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.

119 Responses to What causes kidney stone pain?

  1. Bobby says:

    20 years and 5 stones later I’m 44 now..
    Passed 4 – lithotripsy once – sodium mostly with some calcium.
    During attacks that can last from 10 to 90 minutes :
    I try to jog in place and breathe deliberately.
    When pain increases I lay on a hard surface and massage my abdomen directly at the site of the pain to shift the stone and move it along.
    Some blood in urine common surrounding attacks.
    Pain killers are useless for this type of pain.
    Will go for x-rays if it won’t pass in one week to see if I require surgery.
    We all have our cross to bear. Brings us closer to God.
    I’ve learned how to deal with pain. Best treatment I’ve found.
    I still wish there was a cure.

    • Chuck M. says:

      Bobby,

      If you have not gotten relief from pain killers, your physician hasn’t given you the right ones. Biting the bullet, so to speak, is not for me.

  2. Shannon says:

    The very last sentence of this page actually bought me a little relief knowing that others including a urologist had non-obstructing stones which caused discomfort or pain.
    I had had two ER doctors AND a urologist (who I just met today) informed me that kidney stones which are not in the uretha “do not cause pain”. I have had CAT scans done and a sonogram which showed I had a 9mm x 7mm x 8mm kidney stone in the lower portion of my right kidney. My PCP at least understood my pain.
    I don’t see how doctors say the something that large would not cause pain.
    Anyways….scheduled for lithotripsy two weeks from now.

    I hope every who has any stones finds relief from them cuase they are not fun!

  3. Leigh says:

    oMG had the second bout of a moving kindney stone in the past year within 1 hour I had to take myself to the A&E department of the hospital I work at due to the pain after 3 hours finally given morphine but it really was worse than child birth pain I cried the whole til

    3 days later still in agony and now have to see urologist tomorrow due to yet another stone that is on the move

    Pain killers really ain’t cutting the discomfort

    Feel so sorry for my fellow sufferers of renal colic

  4. Kate Sapadin says:

    Thanks to all for the information. It’s very helpful and I want to give a special shout out to Ryan. Your description of the pain you felt mirrors mine almost exactly. Also, I work at a university and we just had our own move-in day, so I understand what a terrible time that is for you to have this experience.

    Anyway, I am a 44 year-old female who just had my first run-in with kidney stones this Monday (happy Labor Day to me). At first I thought it was appendicitis, but at the ER, I had a lot of blood in my urine so they did all the tests and found multiple small stones in both kidneys (nothing over 2 mm). Urologist on call said that he thought one stone was causing all the problems – but it was “high up” in the ureter and he didn’t know how long it would take to pass. He offered to keep me in the hospital just in case I needed morphine again (and wow did it hurt, and wow did the morphine help). I opted not to stay in the hospital indefinitely and left that day, armed with Flomax and painkillers.

    I have two questions for other more experienced stone sufferers:

    1) Is it possible for a stone to pass without me knowing it? I’m supposed to leave the country next Thursday and I’m a bit worried it won’t pass before that, or that it will and I just won’t feel it. I’m not feeling any pain right now and I’m not taking the painkillers.

    2) The hospital docs told me to call my primary care physician and schedule an evaluation with a urologist. When I called my PCP, he told me not to see a urologist. He said all a urologist would do is try to take my stone out to make some money. My PCP (who I trust) told me to come see him first so he can figure out why I got the stones in the first place. He can’t see me until this Sunday morning. What do you think about this advice? So far, I haven’t contacted a urologist. And my PCP is usually an excellent diagnostician, by the way. He’s a bit like House, weird but really smart.

  5. jim miller says:

    I have had stones every month for 14 years. I have Crohns disease that makes them form rapidly. I’m currently experiencing extreme pain in both kidneys. Drs say it can’t hurt because they aren’t in my uretor! I say bs it hurts! Anyone else who has this problem?

  6. Sam Dhupar says:

    I am 58 now and have had stones every few years ever since I was 20. Recently I have been suffering from stone for the last 1 1/2 month. The stone showed up in the Ultrasound and the doctor said 1 stone is about 3 mm and other two are about 1mm. I was put on flowmax. The urine flow is better now. We did an x-ray about 2 weeks ago and stone was about 1 1/2 inch from the bladder and about 9 to 10 mm. How is that possible that the size has increased. I have no pain now. But we did an x-ray today in the morning and the stone is still very close to the bladder (still 1 ½ inc from the bladder) . But the good news is that I don’t have any pain. I got a call few min ago from the doctor that he wants to setup appt for stone removal from the bladder. More later.

  7. David says:

    I’ve had kidney stones since the age of 11. I’m now 61. Yep — 50 years of those miserable things! I’ve had lithotripsy (ESWL) 11 times and it’s about the only option in many instances. Learn as much as possible about managing the pain and when all else fails get to your local ER. They’ll get you feeling comfortable again.

