What organ can cause pain in your back? A guide to referred pain

September 28, 2025 •

4 min read

Back pain is a common ailment, affecting a vast majority of people at some point in their lives, but not all of it originates from the muscles or spine. Understanding what organ can cause pain in your back is crucial, as the location of the discomfort can be misleading due to a phenomenon called referred pain.

Quick Summary

Several internal organs, including the kidneys, pancreas, and female reproductive organs, can manifest pain in the back. Distinguishing this from musculoskeletal issues involves recognizing specific pain patterns and other accompanying symptoms, such as fever, nausea, or changes in urination.

Key Points

Referred Pain: Internal organ problems can cause back pain because nerve pathways are shared, making the brain misinterpret the source of the discomfort.
Kidneys Are Common Culprits: Located against your back muscles, kidney issues like stones or infections are frequent causes of back pain, particularly in the flanks.
Recognize Accompanying Symptoms: Organ-related pain is often accompanied by other systemic symptoms like fever, nausea, or changes in urination, which are not typically seen with simple muscle strain.
Pancreas and Liver Issues: Inflammation of the pancreas (pancreatitis) or liver disease can also cause pain that radiates from the abdomen to the back.
Location Matters: Organ pain tends to be deeper and higher up the back than common muscular back pain, which often affects the lower regions and is more superficial.
Pain Quality: Organ pain often feels dull and constant, while musculoskeletal pain may be sharper and affected by movement or rest.

Understanding Referred Pain

Referred pain is when a health problem in one area of the body causes pain to be felt in another area. This occurs because the nerves of internal organs and the nerves of certain areas of the body's surface share pathways in the spinal cord. When the brain receives these pain signals, it can sometimes misinterpret the source, leading you to feel organ-related discomfort as back pain.

Internal Organs That Can Cause Back Pain

Kidneys

Your kidneys are located on either side of your spine, just below your ribcage. Problems with these organs are a common cause of back pain that is often mistaken for a muscle strain.

Kidney Stones: These can cause sharp, intense pain that comes in waves and may be felt in your lower back, side, or abdomen, sometimes spreading to the groin.
Kidney Infection (Pyelonephritis): An infection can cause a dull, consistent ache in your lower back or side, typically accompanied by fever, chills, nausea, and painful or frequent urination.
Polycystic Kidney Disease: Fluid-filled sacs (cysts) can cause enlargement of the kidneys, resulting in a persistent, dull ache.

Pancreas

This organ sits behind the stomach and is involved in both digestion and blood sugar regulation. Inflammation of the pancreas, known as pancreatitis, is a notable cause of back pain.

Acute Pancreatitis: This can cause moderate to severe abdominal pain that radiates to your back, often feeling worse after eating, especially fatty foods. Leaning forward may provide some relief.
Pancreatic Cancer: A tumor on the pancreas can cause a dull, nagging pain in the upper abdomen and back.

Liver

While the liver itself has no pain receptors, conditions affecting it can cause referred pain due to inflammation or enlargement.

Hepatitis or Cirrhosis: These conditions can cause inflammation that irritates nearby tissues, leading to a dull or throbbing pain in the upper right abdomen that may radiate to the middle of the back or the right shoulder.

Female Reproductive Organs

For women, certain conditions related to the uterus and other pelvic organs can result in pain felt in the lower back.

Endometriosis: This condition involves uterine tissue growing outside the uterus, which can cause chronic pelvic pain that radiates to the lower back, especially during menstruation.
Uterine Fibroids: These noncancerous growths can press on surrounding structures, causing pain in the lower abdomen and back.

How to Distinguish Organ-Related Pain from Muscular Back Pain

Recognizing the difference is key to seeking the right treatment. Here is a comparison to help you understand the potential cause of your pain.


Characteristic	Organ-Related Back Pain	Muscular Back Pain
Location	Higher up, deeper, and often more localized to the flanks (under the ribs) for kidney issues. Upper abdomen radiating to the back for pancreatic issues.	Typically affects the lower back, and can be anywhere from the neck to the tailbone. Often felt closer to the surface.
Quality of Pain	Dull, constant ache that doesn't change with position. Can become sharp and severe if caused by something like a kidney stone.	Can be sharp, stabbing, or a dull ache. Often improves or worsens with movement or position changes.
Accompanying Symptoms	Fever, nausea, vomiting, changes in urination (e.g., pain, frequency, color), and feeling unwell are common.	Often limited to the back, with possible muscle spasms, swelling, or tenderness in the area.
Relief Factors	Usually not affected by movement or rest. May change based on what is being consumed (pancreatitis).	Often improves with rest, massage, or gentle stretching. Movement can sometimes exacerbate it.
Medical Attention	Frequently requires prompt medical evaluation, especially if fever or severe pain is present.	Often managed with rest, physical therapy, or over-the-counter pain relief, though persistent pain requires a doctor's visit.

When to Seek Medical Attention

While muscular back pain can often be treated at home, organ-related pain requires a doctor's attention. See a doctor if your back pain is accompanied by any of the following symptoms:

High fever and chills.
Nausea and vomiting.
Blood in your urine or cloudy/dark urine.
A sudden, severe pain that feels deep and constant.
Pain that does not change or improve with movement or rest.
Pain accompanied by changes in urination patterns, such as increased frequency or painful urination.
A pulsating sensation in your abdomen.

Conclusion

Back pain is not always a sign of a muscle issue. Internal organs like the kidneys, pancreas, and liver can cause referred pain that is felt in the back. Paying close attention to the specific characteristics of your pain, such as its location, quality, and accompanying symptoms, can provide vital clues to its true source. While self-assessment can be helpful, any persistent or severe back pain, especially when accompanied by other systemic symptoms, warrants a prompt evaluation by a healthcare provider to ensure a correct diagnosis and appropriate treatment. For more information on differentiating between types of back pain, consider reading articles on reputable medical sites like the Cleveland Clinic.

Frequently Asked Questions

Kidney pain is typically a deeper, dull ache located in your flank area (just under the ribs on either side of the spine) and does not change with movement. It is often accompanied by other symptoms like fever, nausea, or urinary changes. Muscle pain is usually more localized and can be affected by movement or stretching.

Pain from pancreatitis often starts as a severe, deep abdominal pain that radiates to the mid-back, feeling worse after eating. It may be relieved by leaning forward.

Yes, liver conditions like hepatitis or cirrhosis can cause referred pain. While the liver itself has no pain nerves, inflammation can irritate surrounding tissues, causing a dull pain in the upper right abdomen and sometimes the mid-back or right shoulder.

Yes, gynecological conditions such as endometriosis or uterine fibroids can cause lower back pain. This often presents as pelvic pain that radiates to the lower back and may be linked to the menstrual cycle.

You should seek immediate medical attention if your back pain is accompanied by symptoms like high fever, chills, severe nausea and vomiting, blood in your urine, or a pulsating sensation in your abdomen.

Unlike typical muscular back pain, which often improves with rest, organ-related pain generally remains constant or worsens, regardless of your position or activity level. It requires treating the underlying medical condition to resolve.

Yes, if a UTI spreads to the kidneys, it can cause an infection (pyelonephritis) that results in intense back or flank pain, along with other symptoms like fever and painful urination.