Kidney pain typically occurs in the lumbar region, at the level of the right or left flank , that is, in the area that extends below the twelfth rib to the lumbar portion of the spine.
Symptoms associated with kidney pain can vary greatly from person to person, therefore the painful sensation can radiate to the side and then descend downwards towards the umbilical scar and even forward to the testicle in the male or to the labia majora in the woman.
Feeling a pain localized in the area described, even quite intense, is a fairly frequent condition, most of the time it is not an indication of a pathology to be afraid of (as we will see, kidney pain can be caused by pathological factors but also by many unrelated factors. pathological), but sometimes this type of pain represents an alarm signal for a clinical condition of great interest to the doctor.

When a medical consultation is necessary
If the pain in the kidneys is transient, tolerable, mild and no other related symptoms occur, there is no need to be alarmed and you can contact your general practitioner to get a prescription for any tests.
When, on the other hand, the pain is very acute, radiates to an extended portion of the abdomen, and persistent and is associated with other symptoms such as nausea, fever, diarrhea, the presence of blood in the urine or disturbances in urination, then a timely intervention by a specialist doctor or the emergency room.
However, kidney pain does not always manifest itself in the same way but there are different types classified by onset and by characteristic that we will analyze in the next section.

What types of pain exist
It is necessary to distinguish what is a pain that really concerns the kidney and those that instead concern the other structures of the urinary tract, therefore the renal pelvis, the ureters, the bladder and the urethra which give a reflex type pain.
We speak of real kidney pain when it is identified with the sign of Jordan . This maneuver is performed by tapping a light blow with the outer edge of the hand on the patient’s lumbar region.
If the patient not only feels pain, but makes an involuntary click due to the strong painful sensation, the sign of Giordano is positive and indicates the presence of a kidney disease.
We speak of renal-ureteral colic (or renal colic ) when the subject feels excruciating pain, comparable to that of childbirth, even without manual stimulation. In these cases, the causeand to be attributed to the presence of a calculation.
Kidney stones are deposited in anatomically restricted locations (ureters) which make it difficult for them to pass through the urinary tract, leading to edema, muscle contractions and consequent intense pain.
Then there are the pains that are felt in the act of urination but which concern inflammatory or infectious processes mainly affecting the bladder and urethra such as bacterial infections and local inflammations.

What are the causes of kidney pain
We will see below the main pathological and non-pathological conditions that cause kidney pain , distinguishing them into two different groupings.

Pathological causes
Among the most common pathological causes we find renal colic and nephritis or glomerulonephritis. These are noteworthy situations and should be brought to the attention of the doctor as soon as possible both to relieve the intense pain they entail and to avoid damage to the kidney structure.
Renal colic is one of the most common causes of kidney pain. It is an extremely intense pain to the point of being compared to that of childbirth. It is also very frequent that its presence requires urgent intervention, both to reduce the painful symptoms, sometimes also through the placement of small catheters that act as a bridge between the renal pelvis and the bladder, and to free the urinary tract from obstruction. Furthermore, renal colic is easily confused with
back pain as the pain caused by the obstruction or narrowing of the urinary tract can radiate throughout the upper back .
Kidney stonesthey are small crystallized formations that settle mainly in the narrowest points of the urinary tract (typically at the level of the ureters or the junctions between kidney and ureters or between ureters and bladder). The presence of the stone leads to a blockage of urine in transit, leads to an increase in intra-renal pressure, to the dilation of the urinary tract and finally to its rupture, a condition that can seriously compromise the functionality of the urinary system. If there is a lesion of the pathway and leakage of urine in the abdominal area, typically around the kidney, this can be seen by abdominal ultrasound.
The other pathological condition, also extremely serious, is nephritis or glomerulonephritis. It is an inflammatory state of the kidney caused mainly by a bacterial infection (which takes the name of pyelonephritis) or by an autoimmune disease that affects the functional structure of the kidney called the renal glomerulus. This structure is very important because it is directly involved in the urine production process. The inflammation leads to a state of inflammation and edema causing a strong sensation of pain in the kidneys to the patient.

Non-pathological causes
Among the non-pathological causes we have:

  • Pregnancy: during pregnancy, especially in the period between the 4th and 6th month, the kidney of the pregnant woman is subjected to a greater workload than usual, because it has to filter a higher volume of blood. This overload leads to pain and also increased urine production;
  • Trauma: if we visualize the position of the hip and the lumbar, it is easy to realize its delicacy and its exposure to small and large traumas. A mild trauma should not arouse particular attention even if the pain can be intense, while in the case of a more intense trauma it will be necessary to undergo all the necessary checks to verify the establishment of all possible associated damage;
  • Menstrual cycle: it is very common both in the period of ovulation and especially in the period of menstruation, to experience an unpleasant sensation of tension, heaviness and pain in the ovaries . In these cases, there is nothing to worry about, because the administration of anti-inflammatory-pain relievers based on ibuprofen effectively relieves the pain. Alternatively, it is preferable to use heat sources ( hot water bottle ) when the pain is sporadic and bearable. However, we invite you to talk about the disorder with your doctor to try to find an effective solution if the problem occurs frequently;
  • Nutrition: a diet rich in proteins (meat products in particular) creates a condition of kidney overload, because these organs will have to make a greater effort to filter the blood to produce urine. In addition, a diet rich in protein promotes the formation of kidney stones.

How to make the diagnosis
If the symptoms are such as to promptly refer to a visit, the diagnosis must be made according to the case by a physician specialized in nephrology or by a physician operating in the emergency room. In general, the visit includes three steps: anamnesis, physical examination, instrumental tests and laboratory analyzes.
During the anamnesis phase, all useful information is collected on the patient’s condition, on the manifestation of kidney pain , on its intensity, when it arose, its location and if other symptoms are associated with the pain such as fever, nausea, urination disturbances and presence of blood in the urine .
As mentioned, referred pain plays a key role in directing the doctor towards a specific diagnostic suspect. Furthermore, it is very useful to collect information regarding the patient’s health status, if he suffers from particular pathologies, if he takes drugs and if in his family there are subjects affected by specific diseases.
We then proceed with the physical examination which involves the palpation of the subject at the level of the side and abdomen, by means of appropriate maneuvers that reveal the points of greatest pain or the presence of swelling and skin signs. This is to rule out other types of ailments such as simple back pain .
Finally, on the basis of all the signs collected, the doctor will request appropriate tests to confirm or deny the diagnostic suspicions, such as urine tests, blood tests and regional ultrasound.

What are the most effective therapies
In case of renal colic it is first of all necessary to attenuate the intense painful sensation felt by the patient with painkillers, which are associated with anti-inflammatory drugs and a therapy that facilitates the expulsion of the calculus based on alpha blocking drugs. These allow the smooth muscles to relax, favoring the transit of the stone. In addition, cortisone drugs are administered to alleviate edema and inflammation in the mucosa of the ureters if the need arises.
On the other hand, in the case of kidney diseases, it is necessary to rely on the therapeutic strategies indicated by the doctor after having carried out all the analyzes necessary to identify the problem.
Remember that the kidneys are very delicate organs that deserve all the care and attention needed to do their job effectively. In any case, he is wary of underestimating the problem and it is strongly recommended to consult a doctor for a thorough examination.
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