  8. Marc says:

    Currently going through second bout of kidney stone. I’m 55 and first episode was 12-13 years ago. Extremely painful, to the point of inducing constant vomiting and unable to keep liquids or medication down. First episode years ago it took 2 weeks for stone to be flushed out. I’ve been w this current stone for about 1.5 weeks and know more pain is coming. All you can do for most small to medium stone is get ibuprofen and pain killers and drink lots of liquids. Pain usually comes in waves. Doctor did prescribe Flowmax this time beside pain killers. Doctors do recommend you go in when any of following occur – blood in urine, unable to urinate, pain killers ineffective, or if you’re unable to maintain liquids due to constant vomiting. Hope this helps. PS: I did ask doctor if there was anything I could do (i.e. Jump) or eat/drink to speed up process, answer was no. As for Lauren – I’d get a referral to see kidney specialist. If you’re getting stones at 13, something is not working right

  9. Ryan says:

    I am 20 and just had my first kidney stone today. I woke up early in the morning the day after moving into my college dorm. I ate a ton of food the previous day and thought that I was having some severe intestinal cramping, but it simply didn’t go away. I had no idea what was wrong so I eventually dialed 911 after waiting for the pain to recede with no success. I was afraid to call because i didn’t want to cause a commotion at my dorm, especially if it was for something as simple as a bowel movement, but after staring at the “911″ typed into my iphone for a while, i eventually hit the send button because the pain was too much and I no longer cared about the consequences (I’m glad I called btw because I couldn’t imagine going through the pain for much longer, and I didn’t know what was causing it). All I could fathom was the relentless pain until they gave me morphine at the hospital and I started laughing because I was so happy that the pain was gone. I still haven’t passed it yet, but i feel much better after getting a cocktail of kidney stone medications, and most importantly pain killers. I’m sure many of you know the pain I had, I didn’t know whether to lay on my side, stomach, back, stand up, walk around, sit down… but i ended up just laying on my bed and smothering my face into my pillow until the EMS arrived in hopes that the lack of oxygen would make my start to lose feeling.

  10. Orvin says:

    I’m 43….Past weekend I had the most grotesque kidney pain that I can describe……Thank God the stone got out with a minimun of lacerations….In fact that was horrible. From 1 to 10, the pain was very close to 14 or 15. (Simply unbearable).

  11. Khaddy says:

    Im having kidney stone that I fell d pain all the time,but the thing that I did not Understand Is im felling more pain after drinking more water,Im trying Acv+lemon+olive oil+ water Im felling releive of the pain when I take this portion

  12. Anne says:

    I have two very small kidney stones, don’t know exact size, in my left kidney. They are located in the lower pole. I was in the hospital for chest pains three months ago. Heart tests fine and most likely from GERD. They found I had a kidney infection with crystals. My blood work was normal.

    I went to my PCP twice after that as infections returned. This was the fourth infection since last August when I might have passed a stone but was not in a lot of pain. The second time she sent me to get a CT scan, the stones were found and a follow up with a urologist. When I saw him we decided to wait and see and I see him again this Tuesday.

    I have been trying the ironing board positioning and drinking lots of water with lemon with no luck.

    Pain and pressure has been slightly worse the last several days as well as the feeling that marbles are rolling around in my kidney but have had these symptoms since April just not as badly. I don’t think I am trying to pass the stone yet but I am becoming increasingly uncmfortable.

    My question is what are the treatment options for KS in the lower kidney if it won’t pass. I know these stones are harder to pass as they need to defy gravity to get to the uterer. Are the same options as KS in other location?
    Thanks.

  13. Ivan says:

    Just passed a kidney stone, must have been a small one because I hardly felt it when I urinated. I haven’t had one for about 6 months which was extremely painful, my urologist said if it doesn’t pass I would need surgery. I heard that jumping up and down sometimes help the passage of the stone, so I tried it. The stone finally passed but probably on it’s own. The most recent stone created quite a bit of constant burning type pain as it made its way out, almost a full day, jumping didn’t seem to help, consumed lots of water, that made me feel nauseated. Today, I’m weak, and tired from lack of sleep. I have changed my diet, but recently found that eating berries is not recommended which I consume quite a bit. Another food item I cannot eat, among the many.

  14. jason says:

    I turned 30, and then got stones… That was 6 years ago I an now 36.. I have passed more than 15. It happens more when I drive long car road trips not sure why… I have been to a urolagy doctor and was given flowmax and after that my stones were gone for a year and a half.. But will get small ones now and then.
    To me when they are passing it feels like I am getting niped and can feel them all the way down to my penis..not sure why but when I feel the wave of pain and the consant urge to pee I know I have a stone… Dose any other guy feel the same pain as I do or have??

    • Molly says:

      I am a woman, but I experience the same pain symptoms you describe.

    • JIM BOB says:

      I know exactly what your talking about because I feel the exact same way. I an scheduled for surgery Wed. so they can use soundwaves or something. They also said I have to get a stint. : / Im 36… The JOYS of getting older…..

    • jojo says:

      Not a male but look up MSK – Medullary Sponge Kidney.

  15. Lauren says:

    I’m 13 and have kidney stones. I’ve been through IVP’s ultrasounds and well anything they do for younger people. Mine hurt so bad I can’t go to school or anything they just took me in for another IVP and said there might be smaller ones in there and they say that I won’t have pain but I do! The pain makes me dizzy and I get a migrane. I end up throwing up and they said my kidneys might be a little swollen.. I seriously hate how I’m in the ER every 3 days because of my pain. I have tried ibuprofen to stop the pain and it never helps. I just want to know why this happens? I don’t quite know much about kidney stones except they hurt like crap! Ugh :(

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