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.

 

250 Responses to What causes kidney stone pain?

  1. Ravi Kumar says:

    1 week back i came to know there was stone of 14mm in my ureter. there was heavy pain at that time. From past 1 week im consuming huge amount of water suddenly there is no pain from 2 days but i couldnt able to urinate comfortably. means i am taking more time to than usual to urinate same amount of water, Urine pressure also very less compare to my usual urine passage. Is that calculus in bladder? Can calculus of that size pass through penis urin duct easily? Please let me know.

  2. CD says:

    Have a Left 3mm stone in the UPJ of the kidney, weird thing is I am having pain on Right flank (not the same side as the stone per the CT scan). Anyone else ever had this? Seems the pain would be on the same side as the stone.

  3. High Water says:

    I’ve had 5 on my left side. Three in two years, until I started taking Magnesium Citrate with Potassium Citrate. Since then, no more stones. In the research that I have done says that the combination of the two blocks the calcium from binding with the oxalate. I also take cranberry gel caps for added insurance. A friend of mine had a 6 mm stone, and he started drinking a gallon of water with apple cider vinegar in it. He told me that the stone had shrunk to 3 mm before he passed it. I have never tried it myself.

  4. Kari Ritter says:

    Hi. I’m 43, have a 3 mm stone in upper pole of left kidney and a tiny one in right kidney. I have stabbing pains in my flank/kidney area. It can wake me up. Or just hit anytime, I saw a nurse practitioner at the urologist last week. She said you only have pain when trying to pass the stone. That can’t be true. I mean I hadon’t a stone 2 years ago that landed me in ER and did not pass until 2 weeks later which I did not feel. I’m miserable and exhausted. Is this normal? I can’t get any help with the pain. Anyone give me some help! Thanks

    • Jamie says:

      I have the EXACT same issue and was told no pain if stone is in kidney. That is absolutely untrue!!

      • Aaron Willy says:

        I’ve had over 300 stones ,11 surgeries in just 9 years. I argue with my urologist all the time about this. You defiantly have pain. I was just in the er this morning thinking I had one stuck and found out I have a 5mm, (2) 2mm, and some gravel in my left. And a 3mm,2mm, and gravel in my right.

    • AEF says:

      I feel your pain– literally and figuratively. I have several 3 mm stones and was told they would only cause pain if blocking. Not true. I have severe pain at times and bleeding. Obviously, no lithotripsy is needed for stones this size. However, if the ureter is 3-4mm wide, and that’s the size of my stones, why wouldn’t there be pain when they pass? Additionally, kidney stones, as they were explained to me at the Cleveland Clinic, are not necessarily perfectly round– they can be sharp suckers that poke and jab you. Ouch. Please, Dr. Urologist, tell me again this doesn’t hurt when the pain takes my breath away.

  5. Karen Falkman says:

    Hello. my name is Karen, and this is my 3rd round of stones in both kidneys since 2011. I am now trying to deal with pain on right side. the pain associated with either getting them to pass, or in my case when they get stuck in the tube is brutal (at least for me). I have taken pain only helps for so long. Moving around helps for a while. I have had Lithotripsy on both kidneys in the past, and it worked for about a year, then stones returned. I do feel for anyone who has had to deal with them.

  6. Victor Herbert says:

    Hello, I’m 23 years old I was diagnosed with kidney stones on January 7. I have received medication but it all finish and i still haven’t gotten relief as yet. So I started to drink cranberry juice, lemon juice and olive oil. I have since stopped getting pains in my right side abdomen and now the pain has to the front just below my abdomen and it’s been there for a while. I am consuming water but still these stones are not passing.

    Please help!!!

    • Aaron Willy says:

      It’s stuck. Down around your pelvic bone your ureter gets smaller. And a regular x-Ray won’t show it you have to get a cut scan. If it’s been their for more then 3 days then chances are it ain’t going anywhere without being broke.

  7. Shantanu says:

    Hello… I’m a 16 year old and I’m currently preparing for entrance exams. I have had not many, just 4 or 5 kidney stones till now. Most of them were when I was 11 years old and i don’t remember much except the horrible pain. Now I’ve got a couple of stones again and I’m scared as hell. I went to the doctor but there’s nothing serious about the 6-8 mm stones that I have. He also said that there are no any medicines that can cure/pass/dissolve a kidney stone and he told me to come back again after 3 months. I am not sure whether it is true or not… it feels more scary as I live alone now… some one please help me

    • Arthur Jackson says:

      I have just had lithotripsy on my stone today.
      Its where they bombard the stone wth ultra sound to try to break it up into smaller fragments so you can pass it naturally. It takes about 2 hours from entering the hospital to leaving. It was not the most comfortable procedure to have but compared to passings whole stone it was a piece of cake. I won’t know if it was a success until I pass the fragments, if I don’t pass the it’s then I will need a follow up dose.

    • Aaron Willy says:

      Lemon juice will help break them down. Go see a different urologist those are large stones (4mm is roughly a 1/4 inch) and your probably not gonna pass them.

  8. Mary Jane Castrese says:

    I feel kidney stone by cold weather

  9. 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

  10. 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 .

  11. 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

      • Laura says:

        I just had my first one this week, passing it at the ER sometime after midnight last night.

        So I appreciate so much all of your insights. It was so perplexing and it’s nice to revisit it with more knowledge.

        Thank you!

      • Aaron Willy says:

        I’ve had over 300 stones and 11, about to be 12 surgeries. 90% of my stones are on my left side and the urologist I’ve seen (6) can’t figure it out. I wonder if mine is tilted also. Thanks for sharing maybe I can get some answers as to why!

  12. 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.

  13. kidney pain says:

    it was so helpful

  14. kidney pain says:

    it was helpful but not so long

  15. 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 !

  16. 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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