4 Causes of Referred Back Pain

Referred Back Pain

Where is your pain coming from?
Where is your pain coming from?. m.ilias1987

Back pain is back pain, right? Not so fast. Sometimes a pain in your back may be coming from an entirely different area of your body, and it could be serious.

What is Referred Back Pain?

Referred pain is pain felt in an area that is located at some distance from its cause. This common condition is often the result of problems in abdominal and thoracic organs. For example, infection of the kidneys, which are located in the low back, may cause referred pain to the lumbar area.

Slide on to learn about the most common non-spine related health problems (many of them quite serious) and the role back pain plays in each.  

Related:  What's that Sharp Pain in Your Low Back?  Is it Serious?

Kidney Stones and Back Pain

Diagram of the urinary system and kidney stones.
Kidney stones can refer pain to your low back. BSIP/UIG/Getty Images

Kidney Stones and Back Pain

Kidney stones are hard pieces that form in the organ and may cause pain, including sharp lower back pain. 

What are Kidney Stones?

Kidney stones are concentrated forms of certain substances in your urine.  (Examples include calcium and phosphorus.)  

This is a very common health problem:  The National Institute of Diabetic and Digestive and Kidney Diseases reports that over 1 million visits to a health provider are made every year for kidney stones, including 300,000 emergency room visits.  

The medical term for the kidney stones themselves is renal calculi; when you have the condition, this is called urolithiasis.  Urolithiasis refers to the condition of having kidney stones anywhere in the urinary system.  If your kidney stones are located in the ureters, this is called nephrolithiasis.

What's so Important About Kidneys?

While the function of the kidneys may not make the best conversation starter, it does play an important role in your overall health.  So let's talk about that.

Most people have 2 kidneys that work constantly to turn blood into urine.  These organs act like filters that remove out potentially harmful waste materials from your blood. Because of this, they can have a wonderful effect on your general health and well-being including regulating your blood pressure, keeping your electrolyte levels stable, and your bones strong.  But when the filtering process provided by your kidneys goes awry, your health may suffer.

And, kidneys are located in your lower back area, just below the ribs.  

Note that the urinary system is made up of more than just kidneys.  It also includes 2 ureters, a bladder, and a urethra.

Symptoms of Kidney Stones

Kidney stones symptoms may include a condition called hematuria, which means "blood in the urine."  You may also get pain while urinating and/or severe pain in your abdominal area, your side (i.e. the "flank") and/or in your groin.  

And of course, there's the sharp pain in your lower back I mentioned at the start of this article.  Pain due to kidney stones can be short or long lasting.  You may also experience some nausea and/or vomiting.

If there's any good news when it comes to kidney stones, it's that small ones often pass through your urinary system unnoticed - with no symptoms at all.

Can you Prevent Kidney Stones?

While diet may play a role in the formation of kidney stones, scientists have not identified any specific food that out and out causes them. That said, experts agree that dehydration may raise your risk because it results in concentrated urine.  

Have you had your water today?

To learn more about kidney stones, including types of treatments, check out All About Kidney Stones. from About.com's Urology site.


Masarani M, Dinneen M. Ureteric colic: new trends in diagnosis and treatment. Postgraduate Medical Journal. 2007.

Kidney stone facts.  Kidney Stones.  MedicineNet website. Last Reviewed Dec 2014 <a href="http://www.medicinenet.com/kidney_stones/article.htm">http://www.medicinenet.com/kidney_stones/article.htm</a>

Prostate Problems and Back Pain

Male reproductive system diagram
Back pain is an important and telling symptom of several prostate problems. adrenalina

Prostate Related Back Pain

Back pain can be a tell-tale sign that you have a serious prostate problem.  Just the same, getting routine prostate checkups may save your life.  Why?  Because prostate problems often don't have symptoms at all, or the symptoms, especially back pain, show up so late in the process that your opportunity for a speedy and thorough healing may be behind you.

Prostate Cancer 

As I mentioned above, most men with prostate cancer do not experience symptoms.  This is especially true when cancer is in early stages.  Symptoms related to difficult or painful urination may present themselves once the cancer starts to block the urethra or the neck of the bladder.  

