Pain on the right side of the back is often blamed on the kidney, but it can come from a nearby organ instead. This guide explains where right kidney pain is felt, its kidney and non-kidney causes, symptoms that point to the kidney, emergency signs, and how it is diagnosed and treated.
Where is right kidney pain felt?
The kidneys sit high at the back of the abdomen, one on each side of the spine, under the ribs. So right kidney pain is usually felt in the right flank or below the ribs at the back. According to Kidney Care UK, it is often a dull ache on one side that can spread towards the front of the abdomen and the groin; doctors call it “loin” or “flank” pain.
Stone pain is usually sharp, severe and comes in waves. Because the right side also holds the liver, gallbladder and appendix, not every pain here is from the kidney. If your pain is on the other side, see our page on left kidney pain.
Kidney causes of right kidney pain
- Kidney and ureter stones: one of the most common causes. According to the NHS, the pain starts in the side or lower back and can spread to the groin, sometimes with vomiting. Read about kidney stone treatment.
- Kidney infection: usually spreads up from the bladder, causing fever and side pain with urinary symptoms. See kidney infection.
- Hydronephrosis: according to the NHS, this is swelling of the kidney from a build-up of urine, usually caused by a blockage such as a stone. Read about hydronephrosis.
- Kidney cysts: according to NIDDK, one large study found simple cysts in about 1 in 10 people (nearly 1 in 5 aged 50 and over). Most cause no symptoms; rarely a large cyst presses on nearby structures, becomes infected or bursts.
- Kidney tumours: an uncommon cause of pain. According to the NHS, kidney cancer often causes no obvious symptoms; possible signs include blood in the urine or pain between the ribs and waist that does not go away.
Right-sided causes outside the kidney
The right side has different neighbours from the left. The table gives general clues, not a diagnosis.
| Source | Usual location | Clues that come with it |
|---|---|---|
| Kidney (stone or infection) | Flank and below the ribs at the back, may spread to the groin | Fever and shivering, urinary symptoms, cloudy or bloody urine; not much changed by movement |
| Gallbladder (gallstones) | Middle of the upper tummy or just under the right ribs at the front | According to the NHS, can last longer than 30 minutes; nausea; sometimes yellow skin or eyes |
| Appendix | Starts around the belly button, then moves to the lower right abdomen | Worse with movement and coughing; loss of appetite, nausea, fever |
| Liver | Upper tummy | Yellowing of the skin and whites of the eyes (jaundice) |
| Muscles or spine | Lower back or anywhere along the spine | Changes with bending, standing or moving |
| Shingles | A patch of skin on one side of the chest or tummy | Tingling or pain in the skin, then a rash a few days later |
| Ovary (in women) | Lower tummy and pelvis | Pelvic pain that can be sudden and severe; period changes |
Bowel problems can also cause right-sided pain.
Symptoms that point to the kidney
Kidney pain is more likely when the pain comes with:
- Flank pain that does not change much with movement, as Kidney Care UK notes.
- Waves of severe pain spreading to the groin.
- Burning or pain when passing urine, or needing to go more often and urgently.
- Cloudy, dark or bloody urine.
- A high temperature, or feeling hot, cold and shivery.
- Nausea or vomiting.
When is right kidney pain an emergency?
Go to an emergency department or get urgent medical help if you have:
- Fever or shivering with flank pain, which may mean an infection behind a blockage; the NHS warns that an untreated kidney infection can lead to sepsis.
- Repeated vomiting so you cannot keep fluids down.
- Very little urine, or no urine all day.
- Severe pain that will not settle or keeps coming back quickly.
- Pregnancy: any flank pain in pregnancy needs prompt assessment.
- A single kidney, a kidney transplant or existing kidney disease, because a blockage puts kidney function at greater risk.
- Confusion, drowsiness or difficulty speaking, yellow skin with fever, or severe pain across the whole abdomen.
How is right kidney pain diagnosed?
The doctor asks about the pain and examines your abdomen and flank. Usual tests include:
- Urine test: to look for signs of infection or blood.
- Blood tests: including kidney function and markers of inflammation.
- Imaging: a urinary tract ultrasound can show the kidneys, any swelling and some stones. NICE guideline NG118 recommends urgent (within 24 hours) low-dose non-contrast CT for adults with suspected renal colic, ultrasound instead of CT in pregnancy, and ultrasound first for children and young people.
If the cause seems to be outside the kidney, other tests or another specialty may be needed.
Treatment depends on the cause
Treatment follows the cause and is decided by your doctor:
- Stones: according to the NHS, many are managed at home with plenty of water and medicines prescribed for pain, while larger stones may need shock wave treatment or a telescope procedure.
- Kidney infection: treated with antibiotics; some people need hospital care.
- Hydronephrosis: according to the NHS, the first treatment in adults is usually to drain the urine to ease pain and protect the kidney, then treat the cause of the blockage.
- Cysts and tumours: many simple cysts need no treatment; tumours need specialist care.
A urologist assesses stones and blockages and refers to a nephrologist (kidney medicine specialist) when there is reduced kidney function or chronic kidney disease. Do not start painkillers or antibiotics on your own before a diagnosis.
Frequently asked questions
How can I tell right kidney pain from back pain?
According to Kidney Care UK, muscular back pain often changes with bending, standing or moving, while kidney pain usually does not, and kidney pain may come with fever, vomiting or problems passing urine. An examination and urine test settle it.
Can gallbladder pain feel like right kidney pain?
Yes, they can be confused. Gallstone pain is usually in the upper tummy or just under the right ribs at the front and may come with nausea. Kidney pain sits more in the flank and back, often with urinary symptoms. Tests and ultrasound tell them apart.
Is appendicitis pain similar to right kidney pain?
They can overlap, but appendicitis pain usually starts around the belly button and moves to the lower right abdomen, getting worse with movement and coughing, with loss of appetite and nausea. Severe or worsening abdominal pain needs urgent assessment.
Is right kidney pain in pregnancy different?
Flank pain in pregnancy can be caused by infection, a stone or kidney swelling, and it needs prompt assessment. NICE recommends ultrasound instead of CT for pregnant women with suspected renal colic.
What tests are usual for right kidney pain?
Doctors usually ask for a urine test to look for infection or blood, blood tests including kidney function, and an ultrasound of the kidneys and urinary tract. If a stone is suspected in an adult, a low-dose non-contrast CT scan may be requested.
Could right kidney pain be a tumour?
This is an uncommon cause. According to the NHS, kidney cancer often causes no obvious symptoms; possible signs include blood in the urine or ongoing pain between the ribs and waist. See a doctor promptly, though these signs do not necessarily mean cancer.
Sources
Book a consultation
Prof. Al-Samarrai and Dr. Amer Mousa assess kidney and urinary problems at Prof. Al-Samarrai Medical Center, Dubai Healthcare City, discuss the options that suit your case, and refer you to a nephrologist when needed. Medical consultations are confidential.
Read more: Urologist in Dubai: doctors, services, insurance and booking
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