Flank pain describes discomfort felt on the side of the torso between the lower ribs and the hip. It can be on one side or both, and may present as a sharp spasm, a constant ache, or pressure. Below you’ll find common causes, how clinicians assess the problem, and indications for urgent care or specialist referral.
Flank pain is usually felt under the ribcage extending toward the back and side of the lower torso. The sensation can be sharp, cramping, dull or pressure-like. Whether the pain is single-sided or bilateral, its duration, relation to movement or urination, and associated symptoms help suggest likely causes.
Common causes include kidney stones, urinary tract infections or kidney infection (pyelonephritis), and musculoskeletal strain of the back or abdominal wall. Spine problems and nerve compression can mimic flank pain, and less commonly, conditions affecting nearby organs (for example intestinal or biliary issues) produce referred pain. More than one factor may contribute at the same time.
Seek urgent medical evaluation for sudden, severe pain; high fever with flank pain; persistent vomiting or inability to keep fluids down; visible blood in the urine; inability to pass urine or severe pain while urinating; fainting or signs of shock. These situations often require immediate assessment in an emergency setting.
Evaluation starts with a focused history and physical exam to localize the pain and identify accompanying symptoms. Urine tests and blood tests can show infection or impaired kidney function. Imaging—most commonly ultrasound and, when indicated, computed tomography—helps detect stones, hydronephrosis, or other structural causes and supports differential diagnosis.
Referral depends on suspected cause: urology or nephrology for kidney or urinary tract problems; orthopedics or physical medicine and rehabilitation for musculoskeletal causes; gastroenterology or general surgery if abdominal organ disease is suspected. For appointments, note when the pain began, its pattern, what changes it, and any other symptoms (fever, urinary changes, gastrointestinal signs). If urgent signs are present, go directly to emergency services.
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