Kidney Stone Pain: Why It Hurts So Much and What You Can Do About It

Have you ever been awakened in the middle of the night by sudden, severe pain in your back or side?

Many of my patients who have experienced a kidney stone describe it as one of the worst pains of their lives. Some compare it to childbirth. Others say they simply could not find a comfortable position no matter what they tried.

One of the most common questions I hear is:

"Why does such a small stone cause so much pain?"

The answer lies in how the kidney and urinary tract respond when a stone blocks the flow of urine.

Kidney stones affect millions of Americans each year and are one of the most common reasons patients seek urgent urologic care. Fortunately, there are effective ways to relieve the pain, and many stones will pass without surgery.

What Exactly Is a Kidney Stone?

A kidney stone is a hard deposit made of minerals and salts that forms inside the kidney. Some stones remain in the kidney and cause little or no symptoms. Problems usually begin when a stone leaves the kidney and enters the ureter, the narrow tube that carries urine from the kidney to the bladder.

If the stone becomes stuck, urine cannot drain normally. Pressure builds up within the kidney, and that is when the pain often begins.

Why Does It Hurt So Much?

The pain from a kidney stone is called renal colic.

When a stone blocks the ureter, pressure builds up behind the obstruction and stretches the kidney. The outer covering of the kidney contains many pain-sensitive nerve endings.

At the same time, the body releases chemicals called prostaglandins, which cause the ureter to contract and spasm in an attempt to push the stone forward. These spasms create the characteristic wave-like pain that comes and goes.

Many patients also experience nausea and vomiting because the kidney shares nerve pathways with the digestive system.

The result can be intense pain that may start in the flank and radiate toward the lower abdomen, groin, or testicle.

Common Symptoms

Symptoms of a kidney stone may include:

• Severe pain in the side, back, or flank

• Pain that moves toward the groin

• Blood in the urine

• Frequent urination

• Burning with urination

• Nausea and vomiting

• Difficulty getting comfortable

  
  

Unlike muscle or back pain, kidney stone pain often causes patients to constantly change positions because no position provides relief.

What Can You Do at Home to Feel Better?

1. Anti-Inflammatory Medications

For many patients, anti-inflammatory medications such as ibuprofen or naproxen can be very effective because they reduce both inflammation and ureteral spasms.

Always check with your physician before taking these medications, especially if you have kidney disease, stomach ulcers, bleeding problems, or are taking blood thinners.

2. Acetaminophen (Tylenol)

Tylenol may be helpful for patients who cannot safely take anti-inflammatory medications.

3. Heat Therapy

A heating pad or warm compress applied to the painful area may provide significant relief. Some studies suggest heat therapy can reduce pain, anxiety, and nausea during a kidney stone episode.

4. Hydration

Staying hydrated is important. However, during a severe acute attack, drinking excessive amounts of water may temporarily increase pressure within the kidney and worsen discomfort.

A reasonable goal is to drink enough fluid to keep your urine a light yellow color.

5. Medications to Help Pass the Stone

Depending on the size and location of the stone, your doctor may prescribe medications such as tamsulosin (Flomax) to relax the ureter and help the stone pass more easily.

My Pain Went Away. Does That Mean the Stone Is Gone?

Not necessarily.

One of the most common misconceptions about kidney stones is that once the pain stops, the stone must have passed. Unfortunately, that is not always the case.

Kidney stone pain is usually caused by a buildup of pressure behind a blockage. If the stone shifts position and urine is able to flow around it, the pressure may decrease and the pain can improve or even disappear completely. However, the stone may still be sitting in the ureter.

In some cases, the stone may have moved farther down the ureter and is no longer causing significant obstruction. In other cases, the stone may have already entered the bladder, where it typically causes little or no pain before eventually being passed during urination.

The important point is this: the absence of pain does not necessarily mean the stone is gone.

If you have not actually seen the stone pass, there is still a possibility that it remains somewhere within your urinary tract.

I occasionally see patients whose pain resolved for days or even weeks, only to return suddenly when the stone shifted and caused another blockage. In some cases, a stone can remain lodged in the ureter with few symptoms while still affecting kidney drainage.

