Can a UTI cause back pain?

Published on May 07, 2024 | 10:00 AM

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Back pain has various causes, not just from strains, overexertion, and the like, but also from sources that don’t necessarily have much to do with the back muscles or the spine. For example, a urinary tract infection, or UTI, can feature back pain as a symptom depending on how it develops in a person. The pain varies in intensity, being described in some patients as a dull, throbbing pain while others report a stabbing, hard-to-tolerate pain. In either case, back pain is a UTI symptom that indicates a person needs medical treatment. 

What is a UTI?

Important to understand when identifying whether back pain is a UTI symptom, a urinary tract infection is an infection that can occur in any part of the urinary tract system, most commonly involving the kidneys, ureters, bladder, and urethra. (1) The infections are bacterial, most often starting because bacteria found around the anus or on the skin have gained entry to the urinary tract through the urethra. (2) As highlighted in The Call-On-Doc Guide to Urinary Tract Infections, conditions concerning UTIs are generally divided into upper and lower UTI, with the the most common symptoms including: 

Lower UTI:

  • Burning or pain when urinating
  • Constant need to urinate
  • Less relief from urinating
  • Clouded and strong-smelling urine
  • Overall fatigue  
  • Blood in urine
  • Lower back pain

Upper UTI:

  • Burning or pain when urinating
  • Constant need to urinate
  • Less relief from urinating
  • Clouded and strong-smelling urine
  • Blood in urine
  • Can be confused and reactive
  • Trouble sleeping
  • Overall fatigue  
  • Chills
  • High fever
  • Nausea
  • Prone to vomiting
  • Upper back pain

When it comes to what part of the urinary tract back pain is associated with, the correlation to where the pain is coincides with what’s infected. More specifically, you’ll generally feel varying levels of back pain when the bladder or kidneys are infected. 

Why is back pain a symptom of UTIs?

As a UTI symptom, back pain can occur in the lower and upper back due to an infection reaching the bladder and kidneys, respectively. (3) The exact location of back pain from either UTI can vary slightly from person to person but is normally based on the affected organs. 

When a bladder infection occurs in the back, the pain is generally slightly above the posterior and waistline but is more commonly felt at the front around the pelvis and groin, especially when passing urine. 

The more common cause of UTI associated back pain is when back pain is when a UTI infects the kidneys, causing pain between the tops of the hips and just above the belly button. Such pain can often cause tenderness on the surrounding skin, resulting in discomfort or pain from the area when touching or tapping it. (3) 

Both types of UTIs require medical attention due to the treatment involving antibiotics. Those experiencing a fever and vomiting alongside back pain related to a UTI should seek out medical care immediately. 

How does bacteria reach the kidneys in a UTI?

In a UTI, bacteria can reach the kidneys through two primary routes: hematogenous spread and ascending infection. 

Hematogenous spread occurs when bacteria from an infection elsewhere in the body enter the bloodstream and travel to the kidneys. While this route is less common, it can occur in cases of severe systemic infections. (4)

The more common route is ascending infection, where bacteria from the lower urinary tract (such as the bladder or urethra) travel upward through the ureters to reach the kidneys. This is facilitated by factors such as incomplete emptying of the bladder, holding in your urine for too long, or having obstructions in the urethra. (4) Obstructions like debris or fuzz from undergarments can play a role in developing a UTI. Additionally, conditions like HPV that can cause genital warts to form in the urethra can also play a role. 

What are the warning signs of a kidney infection?

As an infection, the body will react to a UTI that has reached the kidneys like other infections. Your core temperature will rise in an attempt to kill off the hostile microbes, you’ll be regularly tired throughout the process, and have a general feeling of where the infection has progressed through pain or pressure. More specifically, these symptoms can show as: 

  • Flank Pain: Pain in the lower back or sides, specifically around the area of the kidneys, is a common symptom of a kidney infection. The pain may be severe and may spread to the abdomen or groin.
  • Fever and Chills: A kidney infection can cause a high fever (usually above 100.4°F or 38°C) accompanied by chills and sweating. Fever is often a prominent symptom of kidney infection or pyelonephritis.
  • Nausea and Vomiting: Kidney infections can cause gastrointestinal symptoms such as nausea, vomiting, and loss of appetite. These symptoms may be related to the body's response to infection and inflammation.
  • Fatigue and Weakness: Feeling unusually tired, weak, or lethargic can be a warning sign of a kidney infection, as the body may be fighting the infection and experiencing systemic effects.
  • Cloudy or Bloody Urine: In some cases, a kidney infection may cause changes in urine color and clarity, leading to cloudy or bloody urine. However, these changes may not always be present or noticeable.
  • Painful or Frequent Urination: Often carrying over when a UTI reaches the upper urinary tract, kidney infections can still cause urinary symptoms such as painful urination (dysuria) or increased frequency of urination.
  • Abdominal Pain: Some individuals with kidney infections may experience generalized abdominal pain or discomfort. 

