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.

 

234 Responses to What causes kidney stone pain?

  1. Kelly scheske says:

    I have 8 veg tiny..as described by urologist..in my right and 4 small in left

    My right is agonising !! They haven’t budged and are stuck to kidney..pain is unreal
    Started out just when walking. Standing moving full stop..and could control either pain relief
    Now it’s as soon as I wake up.. lying down!
    Have laser treatment to break them down on Monday by worried it’s not going to work!! I’ve been on sick for 4mitbhs …I’m hca on very busy ward…and now very fed up pain relief not working!!
    Advice? I’m in agony
    Can’t even pick little girl up and moving is agony

  2. Yesenia says:

    I had mines done in March 29 2015 I have not went to take it out .whats happens .i haven’t went couse am afraid what they might say .

  3. Laurie says:

    I had to call 911 on 9/16/16 for severe pain in right side of my back. The pain was excruciating and they couldn’t pump pain meds fast enough to ease the pain. once at the hospital they found 2 golf ball size stones in right kidney and put in a tube that goes from my kidney and right out my back and drains into a bag which I have to empty out every so often. My stone removal surgery is scheduled for 10/3/16 which I can’t wait for. I still have pain when I take deep breaths and also when I move, sit, stand, pretty much anything I do. I had to take off of work for almost a month cause my job consists of lots of lifting, twisting, bending, which I can’t do. I’m afraid that the severe pain will return before my surgery day so I’m taking precautions. I’ve never experienced anything like this before and I hope that I never do again.

    • Joel DeClue Sr. says:

      Laurie,

      I am a chronic kidney stone producer, over the last 28 years I have passed 100’s of kidney stones and have also had 23 ESWL (Shockwave Lithotripsy) procedures done, last one was yesterday.

      I would not wish a single kidney stone on ANYONE and I am very sorry to hear that you not only have them but you are also experiencing the associated pain. It is truly horrible. I assume your pain was caused by a blockage of the kidney itself from draining. That causes nephritis making the kidney swell with fluid, as it can not drain, and the pain is usually an 11 on a scale of 1-10. It is absolutely brutal.

      I wanted to share with you some information for the future based on my 28 years of experience and research resulting from my own condition. Mine are a result of my kidneys being tilted into an abnormal position which does not allow them to drain properly, so for me their is no cure just drink as much water as possible to try and keep fluid going through them.

      As to your specific condition I have assumed that due to the size one of them blocked your kidney from draining. As terrible as this sounds, due to your other kidney, your blocked kidney is not in danger of immediate failing or future injury just because it is blocked, however painful it is. It takes upwards of 20-30 days for a blocked kidney to become damaged. But, yes, the pain is horrible.

      Since they already have placed the drainage tube and bag this is for future reference.

      I have had to go to the ER many times when my own kidneys have become blocked and the only relief is ER meds until the blockage moves back into your kidney or moves and allows drainage. As a result of that I have never let them place a drainage tube into my kidney through my back. Instead I insist on them having a Urologist place a J-Stent in between my bladder and kidney. Essentially this is a tube with drainage holes on either end that when put in place keeps your kidney from being blocked by keeping the stone from blocking and allowing the fluid to drain through the stent.

      The Stent placed between your bladder and kidney is done through a cystoscope and is very invasive while punching a hole through your back, between your ribs and into your kidney is much, much more invasive. It results in scar tissue internally and is much more prone to infection.

      There has been quite a few times where a ER recommended, due to expediency, to place the external stent and bag but in every case I have refused it. And in every case they have been able to keep me medicated so that the stone moves and my kidney drains naturally allowing me time to have the procedure to place an internal stent done a day or so later or, in extreme cases where it would not move, wait overnight for the on-call urologist to be able to place the stent internally without any “cutting” there in the hospital. I have been at an ER due to a blocked kidney upwards of 25+ times minimum.

      I wish I could let everyone know this. It is much, much better to remain medicated in the ER and wait on a urologist to place a stent than have them do what they did to you. I am really sorry that happened and hope in the future if you ever need this info or anyone else reads this that immediate surgery to place an external drain is not the only option. I especially believe in this day and age it should be a very, very rare option and only in remote areas where a Urologist is not available.

      Best of luck to you, prayers Laurie

  4. ihsan ali says:

    Dr sb.
    i have kidney stone in lower ureter 8mm size what is the solution for this kind of kidney stone please help me.
    thanks

    • Ashley says:

      HI my name is Ashley an i am a chronic kidney stone sufferer. I saw your post an i wanted to personally answer (hope that is ok). An 8mm stone is a very large stone, that actually requires surgery. I had an 7mm stone an doctors wouldn’t believe me until I passed it and they sent it to lab. Always do your own research, doctors can be very non informative about kidney stones. If doctors claim that your stone is non obstructive that is false because that stone will eventually move and also it can cause damage to the kidney if not treated . I hope this helps, both my kidneys are damaged duè to hundreds of stones I have passed. God Bless You.

    • Joel DeClue Sr. says:

      Here is my advice, hope it helps.

      If it is in your lower ureter than, while quite large, it may be passable. I have passed hundreds of kidney stones but only two as large as that from my kidneys all the way out. Anything larger has required ESWL, basically soundwaves used to break them up into smaller more passable sizes.

      Anyway, as to your specific case, if the pain is in your lower front abdomen then it is close to your bladder and, if you can get it into your bladder, an 8mm stone can pass out from there as your urethra is larger then your ureter. My recommendation is to drink as much water as possible while also doing jumping jacks and other movements to try and jar it lose and get it to move to your bladder. But, Be Aware if it moves into a position that blocks your kidney it will cause a massive amount of pain in your back flank as your kidney swells since it can not drain. If this occurs and you cannot get it to move, allowing your kidney to drain or get it to move into your bladder, you MUST be prepared to have someone take you to the emergency room.

      The only other options is wait and hope it moves to your bladder on its’ own, go to see a urologist to schedule a procedure to have it removed or wait until it blocks the ureter which will cause massve pain in your back due to your kidney swelling. If the latter occurs and you cannot get it to move to allow your kidney to drain then a visit to the ER will be required as the pain will become unbearable. At that point, stop drinking fluids as it can just keep the pain going by adding more fluid than you can drain. Additionally the cramping of the uruter from the pain can actually cuase it to become even more stuck and sometimes actually push it further up your ureter rather than down. In some cases I have been able to stop drinking, wait through the pain until it slowly drains and then wait further until my ureter finally relaxes than start with the jumping jacks and then fluid sgain for round two.

      If you do end up in the emergency room, sometimes the pain medications they will inject into you will allow your uruter to relax enough to pass the stone into your bladder as well. If they get the pain under control, I recommend that you try drinking fluids slowly and then more and more, if the pain remains controlled in the ER to see if you can pass it while medicated before allowing to do something drastic like insert an external drainage tube into your kidney. If it getsvto that point try to insist on a Urologist placing a stent internally. Cutting a whole into your kidney through your back should be the absolute last case in my opinion.

  5. kidney pain says:

    it was so helpful

  6. kidney pain says:

    it was helpful but not so long

  7. jim genannt says:

    Ayurveda medicine obviously doesn’t work at this point. 12 & 13 mm stones are completely unpassable and MUST be removed surgically. when the pain starts, and it will hit harder than any pain you’ve ever experienced, get to the ER immediately !

  8. dilawar says:

    I have two stone in my rt. Kidney puj is about 12 mm and 13 mm what I do I have used many Ayurveda medicine

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