How to Identify and Treat Flank Pain
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Medically reviewed by Michael Menna, DO
The part of the body that spans from the bottom of the rib cage down to the hips on the left or right side of the spine is known as the flank. Pain in this area is very common—and you may experience discomfort in your flank for a variety of reasons, such as injury, infection, or underlying health conditions.
Depending on its cause, flank pain may feel like a dull ache that lasts a long time or a sharp pain that comes and goes. It is important to get an accurate diagnosis of the cause of this pain from a healthcare provider so you can receive appropriate treatment and improve your symptoms.
Which Organs Are in the Flank?
Several organs are located in the abdomen underneath the ribs. A problem or underlying health condition with one of these organs in the flank area could lead to flank pain:
Kidneys: Most people have two kidneys—one on each side of the spine under the ribcage. These bean-shaped organs are each about the size of a fist. Part of the urinary system, the kidneys do the important job of filtering out waste from the blood and sending it out of the body through urine.
Liver: The liver is a large, cone-shaped organ located in the upper right flank area, just above the stomach and right kidney. The liver carries out many crucial functions in the body, including helping with digestion and blood filtering.
Gallbladder: The gallbladder is located below the liver on the right side of the body. This small organ uses bile made by the liver to help the body digest fats from food.
Pancreas: Stretching underneath the left side of the liver, the pancreas regulates blood sugar and aids in digestion.
Intestines: Parts of the small and large intestines are located in the flank area. Food and waste move through the intestines on their way out of the body.
What Does Flank Pain Feel Like?
Based on the cause of your flank discomfort, you may experience dull or sharp pain. It can feel like an ache, a cramp, or a stabbing sensation. The pain can come and go quickly, or can last a long time. Flank pain usually occurs on either the left or right side of the abdomen, but it is possible to have it on both sides, too.
In severe cases, flank pain may occur alongside other symptoms, like nausea, fever, chills, trouble urinating, or a rapid heartbeat.
Potential Causes of Flank Pain
Many different health conditions or organ problems can lead to flank pain. These conditions range in severity from mild to life-threatening.
Kidney Stones
Kidney stones (medically known as nephrolithiasis) are a common cause of flank pain. Kidney stones are hard collections of crystals, usually made of calcium, that form in the kidneys. When the stones begin to move through the ureters into the bladder, they may cause flank pain. Smaller stones usually pass on their own, but larger stones may need medical treatment.
Large kidney stones that do not pass on their own can lead to a blockage in the ureter (the tube that passes urine from the kidney to the bladder). This blockage does not allow urine to pass out of the kidney properly. As a result, the kidney may become infected or inflamed, causing flank pain, nausea, and vomiting.
Gallbladder Problems
Similar to kidney stones, gallstones are hard collections of material in the gallbladder that can lead to flank pain. Gallbladder diseases or infections (like cholecystitis) also can cause pain on the sides of your abdomen and back.
Back Problems
Flank pain often results from problems with the bones, muscles, or nerves in your spine. Chronic (long-term) conditions such as spinal arthritis or ankylosing spondylitis and acute (short-term) problems like fractures and muscle spasms can lead to flank pain.
Gastrointestinal Conditions
Diseases of the gastrointestinal (GI) tract, the long tube that connects the organs from your mouth to your anus, can cause frequent bouts of flank pain. Conditions like irritable bowel syndrome (IBS), ulcerative colitis, and Crohn's disease can induce a range of abdominal discomfort, including flank pain. A blockage, infection, or puncture in the intestine may also lead to severe pain in the flank area.
Liver Disease
Symptoms of liver disease may sometimes include flank pain. There are many types of liver disease, including hepatitis, fatty liver disease, and cirrhosis. It is also common to experience swelling, nausea, and jaundice alongside liver pain.
Shingles
Shingles is a skin rash caused by the same virus that leads to chickenpox. In adulthood, people who carry the virus may suddenly develop shingles. Shingles often cause painful skin symptoms, but may also affect your nerves and produce flank pain.
Abdominal Aortic Aneurysm
The aorta is the main artery (blood vessel) that carries blood from the heart to the rest of the body. An aortic aneurysm is a bulge in the walls of the aorta, which occurs due to a weakening of the blood vessel walls. If not treated properly, this bulge can grow and press on other parts of the abdomen, causing flank pain. The bulge eventually may burst, which is a life-threatening medical emergency.
When to Contact a Healthcare Provider
Some causes of flank pain can be temporary and resolve on their own. However, others need immediate medical treatment. Contact your healthcare provider right away if your flank pain occurs with other symptoms, such as:
Chills
Nausea or vomiting
Trouble urinating
Abdominal swelling
Increased heart rate
If your pain doesn't go away within a couple of days on its own, it's also important to see a healthcare provider as soon as possible.
Diagnosis
When you report flank pain to your healthcare provider, they will first ask about your symptoms and health history. You can expect your provider to ask the following questions:
Where is your pain located?
When does the pain occur?
Does the pain come and go?
What does the pain feel like?
How long has your pain lasted?
Did you experience any injuries or illnesses recently?
Your provider may also order certain tests to look for the specific cause of your flank pain. Tests may include:
Imaging tests such as X-rays, computed tomography (CT) scan, or ultrasound of the abdomen or back
Blood tests to look at your kidney and liver function
Urine tests to check for underlying conditions that could be causing flank pain
Treatment
If the cause of your flank pain requires treatment, your exact treatment plan will depend on the underlying condition you have. It's worth noting that many cases of flank pain resolve on their own. Many cases can be treated with simple at-home methods such as taking over-the-counter pain-relief medications and getting rest.
Depending on the cause, your healthcare provider may recommend the following treatments for flank pain:
Physical therapy for muscle spasms or arthritis
Pain medication, increasing fluid intake, or surgery for kidney stones
Gallbladder surgery for gallstones
Antibiotics for infections
Antiviral medications for shingles
If conditions like liver disease, kidney disease, IBS, or inflammatory bowel disease (IBD) are causing your flank pain, your provider will treat the condition to help reduce your pain symptoms.
How to Prevent Flank Pain
You can help prevent flank pain by staying in good overall health. In general, this involves not smoking, eating a nutritious diet, exercising regularly, and adopting good sleep habits. It is also important to stay well hydrated, especially if you are at risk of kidney stones or gallstones.
Living With Pain
Flank pain is usually caused by a treatable condition such as a kidney stone or infection. When the underlying condition is treated, the pain will likely go away. However, some pain may become chronic and need long-term treatment. Living with chronic pain may involve:
Taking pain medications to reduce pain
Getting physical therapy to increase mobility
Using complementary health approaches such as acupuncture and yoga to manage symptoms
While long-term treatment can feel draining, treatment is essential. If left untreated, flank pain caused by underlying health conditions may lead to kidney failure, liver failure, infections, and other complications.
If your pain becomes chronic, make sure to take care of your mental health as well. Pain can be stressful and upsetting, so find support where you can. Consider taking up a new hobby, opening up to your loved ones about your condition, joining a support group, or speaking with a mental health provider to learn coping strategies.
A Quick Review
The flank encompasses several organs and structures of your body. For this reason, flank pain can have a wide variety of causes, such as kidney stones, gallbladder disease, liver disease, arthritis, and back problems. If you're experiencing flank pain that doesn't resolve within a couple of days, reach out to your provider for support and treatment to prevent the risk of complications.
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