What causes kidney stone pain?

Diagram of locations where stones become lodged

Three locations where stones become lodged

Stones usually first develop in the kidneys. (For more information on the process of stone development, see: How do kidney stones form?) A kidney stone usually first causes symptoms when it tries to move down the ureter and out of the urinary system. As it makes its way down the ureter, it can cause blockage, which leads to the development of increased pressure in the kidney above. This pressure leads to the pain associated with passing a stone.

As a stone moves  down the ureter, it tends to become lodged in three locations of natural narrowing: the ureteropelvic junction, the crossing of the ureter over the iliac vessels, and at the entrance of the ureter into the bladder. Depending on where a stone is located along this path, the pain associated with it can vary. Stone pain usually starts high up near the kidney then migrates towards the abdomen and eventually down towards the groin as the stone moves further down the ureter. As a stone is almost ready to come out, patients may feel the urge to urinate.

What about kidney stones that aren’t passing?

Most doctors feel that kidney stones only cause pain if they are blocking the ureter and trying to pass down towards the bladder. Stones that are not obstructing, such as those located in the kidney’s calyxes, are generally thought to be non-painful. This explains why some patients can have extremely large stones filling up their entire kidney with no or minimal pain.

However, it does appear that some non-obstructing kidney stones can cause pain because of either blockage of small tubular structures in the kidney itself (the collecting tubules) or for other unclear reasons. Supporting this view is a recent medical journal article suggesting that the treatment of small non-obstructing “papillary” stones may provide pain relief. (Gdor et al, Multi-institutional assessment of ureteroscopic laser papillotomy for chronic pain associated with papillary calcifications, J Urol 2011) Additionally, testimonials from many kidney stone patients (including a urologist with a personal history of kidney stones) suggest that some  non-obstructing stones can cause pain.

81 Responses to What causes kidney stone pain?

  1. Janet Kennedy says:

    Hi, going in for surgery this Friday to remove 1.4 cm stone sitting at junction of of kidney and ureter (had a stent put in 3 weeks earlier – no fun), along with 1.5 cm stone and two 0.2 cm stones behind the two biggies. I have found the pain control regime that works best for me is the Voltarin suppositories (anti-inflammatory) – almost instant relief, along with tylenol #3s. For some reason, the hyrdomorphone pills just don’t do anything for me. Plus breathing during attacks – maintaining control of my breathing helps too. Percutaneous nephrolithotripsy here I come.

  2. Brent says:

    I am in constant daily pain now, and have been for going on four years now due to kidney stones. In these four years the stone count is at 52. The cause of the pain is unknown as for the most part the stones are non-obstructive. The cause for the number of stones is also unknown and has been pinned down to being hereditary as both sides of my family get then. The pain medication barely works anymore and am feeling left out in the dark because I have yet to find a doctor who can help me………….

    • Larry L. Scaglione says:

      I have similar kidney problems. If you would look up renal tubular acidosis, I believe this is what you might have. Yes, it is hereditary. Good luck, and may God bless you.
      Larry

  3. deborah says:

    i was also told to stay away from ibuprofen.I was prescribed narcotics as nothing else touches the pain. i try stay away from these too and find other ways of dealing with the pain.

  4. deborah says:

    Hi, i was diagnosed with multiple kidney stones 7 years ago, i have 9 in left, 7 in the right. They are embedded and i see urologist once a year. They cause me a lot of pain, which he says shouldnt. I have chronic kidney disease stage 3 with 49% kidney function due to these stones, when i first saw him it was 57%. Ive been advised by him to leave them alone as the pain would be great just getting rid of one but if my kidney function becomes lower will have to do something. When the pain becomes too much, i have to lie down for a while and that somehow helps, but its not always convenient to lie down. i also see an osteopath which helps with pain relief as restricted with what painkillers to take.

  5. Angel says:

    I have been told I have multiple kidney stones in each kidney. Over 8 in each. I have pain in my lower back depending on the day and irritated kidney. Today its the left. Most times I take advil and deal. But 3 times over the past 5 years I have been to the er in pain, with a fever and blood in my urine. The xray and ct scans show the stones, but only 2 out of the 3 times did I show I passed them. The doc told me as long as they are in the kidneys and not moving they shouldn’t hurt. I’m NOT making this crap up (nor the fever I get with them. Usually 100.) I am SICK to death of doctors saying, “it shouldn’t hurt…” Well, maybe it shouldn’t, but it DOES!!! So, about a month ago was my 3rd er trip. Usual, pee in a cup first. Well, with the new during cup design, they came into my room, took a syringe and took the top layer of urine off. You could SEE the sediment in the bottom of the cup. I laughed when they came back and said, “Well, nothing in your urine but trace blood and ct shows stones still in your kidneys.” I pointed to the cup and said, “That’s cause its still sitting in the bottom of that cup!” IDIOTS!!!!!

