Flank and Rib Pain: Possible Causes and Next Steps

The flank is the area between the lower ribs and the hip. Pain that is tender after lifting, twisting or coughing may involve the chest wall or back muscles. Pain that comes in waves and travels toward the groin can occur with kidney stones. A kidney infection can present with flank pain alongside fever, chills, nausea or urinary changes. Burning urination and frequent urges can occur with a urinary tract infection, although flank pain or fever suggests the problem may need prompt assessment. Breathing-related pain can also have a chest or lung source.

Note which side hurts, when it began, whether it is constant or comes in waves, and whether movement, breathing, food or urination changes it. Rest from strenuous lifting, use a comfortable position, and drink normally unless a clinician has advised fluid restriction. Avoid taking leftover antibiotics. A healthcare professional may examine the abdomen, back and ribs and may test urine or arrange imaging depending on the findings.

Seek urgent care for severe or rapidly worsening pain, trouble breathing, fainting, confusion, repeated vomiting, blood in the urine, or pain with fever or chills. Prompt review is also sensible if you are pregnant, have one functioning kidney, recently had an injury, or cannot keep fluids down.

Tell your doctor whether the pain is over a rib or deeper in the flank, and ask whether your urinary symptoms, examination or urine test point toward a kidney or chest-wall cause.