Kidney Stone Pain: Location, Symptoms and Relief
Kidney stone pain usually starts suddenly in the side or back, just below the ribs. It may come in waves and travel to the lower abdomen, groin, testicle, penis tip or labia as the stone moves down the ureter – the urine tube from the kidney to the bladder. Many patients feel restless and cannot find a comfortable position. Blood in urine, burning urination, nausea or vomiting may also occur. Fever, chills, inability to pass urine, persistent vomiting or uncontrolled pain are warning signs and need urgent medical care.
| Quick answer |
|---|
| Kidney stone pain commonly starts in the flank or back and may travel towards the lower abdomen or groin. Pain with fever, vomiting, inability to pass urine, very low urine output or severe uncontrolled pain should be treated as urgent. |
Kidney stone pain location: where exactly is the pain?
The location of pain often gives a clue about where the stone may be stuck.
| Pain location | Possible stone location | What the patient may feel |
|---|---|---|
| Side/back below ribs | Kidney or upper ureter | Severe flank pain, nausea, vomiting |
| Side pain moving forward | Upper or middle ureter | Waves of pain towards abdomen |
| Lower abdomen | Lower ureter | Cramping pain, urinary discomfort |
| Groin/testicle/penis tip in men | Lower ureter near bladder | Referred pain, urgency, burning |
| Groin/labia in women | Lower ureter near bladder | Referred pain, lower abdominal discomfort |
| Bladder area | Stone close to bladder | Frequency, urgency, burning urination |
Pain may shift as the stone moves. This is why a patient may first feel pain near the back, then later in the lower abdomen or groin.
What does kidney stone pain feel like?
Kidney stone pain is often called renal colic. It happens when a stone blocks urine flow and causes pressure inside the kidney or ureter.
Patients often describe the pain as:
- Sharp, severe pain in the side or back.
- Pain that comes suddenly, often without warning.
- Pain that rises and falls in waves.
- Pain moving from the flank to the lower abdomen or groin.
- Pain with nausea, vomiting, sweating or restlessness.
- Pain associated with blood in urine or burning urination.
A stone sitting quietly inside the kidney may not cause pain. Severe pain commonly starts when the stone enters the ureter and blocks urine flow.
Kidney stone pain in men and women
Kidney stone pain can affect both men and women. The basic pattern is similar: side pain, back pain, lower abdominal pain or groin pain.
In men, a lower ureter stone may cause pain in the testicle or penis tip. In women, pain may be felt in the lower abdomen, groin or labial area. This does not mean the stone is present in those organs. It happens because of shared nerve pathways.
Can kidney stone pain happen without back pain?
Yes. Not every patient has classic back or flank pain.
A stone near the lower ureter or bladder may present mainly as:
- Lower abdominal pain.
- Groin pain.
- Testicular pain in men.
- Burning urination.
- Frequent urination.
- Sudden urge to pass urine.
- Blood in urine.
This is why urinary symptoms with lower abdominal or groin pain should not be ignored, especially if the pain is sudden or severe.
Symptoms that may come with kidney stone pain
Kidney stone symptoms may include sharp pain in the back, side, lower abdomen or groin, blood in urine, frequent urination, painful urination, cloudy or foul-smelling urine, nausea and vomiting.
Common symptoms include:
- Pink, red or brown urine.
- Burning while passing urine.
- Frequent urge to urinate.
- Passing only small amounts of urine.
- Nausea or vomiting.
- Sweating during severe pain.
- Cloudy or bad-smelling urine if infection is present.
Kidney stone pain vs muscle back pain
Not every back pain is a kidney stone.
| Kidney stone pain | Muscle-related back pain |
|---|---|
| Usually starts suddenly | Often starts after lifting, bending or strain |
| Often severe and wave-like | Often worsens with movement or posture |
| May not improve by changing position | May improve with rest or posture change |
| May travel from back to groin | Usually stays near the affected muscle area |
| May come with urine symptoms, nausea or blood in urine | Usually does not cause blood in urine or vomiting |
Symptoms can overlap. If pain is severe, recurrent or associated with urinary symptoms, evaluation is safer than guessing.
Emergency signs: when kidney stone pain is dangerous
Seek urgent medical care if kidney stone pain is associated with:
- Fever or chills.
- Severe pain that is not settling.
- Persistent vomiting.
- Inability to pass urine.
- Very low urine output.
- Weakness, drowsiness or confusion.
- Pregnancy.
- Single kidney.
- Known kidney disease.
- Diabetes or elderly age with severe symptoms.
A stone with infection is not a simple pain episode. Infected urine trapped behind a blockage can become serious. Kidney infection symptoms may include fever, chills, back/side/groin pain, nausea, vomiting, painful urination and foul-smelling or bloody urine.
Kidney stone pain relief: what is safe?
Pain relief depends on stone size, location, kidney function, infection status, vomiting and other health conditions.
For suspected renal colic, NICE recommends a non-steroidal anti-inflammatory drug, commonly called an NSAID, as first-line pain treatment when it is safe for the patient. If NSAIDs are not suitable or do not give enough relief, doctors may consider other medicines such as intravenous paracetamol or stronger pain relief.
During a pain episode:
- Drink small sips of water if you are not vomiting.
- Do not force large amounts of water during severe pain.
- Use a warm compress if it gives comfort.
- Avoid heavy exertion during severe pain.
- Do not repeatedly self-medicate with painkillers.
- Seek care if pain is severe, recurrent or associated with fever/vomiting.
