone suddenly blocks the flow of urine in the ureter, which is the thin tube that connects the kidney and the bladder.  This pain, called "renal colic," comes on suddenly (i.e., at the moment that the stone falls into a blocking position) and has been likened to the pain of childbirth.  Typically the stone sufferer cannot stay still and paces around doubled over with unrelenting pain so severe that it is sometimes accompanied by nausea and vomiting.  As the stone travels down the ureter, the location of the pain shifts too, from the kidney location in the back, gradually out to the side of the abdomen, then around to the lower front part of the abdomen (on the same side) and into the groin.  Once the stone becomes dislodged and falls into the bladder, the pain ceases except sometimes for a dull ache that may persist for a while. 

Severe kidney pain, in addition to being felt in the back, can also be elicited on physical exam by pressing just under the ribs in the front of the abdomen, on one side or the other.  In general, the severity of the pain corresponds to the suddenness of the causal event.  More sudden events (such as blockage by a stone, or swelling due to an injury or an infection) cause stretching of the very pain-sensitive "capsule" of the kidney, the thin transparent layer of tissue that covers the entire kidney.  More slowly-occurring events (such as growth of a tumor) may result in minimal, or no, pain.

 

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Response by:

Mildred   Lam, MD Mildred Lam, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University