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Flank pain

Definition

Flank pain is pain in one side of the body between the upper belly area (abdomen) and the back.

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Alternative Names

Pain - side; Side pain

Considerations

Flank pain can be a sign of a kidney problem. However, since many organs are in this area, other causes are possible. If you have flank pain and fever, chills, blood in the urine, or frequent or urgent urination, then a kidney problem is the likely cause. It could be a sign of kidney stones.

Common Causes

Arthritis or infection of the spine
Back problem, such as disk disease
Gallbladder disease
Gastrointestinal disease
Liver disease
Muscle spasm
Kidney stone, infection, or abscess
Shingles (pain with one-sided rash)
Spinal fracture

Home Care

Treatment depends on the cause.

Rest, physical therapy, and exercise may be recommended if the pain is caused by muscle spasm.

Nonsteroidal anti-inflammatory drugs (NSAIDs) and physical therapy may be prescribed for flank pain caused by spinal arthritis. You will be taught how to do these exercises at home.

Antibiotics are used to treat most kidney infections. You will also receive fluids and pain medicine. You may need to stay in the hospital.

Call your health care provider if

Call your health care provider if you have:

Flank pain along with a high fever, chills, nausea, or vomiting
Blood (red or brown color) in the urine
Unexplained flank pain that continues

What to expect at your health care provider's office

The doctor or nurse will examine you. You will be asked questions about your medical history and symptoms, including:

Is the pain on one side only or both sides?
Which side?
Is the pain mild or severe?
Does the pain occur from time to time and get worse over seconds to minutes?
What does the pain feel like?
Is the pain severe enough to require strong pain relievers?
Did the pain begin recently?
Has the pain been gradually getting worse over time?
Did the pain rapidly get worse?
Does the pain go into your groin?
Does the pain go into your back?
Does the pain go up into your chest?
Does the pain occur with nausea or vomiting?
What other symptoms do you have?

The health care team monitor how many fluids you receive and how much and often you urinate.

The following tests may be done:

Abdominal CT scan
Blood tests to check kidney and liver function
Chest x-ray
Cystoscopy
Intravenous pyelography (IVP)
Kidney or abdominal ultrasound
Lumbosacral spine x-ray
Retrograde ureteropyelography
Urinalysis and urine culture
Voiding cystourethrography

References

Landry DW, Bazari H. Approach to the patient with renal. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 116.

McQuaid K, Proctor DD. Approach to the patient with gastrointestinal disease. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24thed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 134.

Millham FH. Acute abdominal pain. In: Feldman M, FriedmanLS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 10.

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