For this reason, follow-up is important. Depending on the size and location of the stone, your urologist may recommend imaging studies such as an ultrasound, X-ray, or CT scan to confirm whether the stone has truly passed.

If your kidney stone pain has gone away but you have not seen the stone pass, it is a good idea to schedule follow-up with a urologist. Confirming that the stone has cleared can help prevent future surprises and protect your kidney health.

When Should You Seek Medical Attention?

Some kidney stones can be managed at home, but others require urgent treatment.

You should contact your physician or seek immediate medical attention if you experience:

• Fever or chills

• Severe pain that is not controlled with medication

• Persistent nausea or vomiting

• Inability to keep fluids down

• Decreased urine output

• Difficulty urinating

• Significant bleeding in the urine

  
  

An infected, obstructed kidney can become a serious medical emergency and should not be ignored.

Most Stones Can Be Treated Successfully

The good news is that many small stones pass on their own. In fact, most stones smaller than 5 mm will pass spontaneously, although it may take days to several weeks. For stones that do not pass, modern treatments are highly effective and often minimally invasive.

As a urologist with a special interest in kidney stone disease and minimally invasive stone surgery, I evaluate and treat kidney stone patients on a regular basis. I understand how disruptive, frightening, and painful a kidney stone episode can be—not only for the patient, but often for their family as well.

Because kidney stones frequently occur without warning, our office reserves dedicated appointment openings for patients with urgent kidney stone problems. In many cases, we can evaluate patients the same day or the next business day.

When a stone is causing severe symptoms, obstruction, infection, or other urgent concerns, timely treatment is important. If a patient requires an urgent procedure to relieve an obstruction, control pain, treat an infection, or protect kidney function, I make every effort to provide prompt care, including weekends when medically appropriate.

My goal is simple: to help patients obtain timely evaluation and treatment, minimize unnecessary suffering, and safely return to their normal lives as quickly as possible.

Preventing Future Stones

If you have had one kidney stone, your risk of developing another stone is higher than someone who has never had one. Fortunately, there are steps you can take to reduce that risk.

General recommendations include:

• Drinking enough fluids to produce at least 2 liters of urine daily

• Limiting excessive salt intake

• Moderating animal protein consumption

• Maintaining a healthy weight

• Following dietary recommendations based on your specific stone type

If You Pass a Stone, Save It

If you are fortunate enough to pass your kidney stone, try to collect it if possible. Many patients urinate through a strainer provided by their physician or the emergency room to catch the stone.

Once you have collected the stone, place it in a clean container, pill bottle, or small plastic bag and bring it to your physician's office. The stone can be sent for laboratory analysis to determine its composition.

This information is often very helpful because not all kidney stones are the same. Some are made primarily of calcium oxalate, while others may contain uric acid, calcium phosphate, struvite, cystine, or a combination of materials.

Knowing the stone composition can help your physician develop a more personalized prevention plan to reduce your risk of future stones.

Depending on your history, your physician may also recommend additional testing, including blood tests and a 24-hour urine collection. These studies can identify factors that contribute to stone formation, such as low urine volume, high calcium levels, excess oxalate, low citrate levels, elevated uric acid, or other metabolic abnormalities.

The goal is not simply to treat the current stone, but to understand why the stone formed and help prevent future episodes whenever possible.

Final Thoughts

Kidney stone pain can be one of the most intense pains a person experiences, but effective treatments are available. Early evaluation can often relieve symptoms more quickly, prevent complications, and help reduce the risk of future stone episodes.

If you think you may have a kidney stone, don't ignore it. The sooner the problem is evaluated, the sooner we can determine whether the stone is likely to pass on its own or whether treatment may be needed.

If you have questions or concerns about kidney stones, please contact our office. We are here to help.

Disclaimer

This article is intended for educational purposes only and should not be considered medical advice. The information provided is general in nature and may not apply to your individual situation. Reading this article does not establish a physician-patient relationship. If you are experiencing severe pain, fever, chills, vomiting, difficulty urinating, or any other concerning symptoms, seek prompt medical attention. Please consult your physician or urologist for personalized medical advice and treatment recommendations.