  6. Derk says:

    I too am a constant stone passer.

    I passed my first kidney stone at 24 and now 4 years later I’ve passed 20+ ranging from 1mm-4mm in diameter. For me there are 2 distinct types of pain I feel. The first is what I’ve found called “renal colic”. It comes in waves and seems to be located in my lower back. I almost always have extreme bowel distress along with the pain. This pain comes and goes, it can last upwards of 4-5 hours or be as short as 15 mins. Typically I will have this pain for a week or so before the pain stops completely. Then as regular as clockwork I’ll feel a very sharp stabbing pain in my groin. (I’m male) This pain generally last for 1-10 seconds but usually repeats every 1-3 mins for upwards of an hour. Both types of pain can be so intense that I’m incapacitated. I can now tell when the stone is done “moving” and that it will exit my body during the next urinary movement. Generally the actual event of urinating the stone out of my body is much less painful than any other portion of the passing of the stone. I’ve seen multiple doctors for my chronic kidney stones. Mine show up on a CT scan but never on an X-RAY even when they know where the stone is supposed to be. My doctor rarely prescribes me any sort of pain medication for passing a kidney stone so I usually just take Advil which sucks. I don’t know if anyone else experiences the same sort of distinction between types of pain associated with passing kidney stones but it’d be nice to know I’m not alone in this. Also, from the first moment of feeling a kidney stone, it generally takes a month before I finally pass the stone. I will have days or even weeks without any pain, and then it will start up again. I’m not sure how long it normally takes people to pass stones. What is everyone else’s experience with timing?

  7. Jenn says:

    About a month ago I woke up with a bad pain where my rib meets my spine on the left of my back. It felt like something was swollen behind the rib, or like something didn’t fit right. That lasted a day. The next day I was outside and I stood up straight and the screams began. Felt like labor pain to me. Seizing pain from my rib down my back and then pause, then do it again. Felt like my spine was going to break in half! This was just after my period. Then it just stopped the next day after about four hours of screaming, clenching pain. Now it is back. Can you get kidney stones again that quickly? Does this sound like kidney stones? Thanks!

  8. Amy Dutcher says:

    I too am a “stoner.”. I live in a small town and we have a “bandaid” hospital. I get stones or kidney pain on my left side roughly every three months. Unless there is a “big” stone (they say 3mm to 4mm) that is causing blockage they shake their head, and tell me it shouldn’t hurt. Sometimes the stone might be hgh in my kidney and cause me pain. Do any of yall have pain sometimes even though “clinically” it says you shouldn’t?

  9. Gene says:

    Yes, the pain comes in waves that ramp up, can last for hours and may drop off suddenly, only to reoccur later down the road. As for the nausea, you only hope it doesn’t happen, or you’ll swear you have hurled up your toenails. I have had food poisoning (in the military from a chow hall) and it was much less violent than K.S. nausea. My whole lower abdomen aches for a day following a round of KS nausea. I had an ER doctor give me Demerol the 1st time I had stones, and it had zero effect on the pain, then the ER chief came in and gave me some type of morphine, which certainly stopped the pain. Not too keen on the side effects (bad headaches, weird dreams, sweats, loss of appetite), but I remember he told the junior doctor that it was useless to use Demerol on KS.

  10. Braulio says:

    Is there anybody here who experience the one i have? Please advise.

    • Brenda says:

      I’ve had stones since I was 12 yrs old how at 54 I’ve had them the entire time.
      now im dealing with a stagehorn stone bigger than half my kidney and its moving downward and may cover my urethra, im sitting a waiting now for a call to let me know what the ct scan showed.

      • ria sieuchan says:

        Well , I have stones in my both kidneys& it’s very painful when I have my periods ,I’ve tried anything my doctor or anyone told me will work,but nothing helped but one day one of my friend told me about Changa piedra so I tried it an you all know what it’s the only thing that help me so you all can try it , really works if u take it properly, I got 2 cyst now so that’s wher i get the pain now

  11. Braulio says:

    Is there anybody here who experience this one i have? Please advise.

  12. Braulio says:

    Hi last August 6 ,2013 i went to the toilet for pee and suddenly i urinated a stone..kindle tell me if im lucky or still have possible to have stone on kidney because i plan to check with urology when i got home….

