What causes severe pain in the kidney area of the back that feels as if a kidney punch was received?

It is rare for the kidneys to cause dull, aching pain. People sometimes equate back pain with kidney pain, but dull aching pain in the back -- especially the lower back or the middle of the back -- is usually due to muscles, ligaments, or even vertebrae and disks in the spinal column. Musculoskeletal pain typically gets worse with movement, and is relieved by heat or massage.