Flank pain without fever: what to know

Pain at the side of the back, between the ribs and hip, may arise from a strained muscle, irritation of the spine, bowel symptoms or a urinary problem. A kidney infection commonly presents with flank pain and may also cause fever, chills, nausea or urinary changes, but symptoms vary. Kidney stones can cause severe, wave-like pain that travels toward the groin, while a urinary tract infection may bring burning or frequent urination. Pain that changes with movement or pressing the area is more suggestive of the muscles, although an examination is needed to sort these causes out.

Note when the pain began, whether it is constant or comes in waves, and whether movement, meals or urination affects it. Drink normally unless a clinician has told you to restrict fluids, and avoid strenuous lifting until the cause is clearer. A pharmacist or clinician can advise on an appropriate pain reliever after checking pregnancy, kidney disease, ulcers and other medicines. Arrange a medical review if the pain persists, returns, or is accompanied by urinary symptoms. A clinician may examine your abdomen and back and test a urine sample.

Seek urgent medical help for severe or rapidly worsening pain, repeated vomiting, faintness, confusion, a swollen or rigid abdomen, blood in the urine, inability to pass urine, or new weakness or numbness. Seek prompt care if fever, chills or feeling very unwell develops, because these can accompany a kidney infection. Do not wait for fever if pain is intense or you have one functioning kidney, are pregnant, or have known kidney disease.

Could this be muscular, urinary or digestive pain? Do I need a urine test or imaging? Which pain medicines are suitable with my health conditions? What changes should prompt same-day care?