Back pain can be a sign that the cancer is advanced and has spread.  The same is true of fractures.

In fact, in his article entitled "Prostate Cancer" published on the Emedicinehealth website, Dr. Kevin Zorn warns that when cancer spreads to the spinal vertebra, it can weaken these bones, which may cause them to collapse, compressing the spinal cord.  In this case, symptoms include (but are not limited to) difficulty walking and weakness in your legs, as well as difficulty controlling your bladder or bowels.  You may first experience a centralized pain in your back (for a few days or weeks) before these symptoms present themselves.

Note: The situation described above is a medical emergency. Failure to seek medical attention may lead to permanent spinal cord damage with paralysis, Zorn says.

Related:  Causes and Symptoms of Cauda Equina Syndrome

Enlarged Prostate

 A common condition in older men, an enlarged prostate is usually benign.  Back pain is not a symptom of an enlarged prostate; rather symptoms generally relate to difficulty and pain in urination.


Prostatitis, an inflammation of the prostate gland, is a benign but very common condition.  Unlike enlarged prostate, prostatitis strikes men of all ages equally.

Most symptoms of prostatitis relate to urination, for example, pain or burning, difficulty ejaculating, etc.  But along with these, you may experience pain in the area between the scrotum or rectum (pelvic floor) and/or your low back.  

The type of prostatitis may determine the type of pain.  For example, pelvic and low back pain are typical symptoms of an acute prostate infection, as are achy muscles.  (An acute infection of the prostate is similar to flu.) On the other hand, with chronic non-bacterial prostatitis, which is the most common type of prostatitis, nerves are affected.  This can lead to augmented pain sensitivity and perception - in other words, a chronic pain condition that affects men's pelvises.

Related:  Get straight talk about treatment for prostate problems. and Understand your PSA test results.


Chodak, G., M.D., et. al. Prostate Cancer. Medscape website. Accessed June 2015. http://emedicine.medscape.com/article/1967731-overview#a1

Prostatitis: inflamed prostate can be a vexing health problem. Harvard Medical School and Harvard Health Publications. Accessed June 2015. http://www.harvardprostateknowledge.org/prostatitis-inflamed-prostate-can-be-a-vexing-health-problem

Prostatitis: Inflammation of the Prostate. National Institute of Diabetes and Digestive and Kidney Diseases. NIH. Accessed June 2015. http://www.niddk.nih.gov/health-information/health-topics/urologic-disease/prostatitis-disorders-of-the-prostate/Pages/facts.aspx#sec6

Zorn, K., M.D. Prostate Cancer Emedicinehealth. Last Reviewed: 2015. Accessed: June 2015. http://www.emedicinehealth.com/prostate_cancer/page4_em.htm

Abdominal Aortic Aneurysm and Back Pain

Abdominal Aortic Aneurysm
Back pain is one symptom of a ruptured abdominal aortic aneurysm. Science Picture Company/Collection Mix:Subjects/Getty Images

About Abdominal Aortic Aneurysm

Most common after the age of 60, abdominal aortic aneurysm is an otherwise rare condition in which the aorta enlarges. (The aorta is the body's largest artery.  It branches off from the heart and travels centrally down where it branches again into arteries that go all over the body.)  

Dr. Emile Mohler, III in his 2014 article for UpToDate entitled "Patient information: Abdominal aortic aneurysm (Beyond the Basics)", says that when abdominal aortic aneurysms remain intact, they generally do not cause health problems.  But larger aneurysms can burst.  When this occurs, it may cause bleeding into the abdomen, which is a medical emergency requiring immediate treatment.

That said, Mohler reports that almost 90% of the aneurysms identified by screening are less than 3.5 centimeters in diameter, i.e. small enough that they will likely not burst.