  13. Emily says:

    Hi I’m 15 years old and passed my first kidney stone in June while I was in the ER.After taking a few tests they told us (me and my parents) that there was one more kidney stone in my kidney, only about 2 millimeters. Now two months later I have had two episodes of extreme pain in my right side between my belly button and my hip bone. It will last all day long and will cause me to stay in hour long baths cause that is the only pain relief I can seem to get. This last episode was yesterday and it got to where my doctor was having my mom give me hydrocodone, and a nausea medication. Even with the hydrocodone I was it still feeling losts of pain. Each episode only last a day and in the morning I feel fine but still have not passed the second stone. Does this happen to anyone else?

    • Katja says:

      Hello Emily,

      I’m so sorry to hear about your pain. I’ve had stones 7 times now and also right now. It’s 10mm x 8mm though and has to be surgically removed/broken down. So you are still ‘lucky’. I know that even the smallest ones hurt like hell though.
      I found in the US hydrocodone is the only oral medication for at home that will relieve you of some of the pain. When it is not that strong 2 Tylenol Extra Strength (you can get them without prescription) could help.
      To help the nausea: Try ginger tea. It is known to help to an extend. Peppermint tea is often beneficial as well. Plus it makes drinking so much fluid a bit easier if not all of it is water.
      To relieve the pain a bit I can recommend a heating pad. My boyfriend got me one and I am constantly lying on it when I am in bad pain. It will have a similar effect as your baths do and you can even use it in bed. If you get one, get one with an auto shut off function just to avoid accidents when you use it at night.
      I know you probably don’t feel like walking, but it will help make the stone move, which is what you want, so it travels down and out. Jumping exercises can do the same. Maybe do both at the times when you’re in less pain.
      Lastly, you might want to consider this as it is a small stone:

      http://www.earthclinic.com/CURES/olive-oil-lemon-juice-for-kidney-stones.html

      I haven’t tried this remedy as my stone is too big to pass naturally, but in your case I would definitely give it a go.

      All the best!

  14. RJ says:

    Ugh, it’s happening again. I’ve past probably 16 or 17 stones in my lifetime, the last in June 2005. Only two of all those required any type of medical assistance.

    A geeographical change in my life made me think I may have said goodbye to these rascals, but as I type that old familiar pain is upon me once again.

    Best wishes, all you stoners. I’m leaving work and headed for home and hydrocodone.

  15. Stan Schurman says:

    Had a kidney stone roughly 2 years ago. It was successfully pulverized with a laser and passed through a stent with a minimum of pain. Some burning during urination, but that was only for a couple of days following the procedure. And guess what? I didn’t have to deal with blood sucking insurance companies and it didn’t cost me a cent. Why? I live in Canada. Wake up America!

    • Cathy C. says:

      As an American, I really wish we could get some common sense to spread about the many benefits of socialized medicine. As it stands now, I have the pain of the kidney stone, and then the pain of the pocketbook. Double whammy every time!

      • Kat says:

        My boyfriend is going through this right now. We are fortunate that he is covered on my insurance. We have, however, spent $2500 out of pocket over the last two weeks on “diagnostics” like CT scans and cystoscopy, because they wanted to make sure it wasn’t something more “serious”. He is in extreme pain, is crying and yelling, and yet his doctor refuses to give him any pain prescriptions! Even the nurse said they should have. Now he is unable to pee altogether. So I’m taking him to the ER, where we’ll get charged an arm and a leg, just so HOPEFULLY someone can give him some pain meds and Flomax! He’s been through this before….we know what he needs. Apparently this world-renowned doctor at the Cleveland Clinic does not. He actually told my boyfriend to take Tylenol Extra Strength. Seriously. He has obviously never had a kidney stone before.

        • Trey says:

          Kat,
          I wish you both the best, I’ve been through 5 ureteroscopies in the past 2 years and my doctor is the same with pain meds. Even after surgery he’d only give toradol. The only way I can get relief is going to the ER. Its a miserable road with Kidney Stones. GOOD LUCK!

    • Diana says:

      I live in America and I don’t want socialized medicine. WAKE up Canada!!!!
      I went to the emergency room last night and was treated for a small kidney stone and since I have Medicare/BCBS it didn’t cost me a cent. Of course I still have the stone but am hoping it will pass without more pain.

      • Chloe says:

        Just wanted to point out that Medicare is a “National Social Insurance Program” run by the federal government.

