How to Evaluate Pain in the Lower Left Side Near the Hip and Waist

Pain around the lower-left waist and hip can originate in the muscles, hip joint, spine, intestines, urinary tract, or abdominal organs. The exact location, type of pain, and accompanying symptoms can help narrow the possibilities, but they cannot provide a definite diagnosis.

Because I am over 70 and have diabetes and a history of kidney concerns, new, persistent, or worsening pain in this area deserves timely medical attention.

Could It Be the Spleen?

The spleen is on the left side, but it is located much higher than the hip—underneath the lower-left ribs. A spleen problem usually causes pain or fullness in the upper-left abdomen, sometimes with pain in the left shoulder.

Spleen injury or rupture is uncommon without trauma, although an enlarged spleen can be vulnerable. Severe upper-left abdominal pain following a fall or blow, particularly with dizziness, weakness, faintness, or left-shoulder pain, requires emergency care.

A spleen problem is less likely when the pain is confined to the lower-left waist, hip, groin, or buttock.

Could It Be the Left Kidney?

It is possible. The kidneys sit toward the back of the body, roughly between the lower ribs and the upper hips. Left-kidney pain is generally felt in the flank—the area beside the spine between the ribs and hip—but it may travel into the lower abdomen or groin.

Possible kidney-related causes include:

Kidney stone

A kidney stone commonly causes sharp or intense pain that may come in waves. The pain can move from the back or side toward the lower abdomen, groin, or testicle. Other possible signs include:

• Blood in the urine
• Pain or burning during urination
• Frequent or urgent urination
• Nausea or vomiting
• Cloudy or bad-smelling urine
• Difficulty passing urine

The National Institute of Diabetes and Digestive and Kidney Diseases identifies sharp pain in the back, side, lower abdomen, or groin as a typical kidney-stone symptom.

Kidney infection

A kidney infection may cause a steady ache in the side or back accompanied by:

• Fever or chills
• Painful or frequent urination
• Cloudy, bloody, dark, or foul-smelling urine
• Nausea or vomiting
• Weakness or feeling generally ill

A kidney infection requires prompt medical treatment, particularly in someone with diabetes. NIDDK explains the warning signs of kidney infection.

Urinary obstruction

A kidney stone, enlarged prostate, or another blockage can interfere with urine flow. Warning signs include difficulty starting urination, a weak stream, passing very little urine, frequent urination, blood in the urine, or inability to urinate.

Chronic kidney disease itself often produces no pain. Therefore, pain near the left kidney does not necessarily mean that kidney function has worsened.

Diverticulitis: An Important Left-Sided Possibility

Diverticulitis is one of the more important causes of lower-left abdominal pain, especially in older adults. It occurs when small pouches in the colon become inflamed or infected.

Possible symptoms include:

• Persistent lower-left abdominal pain or tenderness
• Fever or chills
• Bloating
• Nausea or vomiting
• Constipation or diarrhea
• Loss of appetite
• A noticeable change in bowel habits

The pain may become worse when moving, coughing, or pressing the area. Mild diverticulitis and a serious complication can initially feel similar, so persistent localized pain—particularly with fever or bowel changes—should be evaluated rather than treated at home with laxatives.

Constipation or Intestinal Gas

Constipation can produce pressure, bloating, cramping, and discomfort in the lower-left abdomen, where part of the colon is located. Gas pain may move around and improve after passing gas or having a bowel movement.

Constipation is more likely when stools have become infrequent, dry, hard, or difficult to pass. However, severe or steadily worsening pain should not automatically be dismissed as constipation or gas.

Avoid taking a strong laxative for unexplained, localized abdominal pain until intestinal blockage, diverticulitis, and other urgent conditions have been ruled out.

Muscle or Tendon Strain

A muscle strain is especially possible if the pain started after:

• Squats or another exercise
• Increased walking
• Lifting or carrying something
• Twisting or reaching
• Coughing
• Sleeping in an unusual position

Muscular pain usually changes when bending, twisting, lifting the leg, rising from a chair, or tightening the abdominal muscles. There may be a specific tender spot. Fever, vomiting, urinary symptoms, and major bowel changes would be unusual with a simple strain.

Because I have considered doing 100 squats each morning, I should notice whether the pain started after squatting or increasing my activity. It would be sensible to pause strenuous squats until the cause is clearer.