Pain relief does not always mean the stone has passed. Pain can reduce temporarily even when the stone is still stuck.
Should you drink more water during stone pain?
Hydration is important for stone prevention, but during an acute severe pain episode, forcing water may worsen discomfort if urine flow is blocked.
Drink normally if you can. If you are vomiting, dehydrated, unable to pass urine or in severe pain, you need medical evaluation rather than simply drinking more water.
How long does kidney stone pain last?
Kidney stone pain may last minutes to hours and can come in repeated waves. Some patients have one severe episode. Others have pain that comes and goes over several days.
The duration depends on:
- Stone size.
- Stone location.
- Degree of blockage.
- Swelling of the ureter.
- Infection status.
- Whether the stone is moving or stuck.
Pain that keeps returning should be evaluated, even if it settles with medicines.
How is kidney stone pain diagnosed?
A urologist may advise tests based on symptoms and severity.
Common tests include:
- Urine routine and microscopy.
- Urine culture if infection is suspected.
- Serum creatinine to check kidney function.
- Ultrasound KUB.
- CT KUB when needed to confirm stone size, site and blockage.
NICE recommends urgent low-dose non-contrast CT within 24 hours for adults with suspected renal colic. Ultrasound is preferred first in pregnancy and children.
Will the stone pass on its own?
Some small ureter stones can pass with observation, pain control and selected medicines. But this depends on stone size, location, kidney swelling, infection, pain control and kidney function.
Medicines to help stone passage may be considered in selected patients with distal ureteric stones less than 10 mm, depending on evaluation.
Surgery or urgent drainage may be needed if:
- Pain is not controlled.
- Fever or infection is present.
- Kidney function is affected.
- The stone is large.
- The stone is unlikely to pass.
- There is a single kidney or severe blockage.
The European Association of Urology recommends urgent decompression when there is sepsis with an obstructing stone.
Treatment options if pain keeps coming back
Treatment depends on the stone.
Options may include:
- Observation with follow-up.
- Pain control and medical expulsive therapy in selected cases.
- DJ stenting for drainage.
- URSL for ureter stones.
- RIRS for selected kidney or upper ureter stones.
- PCNL for larger kidney stones.
- Emergency drainage if infection and obstruction are present.
The best option is decided after seeing the CT/ultrasound findings, urine report, creatinine and the patient symptoms.
What to bring for consultation
Please bring:
- Ultrasound KUB report.
- CT KUB film/report if done.
- Urine routine report.
- Urine culture report if done.
- Serum creatinine report.
- Current medicines and allergy history.
- Fever record, ER notes or discharge summary if any.
- Previous stone surgery records.
- Passed stone sample if available.
FAQs
Where is kidney stone pain usually felt?
Kidney stone pain is usually felt in the side or back below the ribs. It may move to the lower abdomen, groin, testicle, penis tip or labia as the stone travels down the ureter.
Can kidney stone pain come and go?
Yes. Kidney stone pain often comes in waves because the ureter contracts while trying to push the stone down.
Can kidney stone pain be only in the groin?
Yes. A lower ureter stone can cause mainly groin pain, testicular pain, penile tip pain, lower abdominal pain or urinary urgency.
Does pain relief mean the kidney stone has passed?
Not always. Pain may reduce even if the stone is still present. Follow-up imaging may be needed.
Should I drink lots of water during kidney stone pain?
Drink normally if you can. Do not force excessive water during severe pain, vomiting or suspected blockage. Get evaluated if symptoms are severe.
When is kidney stone pain an emergency?
Kidney stone pain with fever, chills, persistent vomiting, inability to pass urine, severe uncontrolled pain, pregnancy, single kidney or known kidney disease needs urgent medical care.
Can kidney stone pain feel like gas or stomach pain?
Sometimes lower ureter stones can feel like lower abdominal cramping. But blood in urine, burning urination, groin radiation, nausea or severe wave-like pain suggest urinary stone evaluation is needed.
Related reading
- Kidney Stone Symptoms in Men and Women
- Blood in Urine Due to Kidney Stone: Is It Serious?
- Vomiting with Kidney Stone Pain: When Is It Serious?
- Fever with Kidney Stone Pain: When to Go to Hospital Immediately
- Can Kidney Stone Damage the Kidney?
- Kidney Stone Doctor in Latur
- RIRS Surgery in Latur
References
- 1. National Institute of Diabetes and Digestive and Kidney Diseases. Kidney Stones: Symptoms & Causes https://www.niddk.nih.gov/health-information/urologic-diseases/kidney-stones/symptoms-causes
- 2. Urology Care Foundation. Kidney Stones: Symptoms, Diagnosis & Treatment https://www.urologyhealth.org/urology-a-z/k/kidney-stones
- 3. NICE Guideline NG118. Renal and ureteric stones: assessment and management https://www.nice.org.uk/guidance/ng118/chapter/recommendations
- 4. European Association of Urology. Guidelines on Urolithiasis https://uroweb.org/guidelines/urolithiasis/chapter/guidelines
- 5. National Institute of Diabetes and Digestive and Kidney Diseases. Kidney Infection Symptoms & Causes https://www.niddk.nih.gov/health-information/urologic-diseases/kidney-infection-pyelonephritis/symptoms-causes
- 6. Campschroer T, Zhu Y, Duijvesz D, Grobbee DE, Lock MT. Alpha-blockers as medical expulsive therapy for ureteral stones. Cochrane Database Syst Rev https://pmc.ncbi.nlm.nih.gov/articles/PMC6494465/