From the Research
The recommended treatment for pain associated with kidney stones typically involves nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (600-800mg every 6-8 hours) or naproxen (500mg initially, then 250mg every 6-8 hours) as first-line therapy, as supported by the most recent and highest quality study 1.
Key Considerations
- For more severe pain, opioid medications such as morphine or hydrocodone may be necessary, but their use has been decreasing in favor of NSAIDs due to concerns about opioid dependence and abuse 2.
- Alpha-blockers like tamsulosin (0.4mg daily) can help relax ureter muscles, facilitating stone passage and reducing pain, although a more recent study suggests that tadalafil may be more effective for distal ureteral stones 3.
- Adequate hydration is crucial—patients should drink 2-3 liters of water daily to help flush out the stone and prevent dehydration.
- Application of heat to the affected area using a heating pad can provide additional comfort.
- For nausea that often accompanies kidney stone pain, antiemetics like ondansetron (4-8mg every 8 hours) may be prescribed.
Important Outcomes
- Pain typically subsides once the stone passes, but medical attention should be sought immediately if pain becomes unbearable, is accompanied by fever, or if there's inability to urinate.
- These medications work by reducing inflammation and blocking pain signals, while increased fluid intake helps move the stone through the urinary tract more quickly.
Additional Guidance
- The choice of medication should be based on the severity of pain, patient comorbidities, and potential side effects, with NSAIDs being the preferred first-line treatment due to their efficacy and safety profile 1, 4.
- Regular follow-up with a healthcare provider is essential to monitor stone passage, adjust treatment as needed, and prevent complications.