Hip Bursitis

Hip bursitis usually produces pain over the bony point on the outside of the hip. It may spread down the outside of the thigh.

The pain is often worse when:

• Lying on the painful side
• Walking for a long time
• Climbing stairs
• Squatting
• Rising from a chair
• Pressing directly on the outer hip

These are typical features described by the American Academy of Orthopaedic Surgeons.

Hip Arthritis

Arthritis of the hip can cause an ache in the groin, outer thigh, buttock, or occasionally the knee. Other clues include:

• Stiffness after sitting or sleeping
• Reduced hip movement
• Difficulty putting on shoes or socks
• Pain while walking or bearing weight
• Limping
• Trouble getting into or out of a car

Pain coming from inside the hip joint is often felt in the groin rather than directly over the outside of the hip.

Lower Back, Sacroiliac Joint, or Nerve Pain

Problems in the lower spine or sacroiliac joint can create pain near the waist, upper buttock, or hip. The pain may change with standing, walking, bending, or turning over in bed.

A pinched or irritated nerve may cause:

• Burning or electric pain
• Tingling or numbness
• Pain extending into the buttock or leg
• Leg weakness

New weakness, loss of bladder or bowel control, or numbness around the groin is an emergency.

Hernia

A groin or abdominal-wall hernia can cause aching, pressure, or a visible bulge. The discomfort often becomes worse with standing, coughing, lifting, or straining during a bowel movement.

A bulge that becomes very painful, hard, discolored, or impossible to push back—especially with vomiting or abdominal swelling—requires emergency treatment.

Shingles

Shingles can begin with one-sided burning, tingling, itching, or extreme skin sensitivity. The pain may start several days before a rash becomes visible.

Check the skin around the left waist, abdomen, back, hip, and groin for redness or clusters of blisters. Early antiviral treatment is most effective, so contact a clinician promptly if a shingles rash develops.

Questions to Ask Yourself

Before contacting a healthcare professional, write down the answers to these questions:

1. Is the pain mainly in my abdomen, side, back, groin, buttock, or directly over the hip?
2. Did it begin suddenly or gradually?
3. Is it sharp, burning, cramping, throbbing, or a dull ache?
4. Is it constant, or does it come in waves?
5. Does walking, twisting, coughing, lying on the left side, or moving the hip change it?
6. Do I have fever, nausea, vomiting, bloating, constipation, or diarrhea?
7. Has my appetite changed?
8. Is urination painful, frequent, reduced, cloudy, foul-smelling, or bloody?
9. Is there a lump, rash, numbness, weakness, or pain traveling down the leg?
10. Did the pain begin after a fall, exercise, squats, lifting, or extra walking?
11. Is it improving, remaining unchanged, or becoming worse?

Do not repeatedly press hard into the abdomen in an attempt to diagnose yourself.

When to Seek Immediate Help

Go to an emergency department or call 911 if the pain is severe or rapidly worsening, or if it occurs with:

• A hard, swollen, or extremely tender abdomen
• Fever, shaking chills, confusion, or marked weakness
• Repeated vomiting or inability to keep liquids down
• Blood in the urine or stool
• Black, tarry stool
• Inability to urinate
• Inability to pass stool or gas
• Dizziness, fainting, chest pain, or trouble breathing
• A painful, hard, or discolored groin bulge
• New leg weakness or loss of bladder or bowel control
• Inability to stand or bear weight after a fall
• Upper-left abdominal pain after an injury, especially with left-shoulder pain or faintness

The Sensible Next Step

If the pain is new and lasts longer than a day, repeatedly returns, disrupts sleep, affects walking, or has no clear muscular explanation, contact a primary-care clinician or urgent-care center. Given my age, diabetes, and kidney history, a same-day call is reasonable, especially if I have urinary symptoms, fever, bowel changes, or localized abdominal tenderness.

A medical evaluation may include an examination of the abdomen, back, groin, and hip; a urinalysis; blood tests for infection and kidney function; and possibly an X-ray, ultrasound, or CT scan.

Until evaluated, avoid strenuous squats and heavy lifting. Track the pain and associated symptoms, remain normally hydrated unless a clinician has restricted fluids, and avoid starting ibuprofen or naproxen without medical advice because these medicines can present added risks for someone with kidney concerns.