        Medicare=Socialized Medicine

  16. i was recently admitted to my local hospital for kidney stones and had a 24 hour urine test done and a stent in place i asked the doctor if i really had to have done and he answered yes and that i was lucky to come in when i did because i could have gotten really sick and that i have other medical problems i want to know why it was painful for me when they placed the stent and why i have to wait two weeks to have surgery when i am so much pain that the only thing that helps me sleep and do regular stuff like housework

  17. Michael L says:

    I am currently a patient in the VA (veterans) health care system. I have had to go to the er twice in the past 36 hours for stone type pain. I have been cysto’d for stones over 20 times in the past and currently have 3 stones in the right kidney, 1 OVER 7mm in the lower pole and 2 over 3mm in the upper. I also have a small stone in the left kidney. The doctor in the er and the doctor I normally see both say the same BS! That the stones will move inside the kidney, cut the inside of the kidney, and I’ll pass blood in my urine BUT they don’t hurt!! They do hurt, badly at times. How do I get these idiots to know the truth?

    • Anne M says:

      You are so right! they always tell me that the ones in the kidney are not causing me pain and I say, yeah, well why am I in screaming pain and puking! It hurts and they need to deal with it! Feel better!

      • Deborah T. says:

        Oh my gosh Anne and Michael, I feel your pain. I had a 6mm stone lodged in my ureter and removed (finally!) last October. There were two stones remaining in my left kidney. I have been having left flank pain that radiates around my hip and down into my lower abdomen. I’ve had a complete physical, blood work, GYN appointment and vaginal u/s, two renal u/s and a KUB X-ray. I do have a small amount of microscopic blood in my urine, nurse practioner says most likely from the stone. CT scan from last October shows stone in the same place in the left kidney, as does a KUB x-ray done mid-June, when I had a 5mm non-obstructing stone removed from my right kidney – that one “behaved” – didn’t bother me, but urologist felt we should take it out. Meanwhile, I returned to my urologist, with my left flank pain and he is of the belief that stones that are still in the kidney DO NOT cause pain. I had a repeat u/s recently and upon talking with him, am going in for my third lithotripsy mid-July. I can hardly wait! The flank pain is RIGHT there in the left kidney area, and I feel the same symptoms like I did last summer, before the 6mm stone dropped and got lodged in the ureter. Although I do trust my urologist, I think he is mistaken in his belief that stones only cause pain once they descend into the ureter. It’s so reassuring to see that other people have also had the same kind of discomfort I am feeling. Does your discomfort come and go? I can go a stretch of days feeling pretty good, and then I get that same feeling again. I’m thinking that it’s probably the stone moving around in the kidney. The heating pad seems to help a little bit and the urologist did give me a Rx if need be. I honestly can’t wait for the lithrotripsy. I just want this stone removed and hoping it will resolve all my flank pain issues. Thanks for posting…hoping you reply as well.

  18. Devi Bishop says:

    What are all of the symptoms of kidney stones?
    I heard they can cause all sorts of symptoms.
    And they tend to vary.

    • Terry says:

      Grinding continuous sickening pain that may go on for eight to ten hours or more each time the stone is on the move in the ureter. It makes you want to take hot showers in an effort to find relief and often doubles you up on your stomach over a chair or ottoman. Nothing really helps except hydrocodone or similar. Twenty years ago they gave you demerol, but the government put a stop to that, and now you’re lucky if you can get a few hydrocodone tylenol combination tabs which dilutes them so they are less attractive for sale to a druggie. Like you would do that anyway, when you need them so badly yourself.

    • bonnie neville says:

      Devi Bishop . Symptoms do vary. Diarrhea, pain in the flank (region just below the cage). nausea or vomiting, fever if accompanied by kidney or bladder infection, some people get pain around the side of their abdomen, inability to pass much or any urine, passing only small amounts of urine frequently if able to pass any at all, feeling the need to keep moving (laying down or being still makes the pain worse). Terry had it right when she/he said “sickening pain”. It is grotesque and very sickening pain. The best way I have found to describe the pain is you feel like you must know what it is like to have someone grind and dig a butcher knife into your side non-stop for hours.

  19. Dora Tellez says:

    I would like to know what to look for when passing a kidney stone. I had a stent placed 3 weeks ago and since I don’t have insurance have not been able to get my follow-up until I get the amount they are asking for up front.

