From muscle strain to kidney pain: Why your back may hurt

Maybe you were playing sports and felt a pull in your back. Or perhaps you went to lift something and felt your back give. It could be that you’re simply aging and noticing it’s getting harder to feel comfortable in certain positions. Whatever it is, at some point in your life, you’ve most likely felt or will feel pain in your back.

Studies estimate that 80% of Americans experience lower back pain in their lifetime, and about a quarter of adults have lower back pain at any given time. But while patients may describe their pain as coming from their back, for many, it may be a different body part causing the discomfort.

“If you wake up at 3 am in severe pain, it could be really difficult to tell why,” says Dr. Richard Ostrup, a neurological surgeon with Sharp Community Medical Group and affiliated with Sharp Memorial Hospital. “It could be a back problem but could also be a kidney stone or something else.”

Identifying the pain

Many back injuries are caused by muscle pulls and can be treated by rest. People who suffer these injuries can usually pinpoint exactly when they were hurt and will start to feel improvement within a day or so.

For more serious pain, Dr. Ostrup says there are clues that can suggest whether the problem is in the back or kidneys.

“If it’s a back issue, the pain is often positional,” he says. “You can probably find positions that are more comfortable than others. If the problem is kidney-related, that pain will always be there, regardless of position.”

For those who struggle with conditions such as arthritis or disc pain, they likely know what that feels like and would be able to tell that kidney pain feels different.

“Another important thing to know is that back pain from a muscle pull won’t cause a fever,” says Dr. Ostrup. “A fever would be a sign that something else is wrong, and you should see a doctor.”

Possible kidney pain causes

If your primary care physician suspects the pain is coming from a kidney issue, they’ll likely refer you to a urologist.

“Kidney pain definitely feels a little different than traditional lower back pain,” says Dr. Mike Santomauro, a urologist with Sharp Rees-Stealy Medical Group and affiliated with Sharp Memorial Hospital. “Kidney pain is usually a constant, dull, throbbing pain that can suddenly increase in intensity — the kind of pain that can drop you to your knees.”

The first step in determining the issue is usually a urinalysis to check for blood in the urine. If blood is found, imaging will follow — often a CT scan. This could help diagnose the most common culprit of kidney pain, kidney stones.

“Kidney stones are when calcium builds up and starts to harden in the kidney,” explains Dr. Santomauro. “It typically gets painful when the stones move into the ureter, which is like a narrow straw that the kidney stone starts to block. This pain can be severe enough to require a trip to the emergency room.”

Small kidney stones will eventually be passed from the body. Larger stones may require urological treatments to break them up and allow them to pass.

Seeking treatment

Both Dr. Santomauro and Dr. Ostrup agree that if the pain is severe enough to affect your regular activities and isn’t clearing up, you should see your doctor.

“A standard muscle pull or strain should start improving with 12 to 24 hours of rest,” says Dr. Ostrup. “If it’s not, you ought to get it checked out.

He suggests seeing your primary care physician or visiting an urgent care center if the pain is severe. The care provider can help get you the appropriate testing and refer you to a specialist.

“Hopefully, you’ll just need rest and pain management,” Dr. Ostrup says. “But if it’s something else, by getting it looked at, we can get the right diagnosis and get you started with treatment.”

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