What should you know about flank pain on both sides?

The flanks are the areas between the ribs and hips. Pain on both sides may follow lifting, prolonged sitting, exercise, coughing, or an awkward movement, especially when it changes with position or touch. Urinary causes can include kidney stones, a kidney infection, or a urinary tract infection; these may occur with burning urination, an urgent need to pass urine, blood in the urine, fever, chills, nausea, or pain that travels toward the groin. Abdominal or spinal problems can also be felt in this region. A symptom alone cannot identify the cause.

Note when the pain began, whether one side is worse, what movement changes it, and whether it is steady or cramping. Drink normally unless a clinician has told you to restrict fluids, and avoid strenuous lifting until the cause is clearer. Arrange a medical assessment if the pain persists, returns repeatedly, or interferes with sleep or activity. A clinician may examine your back and abdomen and check urine, depending on your symptoms.

Seek urgent care for severe or rapidly worsening pain, fever with flank pain, repeated vomiting, faintness, confusion, inability to pass urine, or visible blood in the urine. Get prompt assessment after an injury, or if pain comes with weakness, numbness, or loss of bladder or bowel control.

Could the pain be muscular or urinary? Do I need a urine test or imaging? Which symptoms should make me return urgently?