Where does your back hurt if you have a kidney infection?

Kidney infection or pyelonephritis is a medical condition in which one or both kidneys get infected. A person has two kidneys that are located under the rib cage on each side of the spine. The pain of kidney infection may be felt on the sides (flanks) and the back. Unlike the classical back pain due to muscle or bone involvement, which typically affects the lower back, kidney pain is felt higher up and at a greater depth. The pain is most commonly felt under the ribs and depending on the involvement of one or both the kidneys, it may be felt on one side or both sides of the body. Kidney pain may also be felt in areas such as the belly or groin. Unlike back pain, the pain of kidney infection may be associated with other symptoms such as:
- Fever which is generally high grade
- Chills
- Nausea with or without vomiting
- Frequent urination
- Pain, burning, or difficulty in passing urine
- Change in the smell or appearance of the urine, such as cloudy or blood-tinged urine
Kidney infection is generally a serious medical condition. Thus, you must seek urgent medical care if you think you have a kidney infection.
What causes a kidney infection?
The commonest cause of kidney infection is the bacteria called E coli (Escherichia coli). The mode of infection is ascending of the germ from the anogenital area.
The urinary system includes the kidneys, ureters (the tube that connects the kidney to the bladder), urinary bladder, and the urethra (the short tube through which urine flows out of the bladder. Certain bacteria, such as E coli, are found as normal residents in the bowel (intestines). These bacteria can enter the urinary tract via the urethra. The infection can occur during sexual intercourse or because of poor hygiene habits after bowel movements. On entering the urethra, the bacteria can migrate upwards to infect the bladder (cystitis) and the kidneys (pyelonephritis). Although pyelonephritis is rarer than cystitis, it is a serious condition and needs prompt medical management. Kidney infections can even occur in the absence of a bladder infection. This may be seen in conditions, such as kidney stones (renal calculi), and with weak immunity, such as diabetes and HIV.
Who is at risk of a kidney infection?
Certain medical conditions may increase your chances of having a kidney infection. These include:
- Conditions that may weaken the body’s immunity, such as diabetes and HIV.
- Frequent bladder or other urinary tract infections (UTI). A UTI in a pregnant female is a particularly serious condition and should be immediately brought to medical attention.
- Structural problems in the kidney that may alter the flow of urine, such as kidney stones, congenital (present since birth) structural problems of the urinary tract, and tumors present inside or outside the urinary tract.
- Females are at greater risk of a UTI since they have a shorter urethra compared to males.

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Cleveland Clinic. Kidney Pain. https://my.clevelandclinic.org/health/symptoms/17688-kidney-pain
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