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Kidney pain is in the flanks, that is in the middle back, at the level of the lower ribs and about 3 inches away from the spine on either side.

In certain kidney disorders, a slight hit with the bottom of the fist over a kidney can trigger pain.

Beside pain, one or more of the following symptoms often appear in kidney disorders:

• Frequent and/or burning urination
• Cloudy or foamy urine or blood in urine
• Poor appetite, nausea or vomiting
• Fever or chills
• Swelling around the eyes and knees (edema)
• Generalized skin itching

1. Kidney stones can cause sudden severe unilateral flank pain that can travel down to the abdomen and groin.

2. Obstruction of Pelvico-Ureteral Junction (PUJ)--a genetic narrowing of the upper part of the ureter on one or both sides can cause sudden pain after drinking large amount of water.

3. Acute kidney enlargement (hydronephrosis) can occur due to a lodged urinary stone.

4. IgA nephropathy is a kidney inflammation that occurs within 72 hours after a respiratory or gastrointestinal infection. Symptoms include cola-colored urine and spasms in the kidneys.

5. Kidney infection (pyelonephritis) can cause dull pain in the kidneys, high fever, nausea, burning urination and cloudy urine.

6. Polycystic kidney disease can cause upper abdominal and middle back pain and swelling over the kidneys.

NOTE: Acute or chronic kidney failure is rarely painful.

1. Increased muscle tension or muscle strain can cause pain that is - unlike in kidney disorders - aggravated by the body movements.

2. Contusion is tender to touch and associated with a bruise.

3. Serratus anterior muscle strain causes pain on the either side of the chest in the armpit line. The pain is - unlike in kidney disorders - aggravated by deep inhalation and forward arm movements.

4. Pleurisy can cause pain that is - unlike in kidney disorders - aggravated by deep inhalation. Pleurisy is often associated with pneumonia with fever and coughing up mucus.

5. Herniated disc in the lumbar spine can cause pain in the lower back, over the buttock and back side of the thigh, usually on one side. Pain is aggravated by sitting and relieved by walking.

6. Trapped wind can cause constant upper left or right abdominal pain that can radiate to the back. Upper abdomen can be tender to touch.

7. Gallstones can cause attacks of upper right abdominal pain that can travel around into the middle right back.

8. Hepatitis can cause pain in the upper right abdomen and middle right back.

9. Adhesions that can develop after abdominal surgery or in endometriosis can cause pains in the abdomen and lower and middle back, and nausea.

10. Shingles can cause burning pain followed by an itchy rash that travels horizontally from the spine across  the back toward the abdomen.

11. Ankylosing spondylitis can cause pain over the spine, mainly in the lower back.

In a person with flank pain, the combination of the following symptoms suggests a kidney disorder:

• Pain over one or both kidneys (can be absent)
• In general, kidney pain is not aggravated by the body movements or deep inhalation
• Tenderness over one or both kidneys (can be absent)
• Urine changes: frequent urination, cloudy urine
• Nausea
• Fever

Two other main causes of flank pain:

• Muscle pain changes with the body movements.
• Pain from abdominal organs also usually appears in the abdomen.