How long does it take for a kidney infection to develop?

After entering the urinary tract through the urethra, hostile bacteria most often take around 48 hours or two days to develop into a UTI. Those who are healthy and have strong immune systems will have an infection that has difficulty spreading through their body. Those who are unhealthy and have compromised immune systems may have an infection progress from the urethra 

How do I know if I have a kidney infection or just back pain?

Distinguishing between a kidney infection (pyelonephritis) and back pain unrelated to a urinary tract issue can be challenging, as both conditions can cause discomfort in the lower back area. However, there are key differences and additional symptoms that can help differentiate between the two:

Location of Pain:

  • Kidney Infection: Back pain associated with a kidney infection is typically felt on one side of the lower back, near the area of the affected kidney. The pain may be dull, achy, or sharp and may radiate to the abdomen or groin, but overall constant as you will not be able to physically move to relieve the pain itself
  • Non-Urinary Back Pain: Back pain unrelated to a kidney infection may be more generalized and not specifically localized to one side of the lower back. It may be related to muscle strain, injury, posture issues, or other non-urinary causes. In most cases, you’ll be able to physically adjust and get some relief from this type of back pain. 

Urinary Symptoms:

  • Kidney Infection: Along with flank pain, a kidney infection often presents with urinary symptoms such as frequent urination, urgency, burning or pain during urination, cloudy or bloody urine, and a strong urge to urinate even when the bladder is not full.
  • Non-Urinary Back Pain: Back pain without urinary symptoms may be more indicative of a non-urinary issue such as muscle strain, spinal problems, or other musculoskeletal conditions.

Systemic Symptoms:

  • Kidney Infection: In addition to flank pain and urinary symptoms, a kidney infection may cause systemic symptoms such as fever, chills, nausea, vomiting, fatigue, and general malaise.
  • Non-Urinary Back Pain: Back pain unrelated to a kidney infection typically does not cause systemic symptoms unless there is an underlying medical condition or infection.

What is the best way to flush out a kidney infection?

Whereas you may be able to treat a minor UTI yourself by increasing your water intake, getting plenty of rest, and being overall healthy, you should not attempt this with a kidney infection. There are a number of reasons why, with the most common including: 

  • Risk of Complications: Kidney infections (pyelonephritis) can lead to serious complications if not properly treated. These complications may include kidney damage, sepsis (a life-threatening bloodstream infection), abscess formation in the kidneys, and long-term kidney dysfunction.
  • Incomplete Resolution: Flushing out the infection with increased fluid intake alone may not effectively eliminate the bacteria causing the infection. Without appropriate antibiotic therapy, the infection can persist and potentially spread to other parts of the urinary tract or bloodstream.
  • Pain Management: Kidney infections can cause significant pain and discomfort, including flank pain, urinary symptoms, and systemic symptoms such as fever and nausea. Medical treatment not only addresses the underlying infection but also provides pain management and symptom relief.
  • Preventing Recurrence: Proper medical treatment of a kidney infection helps prevent recurrent infections and reduces the risk of developing antibiotic-resistant bacteria, which can occur with inadequate or incomplete treatment.

Can a kidney infection be treated like a UTI?

Yes, UTI treatment and medical care for a kidney infection are similar, if not the same, due to most cases of each being treated through a prescription that includes antibiotics. However, more severe kidney infections may require more intensive care found in hospitals. (5)

Call-On-Doc offers an effective and fast-acting option for those needing UTI treatment. Alongside being accessible wherever you are, your prescription can be picked up from the pharmacy of your choice within only a few hours!

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Wayne Hahne,

English graduate and Call-On-Doc’s medical resource guide, Wayne C. Hahne is an experienced and passionate medical education content expert. Through diligent research, provider interviews and utilizing the industry's leading resources for wellness information, it is Mr. Hahne’s personal mission to educate the general public on medical conditions with in-depth and easy-to-understand written guides.

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