Related:  Learn about Screening for Abdominal Aortic Aneurysm

Back Pain and other Symptoms Caused by Abdominal Aortic Aneurysms

While most enlargements present few, if any, symptoms, when they rupture suddenly, two of the most obvious symptoms are sudden onset of severe abdominal pain and sudden onset of severe back pain.  The pain may spread to your groin and buttocks, and may radiate down your leg, as well

It may be hard to get rid of this kind of pain, even with adequate rest.  

According to the NIH, other symptoms of abdominal aortic aneurysm include. 

  • Passing out
  • Clammy skin
  • Dizziness
  • Nausea and vomiting
  • Rapid heart rate
  • Shock

This is not Back Pain as Usual - Seek Medical Attention Immediately

If you have any of the symptoms listed above seek medical attention immediately.  Surgery is often required as a life-saving measure, so the sooner you can get the appropriate help, the better.


Abdominal aortic aneurysm. Medline Plus. U.S. National Library of Medicine. NIH. Accessed June 2015. http://www.nlm.nih.gov/medlineplus/ency/article/000162.htm

Mohler, E., M.D. Patient information: Abdominal aortic aneurysm (Beyond the Basics). UpToDate. Last Updated: 2014. Accessed: June 2015. http://www.uptodate.com/contents/abdominal-aortic-aneurysm-beyond-the-basics

Gallstones and Back Pain

Internal Organs
Back pain can be referred from the gall bladder. VintageMedStock/Archive Photos/Getty Images

Gallstones and Back Pain

Similar to kidney stones, gallstones are hard pieces that form in the organ and may cause problems.  When gallstone symptoms make themselves known, they can include, among other things, pain under your right shoulder blade.  

What are Gallstones?

Gallstones are pieces - large or small - of solid matter that form in the gallbladder.  If you've forgotten what you learned in science class, the gallbladder is an oblong-shaped organ attached to the underside of the liver.  It is the storage site of bile, which is a fat digesting fluid made by the liver. 

How Gallstones are Formed

When substances in the bile combine, crystals may form.  These crystals may stay in the gallbladder and over time become gallstones.  Sometimes a gallstone gets stuck in the duct through which bile travels on its way to the small intestine.  When this happens, the ensuing blockage may create inflammation - in the gallbladder, the duct or possibly even the liver or pancreas.

While experts still aren't sure of what causes gallstones, they have found that most contain cholesterol.  Experts also agree that diet may be a factor in the formation of gallstones, especially one that is high in animal fats.

Symptoms of Gallstones

Gallstones are often asymptomatic.  But when symptoms do make themselves known, they will likely include severe pain in your upper abdomen on the right side that starts suddenly and lasts for at least a half hour.  And, as mentioned above, you may also have pain under your right shoulder blade.

If you get indigestion after eating a high fat or high protein meal (which includes desserts and/or fried foods, of course) this may be a sign of a gallstone, as well.

A 2006 Scandinavian study questioned 220 patients with gallstones and found that 63% had referred back pain related to this condition.  The survey also found that for 5% of participants, the back pain was their most pronounced symptom.

Gallstone Treatment

Gallstones that don't cause symptoms (called "silent" gallstones) are generally left alone.  But if you have symptoms your doctor will likely suggest surgery. The Norwegian study reports that pain is usually the "indication" for surgery, i.e. the reason why the surgical treatment route is initiated in the first place.

For more details on gallstone surgery, including types, check out About.com's Heartburn Expert, Sharon Gillson's, article "What is the Treatment for Gallstones?


Dieting and Gallstones.  National Institute of Diabetes and Digestive and Kidney Diseases.  NIH website. Last Updated March 2013.  http://www.niddk.nih.gov/health-information/health-topics/weight-control/dieting_gallstones/Pages/dieting-and-gallstones.aspx

Tewelde Berhane, Morten Vetrhus, Trygve Hausken, Snorri Olafsson, Karl Søndenaa.  Pain attacks in non-complicated and complicated gallstone disease have a characteristic pattern and are accompanied by dyspepsia in most patients: The results of a prospective study Scandinavian Journal of Gastroenterology. 2006.  http://informahealthcare.com/doi/abs/10.1080/00365520510023990

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