- Severe lower back or side pain that comes in waves may be a sign that a kidney stone is blocking urine flow.
- Fever, chills, cloudy urine, or foul-smelling urine can suggest an infection and should be assessed urgently.
- Difficulty urinating, decreased urine output, or blood in the urine may signal a blockage or urinary tract irritation.
Kidney stone symptoms can include intense lower back pain, cramping, nausea, vomiting, and pain or burning with urination. These symptoms often appear suddenly, especially when a stone moves through the ureter, bladder, or urethra, or becomes stuck in the kidney.
Kidney stone symptoms can vary depending on the size and location of the stone, as well as how long it remains in the urinary tract. Smaller stones may not cause noticeable symptoms and are often found during imaging tests, while larger stones are more likely to cause severe pain and urinary changes.
In some cases, kidney stone symptoms may include blood in the urine, fever, chills, or difficulty urinating, which can signal complications like infection or blockage. Treatment may involve pain relief, hydration, medications to relax the urinary tract, or procedures such as laser therapy or surgery for larger stones.
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Main symptoms
The most common symptoms of kidney stones are:
1. Intense pain in the lower back
Kidney stone pain is typically severe and felt in the lower back or side (flank). It often occurs when a stone moves out of the kidney and into the ureter, where it can become lodged and block urine flow.
The pain is commonly described as intense and cramping, similar to labor pain, and may be severe enough to make it difficult to stay still or move comfortably.
Less commonly, kidney stones may cause a persistent pressure or dull ache in the lower back or side rather than sharp pain.
2. Sharp pain that radiates to the groin or abdomen
Kidney stone pain typically begins suddenly and can be severe, often radiating to other areas such as the groin. In men, the pain may extend to the testicles, while in women, it may radiate to the vaginal area.
As the stone moves through the urinary tract, it can also cause pain in the lower abdomen.
3. Intense cramping
Renal colic (kidney stone pain) typically occurs in waves of severe pain that come and go. According to the National Institute of Diabetes and Digestive and Kidney Diseases, this pain can occur when a kidney stone moves through or becomes lodged in the urinary tract.
These episodes may last 20 to 60 minutes and often occur when a kidney stone becomes lodged or blocks part of the urinary tract.
4. Nausea and vomiting
Kidney stones commonly cause nausea and vomiting. These symptoms occur due to stimulation of the splanchnic nerves, which supply both the kidneys and the gastrointestinal tract.
5. Pain or burning with urination
Pain or a burning sensation during urination (dysuria) is commonly associated with a urinary tract infection (UTI), but it can also occur with kidney stones. This discomfort may develop when a stone moves into the ureter or urethra, or when it obstructs the normal flow of urine from the kidney.
6. Urinary frequency
Kidney stones can cause urinary frequency or urgency, particularly when the stone is located near the vesicoureteral junction, where the ureter meets the bladder.
7. Decreased urine output
Decreased urine output or difficulty urinating may occur when a kidney stone partially or completely blocks the urinary tract, including the ureter, bladder, or urethra.
This blockage can cause urine to back up into the kidneys, leading to swelling (hydronephrosis). If left untreated, this may increase the risk of a kidney infection (pyelonephritis).
8. Blood in the urine
Kidney stones can damage the lining of the urinary tract, which may lead to small amounts of blood in the urine. This is most likely to occur when a stone is moving through the urinary tract.
Blood in the urine can also be a sign of a UTI. Check out other UTI symptoms that may occur.
9. Cloudy or foul-smelling urine
Kidney stones can alter the appearance of urine, making it look cloudy or more concentrated. They may also cause a foul odor, which is often associated with a UTI or kidney infection.
10. Fever or chills
Fever and chills may occur if a kidney infection develops from a UTI or kidney stones. According to the NHS, kidney stone symptoms can also occur when a stone leads to an infection.
Why does the pain come back?
Following a kidney stone episode, it is common to experience ongoing pressure, mild pain, or a burning sensation during urination. These symptoms may indicate that additional stones are still passing through the urinary tract.
In these cases, aim to drink at least 2 liters of water per day to help flush out the stones. You may also take medications prescribed by a healthcare provider to relieve pain and relax the urinary tract muscles.
If the pain becomes severe or does not improve within 2 hours of taking pain medication, seek care in the emergency department for further evaluation and treatment.
Treatment options
Kidney stone treatment should be guided by a urologist or primary care provider. Initial management typically includes pain relief (such as acetaminophen) and antispasmodic medications (such as scopolamine).
If the pain is severe or does not improve, patients should seek care in the emergency department, where intravenous (IV) medications may be administered. Once symptoms are controlled, many patients are discharged with instructions for follow-up care.
At home, treatment usually involves oral pain medications, rest, and adequate hydration, aiming for at least 2 liters of water per day, to help pass the stone.
In cases where the stone is too large to pass on its own, procedures such as surgical removal or laser therapy may be required. During pregnancy, management is typically more conservative and may be limited to pain control and close monitoring.