    • Carolyn says:

      Dora, If need be go to the emergency room and tell them its causing allot of pain and discomfort. Maybe you can get them to remove it. I went to the emergency room with pain on my left side. I was in renal failure from having kidney stones on both sides. They were blocking some of the urine. The ER admitted me. I had tubes put in my back to drain it also had caused a bad infection. I got MRSA of the blood from it. One of the urologists not usually associated with that hospital came to my room and said I know your circumstances and that you have no insurance. He said don’t worry will figure something out. He told me to see him when I got released and gave me his card. Needless to say I was in the hospital 8 days. I had a pic like inserted into my arm so that I could go back to the hospital everyday at 1:00 pm to have a very strong antibiotic IV for 2 1/2 hours for 4 weeks straight. I have had 2 procedures since May 8th and I am still having procedures done. This urologist hasn’t asked me for a penny. I had the left stent removed and the right kidney shocked to break up an 8mm I also had 5 smaller stones removed from the right side as well. I had about 4 removed from the left. I almost died and had no idea I was that sick. I believe God sent that Doctor to me, he wasn’t at all worried about the money God bless him.
      So try the ER and good luck I will pray for you to get the help. Let me know how it goes not all Doctors are money hungry and do believe in healing the sick. Good Luck

    • Lina says:

      Hello, I am in same case, what I did is after I was advised by the doctor who put the stent that since I don’t have insurance she cannot schedule my procedure, she advised me to go to the emergency telling them that the stone and the stent are really hurting me, and told me to ask them to call her. I went to the emergency they called the doctor I was scheduled for the next day. Stone removed I still have a second stent, but the doc left a string so she can pull off the stent in her office, she told me that I can take it off by myself but I said no thank you. Many doctors do that for persons that don’t have insurance. Hope I helped you. Good luck

      • Jackie says:

        They are right. I have a college degree in Medical Administration… Any hospital Emergency Room that receives federal funds HAS to see patients the ER. The patient cannot be turned down regardless of their medical insurance situation. So, if your primary physician will not see you, go to the ER!

    • Stones are very hard to see when you pass them. They are very small. Most people are given a strainer to urinate into. Even when using a strainer, you could easily miss and not see the stone. It is my personal opinion that it is unconscionable to not get your follow up until you have the money up front. Go to the emergency room and have the stent removed. Ask for a strainer if you don’t already have one. They can do a CT scan to see where the stone is if it is “hung up”. Is it in the kidney, the ureter, the bladder? One time I had a stone that was lodged in my urethra and the doctor had to flush the urethra.
      Usually when passing a stone you will have a bit of red blood in the urine or you will see it on the toilet paper. I certainly hope this helps you. If you ever get another stone; I highly recommend that you use a different urologist-preferably ne with a conscious.

  20. malissa says:

    Does having a kidney stone feel like labor pains

    • Brian says:

      I’ve had multiple female friends say they would choose unmedicated labor over kidney stones any day. They say the contractions give you breaks to recover whereas the stones do not.
      So I would assume they mean the feel similar.
      I just passed my 3rd this morning and it was by far the most painful thing I have ever experienced.

    • Katie says:

      Yes and no. I am a “stoner” meaning I have had many stones over the last 30 years. I also gave birth to two children without medication. I will take the childbirth any day. That said, yes, the pain can be as intense as childbirth, especially if the stone is stuck. Kidney stone pain often comes in waves. However, not every stone and everyone who suffers from stones, has the same type of pain. Do not be afraid to go to the E.R. for testing and pain control. Good luck to you.

    • bonnie neville says:

      I was found to have hundreds of stones (msk and rta type 1) at 19. I am 53 now. My kidneys are still full of them embedded throughout and I have had more than 60 surgeries. Lithos and cystos. Mostly cystos. It is true that not all stones feel the same, and not all cause unbearable pain. The ones that have caused me the unbearable pain are the ones that had blocked the exit from my kidneys, or blocked the pathway in my ureters, essentially blocking my urine. Also when it comes to ones that are not totally blocking the urine, it is the smallest ones that cause me the most pain. I believe the smaller ones are more wicked because under a magnifier I see that my stones are covered with glass like shards, hence with each tiny progression of stop and go movement which sometimes takes months before entering my bladder, or even exiting the kidney…these small ones latch to a new piece of ureter or kidney flesh causing renewed pain, not to mention the cutting and swelling left in their wake. I have had four children and yes, it is like and usually worse than labor pains. I have always said I would rather have all four of my children at one time than to have a stone that totally blocks my urine. The pressure is just like you feel in labor and so I find myself always feeling the need to “push” when I have a stone, as well as using lamaze breathing technics. These physical responses are not thought out, they just are automatic when I have an active stone. Any man whom has had a stone essentially knows what it is like to have “labor”. And then there are stones which cause me the bearable with a little narcotic help pain.

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