Flank pain in older adults

Overview

Flank pain is a discomfort on one side of your back, between the ribs and hip. It can be a sharp stabbing pain or a dull ache and may come and go. In older adults, it often has causes that are treatable.

Yes, flank pain is common in older adults. Conditions like kidney stones, urinary tract infections, and shingles become more frequent with age.

Older adults, especially those over 60. People with a history of kidney stones, repeated urinary tract infections, back problems, or weakened immune systems are more at risk.

Symptoms

Common symptoms

• A dull ache or sharp pain on one side of your back or side.
• Pain that may spread to your lower abdomen or groin.
• Pain that gets worse with movement or when you press on the area.

Symptoms in children

• Flank pain in children is less common and usually related to urinary tract infections or kidney problems. It may present with fever and fussiness.

Symptoms in older adults

• Pain that is more constant and may interfere with sleep.
• Pain accompanied by fever, chills, or confusion (may signal a kidney infection).
• Pain from shingles, which often includes a burning sensation and a rash on one side of the body.

Causes

Main causes

• Kidney stones – hard deposits that form in the kidneys and can cause sharp pain.
• Urinary tract infection or kidney infection – infection in the bladder or kidneys.
• Muscle strain or ligament injury – often from lifting or sudden movement.
• Shingles (herpes zoster) – a painful rash caused by the chickenpox virus reactivating.
• Kidney disease or cysts – conditions that affect how your kidneys work.

Risk factors

• Age over 60.
• History of kidney stones.
• Repeated urinary tract infections.
• Diabetes or high blood pressure.
• Weakened immune system from illness or medicines.
• Recent back injury or heavy lifting.

When to see a doctor

See a doctor urgently if:

• Sudden, severe flank pain that comes on quickly.
• Pain with fever, chills, or confusion.
• Blood in your urine or trouble passing urine.
• A pulsating lump in your belly.

Book a routine appointment if:

• Mild flank pain that lasts more than a few days.
• Pain that comes and goes over weeks.
• Discomfort after activity that doesn't improve with rest.

Diagnosis

Your doctor will ask about your symptoms, medical history, and perform a physical exam. They may press on your back and side to check for tenderness.

Tests that may be done

• Urine test to check for infection or blood.
• Blood tests to check kidney function.
• Imaging tests such as an ultrasound or CT scan to look at your kidneys and surrounding structures.

What to expect at your appointment

The doctor will explain the likely cause and discuss next steps. Tests are usually simple and can be done in a clinic or hospital. You may need to provide a urine sample or have a scan.

Treatment

Treatment depends on the cause. Many causes of flank pain can be managed with rest, fluids, and medicines your doctor prescribes.

Self-care at home

• Rest and avoid activities that worsen the pain.
• Apply a warm compress or ice pack to the area for 15–20 minutes at a time.
• Drink plenty of water, unless your doctor advises otherwise.
• Avoid heavy lifting or sudden twisting movements.

Medical treatments

Your doctor may prescribe antibiotics for an infection, pain relief medicines (over-the-counter or prescription), medications to help pass kidney stones, or antiviral drugs for shingles. Always follow your doctor's advice about which medicines are safe for you.

When is surgery considered?

Surgery is rarely needed but may be considered for very large kidney stones that do not pass, or for certain kidney conditions. Your doctor will explain if surgery is an option and what it involves.

Living with this condition

Manage flank pain by following your treatment plan. If you have a chronic condition like kidney disease, you may need regular check-ups and monitoring.

Lifestyle tips

• Stay well hydrated by drinking enough water.
• Maintain a healthy weight through balanced eating and gentle exercise.
• Avoid smoking and limit alcohol.
• Manage underlying conditions like diabetes and high blood pressure.

Diet and exercise

Eat a balanced diet low in salt to support kidney health. Gentle exercise like walking can help maintain strength, but avoid heavy strain. Talk to your doctor before starting any new exercise.

Mental health and emotional wellbeing

Chronic pain can be stressful and affect your mood. It's important to talk to your doctor if you feel anxious or depressed. Support from family, friends, or a counselor can help you cope.

Prevention

Not all causes can be prevented, but you can lower your risk by staying hydrated, treating urinary tract infections early, and managing conditions like diabetes and high blood pressure.

Vaccines

There is a vaccine for shingles, which can cause flank pain. Ask your doctor if the shingles vaccine is right for you.

Screening programmes

Regular check-ups to monitor your kidney function if you have risk factors. No special screening test for flank pain is needed for most people.

Complications

If left untreated

• Kidney infection that spreads to the bloodstream (sepsis).
• Kidney stones that block the flow of urine and cause kidney damage.
• Untreated shingles that may lead to long-term nerve pain (postherpetic neuralgia).

Long-term outlook

Most cases of flank pain in older adults improve with proper treatment. Even serious causes can often be managed effectively when caught early. With your doctor's help, you can maintain a good quality of life and prevent complications.

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