Can a UTI Cause Back Pain?

Urinary tract infections  (UTIs) can feel quite uncomfortable — and if you’re experiencing the discomfort of back pain along with it, you may be wondering what your next steps are. 

It’s important to remember that back pain may not be an additional irritation; it can indicate a more serious underlying issue. Understanding the connection between UTIs and back pain is crucial for your health and well-being. 

In this article, we’ll explore why back pain might accompany a UTI and when it’s crucial to seek medical advice from a primary care provider. 

What’s the Connection Between UTIs and Back Pain?

UTIs are caused by bacteria — typically E. coli — entering the urinary tract. E. coli is naturally found inside your digestive tract. However, certain activities like sex or wiping improperly after going to the bathroom can transport it from the rectum into the urethra.

Once inside, the bacteria can colonize the urethra and move into the bladder. UTIs affecting these areas are known as lower urinary tract infections — or cystitis—and are the more common form.

If they’re left untreated, lower urinary tract infections can progress into the upper urinary tract. In these cases, the bacteria can travel up from the bladder and into one or both kidneys. This type of infection is more severe. And, since the kidneys are located on either side of your spine, it’s also more likely to come with back pain.

Symptoms of UTIs

Lower UTIs are most likely to cause the following symptoms:

• Urinary urgency
• Frequent need to urinate but passing only small amounts of urine
• Pain or burning during urination (dysuria)
• Dark, cloudy, or foul-smelling urine
• Discomfort in your pelvic region (for women)
• Rectal pain (for men)

If your UTI is also accompanied by back pain, the infection may have progressed to your kidneys. In that case, you may experience the symptoms of a lower UTI along with the following ones:

• Back pain in your flank area
• Fever
• Chills
• Nausea
• Vomiting
• Confusion — more likely in older adults

Types of Back Pain Associated with UTIs

Back pain can be a symptom of a UTI, and where it shows up in your back can help provide clues about what’s going on in your body.

For example, your bladder and parts of your back share nerves, so pain can sometimes radiate from your bladder or urethra to your lower back. If you have a UTI and your pain is confined to your lower back and pelvis, you may have a lower tract infection.

However, if your back pain is in your flank, it’s more likely to result from a kidney infection. Your flank is the area just below your ribs, which is also where your kidneys sit inside your body. Because of this, pain in your sides or back in this area may signal an upper urinary tract infection in your kidneys, also known as pyelonephritis. If pyelonephritis is not treated, it can get worse and sometimes cause permanent kidney damage. 

Diagnosing UTIs and Back Pain

Back pain can have a number of different causes. To determine whether yours is related to a UTI or not, your primary care provider will begin by taking your history.

UTI symptoms alone are often enough to make a diagnosis. If you’re struggling to get an appointment with your primary care provider — or you don’t have a provider at all — lower UTI or cystitis can be suitably treated with virtual care.  Primary care providers on Maple can diagnose and treat the condition by faxing an online prescription directly to you or to the pharmacy of your choice.

However, this may not be the case if your back pain is linked to a kidney infection. Kidney infections can become medically serious and may require intravenous (IV) antibiotics to clear fully. If you’re suspected of having one, your provider may suggest in-person testing to ensure you’re properly diagnosed.

Tests and Exams

As mentioned, UTIs can often be diagnosed based on your symptoms. However, sometimes your provider may recommend additional diagnostic testing or lab work. This typically takes two forms.

The first is a urinalysis. To begin, your practitioner will ask you to provide a urine sample which they’ll examine visually for cloudiness or darkening.

Then, they’ll use a test strip to check the urine for nitrites and leukocytes. Nitrites indicate the presence of certain bacteria, while leukocytes show that white blood cells — your immune system’s first responders — are present. 

For an uncomplicated UTI, urinalysis is typically enough. However, if the infection has spread to your kidneys or you have another complicating factor such as pregnancy or a long-term health condition, you may need a urine culture.

To do a urine culture, a small amount of your urine will be added to a growth compound to see if organisms — like bacteria or fungi — grow. If they do, these organisms can be tested to determine their exact type. This allows your healthcare provider to choose the antibiotics that will target them most effectively.

Treatment options for UTI-induced back pain

Urinary tract infections are painful, but they’re also relatively easy to treat. Typically, a short course of antibiotics, somewhere between three to seven days, will do the trick. You should begin to feel some symptom relief within 24 to 48 hours.

Keep in mind, however, that no matter how quickly your symptoms disappear, you must take your entire antibiotic prescription. Stopping the medication before it’s finished can leave some bacteria alive. This can allow the infection to return and potentially progress to your kidneys. It may also cause the bacteria to become resistant to the antibiotic, making it more difficult to get rid of in the future.

While a short course of antibiotics is typically enough, if your UTI has progressed to your kidneys, you may need a longer treatment. A severe kidney infection may even require hospitalization and IV antibiotics. Most people who are diagnosed and treated promptly feel completely better after about two weeks. Individuals who are older or have underlying conditions may take longer to recover.

As you’re treating your UTI, heat therapy can also provide some comfort as applying a warm compress or heating pad to the area will help to relax tense muscles. Ask your primary care provider if you can safely take pain medications for relief. 

Whatever you decide, rest is important. It allows your body to focus on healing itself and prevents you from doing anything that could strain your back or contribute to more discomfort. 

Preventative Measures

Kidney infections can happen at any age and are much more common in women. This is because a woman’s urethra is shorter, making it easier for bacteria to reach the kidneys.

Younger women are most at risk because they tend to be more sexually active which increases the risk of getting a kidney infection.

UTIs are common, but getting one isn’t inevitable. Good hygiene and a few other practices can help to reduce your chances of contracting one. To help prevent a UTI, make sure to:

• Wipe front to back
• Urinate after sex
• Stay hydrated with plenty of fluids, such as plain water
• Avoid douching
• Wear cotton underwear
• Treating constipation
• Empty your bladder as soon as you feel the need to, rather than holding it in
• Wash your genitals every day, and before having sex, if possible

Despite your best efforts, certain populations will still be at higher risk of contracting UTIs. If you find that you’re dealing with more frequent UTIs it may be due to certain factors such as kidney stones, diabetes or perimenopause. In either case, it’s a good idea to speak to a primary care provider about how to mitigate your risk.

Back pain can be part of a constellation of UTI symptoms. However, since it can also signal a more severe infection, it’s best to speak with a primary care provider right away if you’re experiencing it. But if you’re one of the 6.5 million Canadians who don’t have access to a primary care provider, this isn’t always easy to do.

Maple can help by connecting you to a doctor or nurse practitioner within minutes, 24/7/365, over text or video call. They can help you navigate your next steps and give you peace of mind, knowing you can tackle an already uncomfortable illness. 

The information presented here is for educational purposes and is not meant to replace the advice from your medical professional. Virtual care is not meant for medical emergencies. If you are experiencing an emergency, like chest pain or difficulties breathing, for example, please call 911 or go to your nearest emergency room.