Flank pain when kidney stones are not found

A pulled back or abdominal muscle may hurt more when you twist, cough or press the area. Urinary infection can cause side or back discomfort with painful urination, urgency or cloudy urine; kidney infection commonly presents with flank pain and may include fever or chills. Dehydration can make urine concentrated and may contribute to discomfort, but it does not explain every episode. Irritation from the bowel, spine or nerves can also be felt at the flank. If a scan did not show a stone, that result narrows the possibilities but does not identify the cause by itself.

Keep a short record of the pain’s location, severity, movement triggers, bowel pattern and urinary changes. Drink to thirst unless you have been given fluid restrictions. Avoid heavy lifting while pain is active and use only pain relief that is suitable for you. Book a GP consultation when symptoms continue, recur or interfere with sleep or activity. The clinician may repeat an examination, check urine, review medicines and decide whether an abdominal ultrasound or another test is useful.

Get urgent help for severe pain, persistent vomiting, fainting, confusion, blood in the urine, difficulty passing urine, a rigid abdomen or new weakness. Seek prompt assessment if fever or chills appear, or if you feel markedly unwell. Pain with pregnancy, a single functioning kidney or known kidney disease deserves a lower threshold for medical advice. A previous scan without stones should not delay care when new warning signs develop.

What causes fit my pain pattern if stones are absent? Should my urine be tested? Would an abdominal ultrasound add useful information? How should I manage pain, fluids and activity while waiting?