When Back Pain Isn’t Just Muscle Strain

Back pain is common, but not all back pain comes from muscles or posture.

As a urologist, I often see patients who treat severe flank or lower back pain with painkillers and physiotherapy, only to discover later that the cause was a kidney stone, infection, or obstruction.

Urological back pain typically:

• Appears suddenly
• Radiates to the abdomen or groin
• Is associated with nausea or urinary changes
• Worsens in waves rather than constant ache

Kidney stones, ureteric obstruction, or infections can all present as back pain. Ignoring these signs can lead to complications like kidney damage or sepsis.

If back pain is severe, recurrent, or associated with urine symptoms, it should never be assumed to be muscular without evaluation.

A simple ultrasound or urine test can differentiate between orthopedic and urological causes early — saving time, pain, and complications.