From the Guidelines
Flank pain caused by a kidney stone is called renal colic. This condition is characterized by intense, sharp pain that typically occurs when a stone blocks the ureter, causing urine to back up and stretch the kidney 1. The pain often comes in waves, radiating from the flank (the area between the ribs and hip) to the lower abdomen and groin on the same side. According to the most recent study on acute onset flank pain-suspicion of stone disease (urolithiasis) published in the Journal of the American College of Radiology in 2023, men are more commonly affected than women, and the incidence increases with age until 60 years of age 1.
Some key points to consider in the management of renal colic include:
- Pain management with NSAIDs like ibuprofen or prescription medications such as ketorolac
- Narcotic pain relievers may be needed for severe pain
- Alpha-blockers like tamsulosin can help stones pass more quickly by relaxing ureter muscles
- Staying hydrated is crucial—aim for enough fluid to produce clear or light yellow urine
- If you experience severe pain, vomiting, fever, or cannot pass urine, seek immediate medical attention as these may indicate complications requiring urgent intervention 1.
The pain occurs because the stone irritates the ureter lining and blocks urine flow, triggering muscle spasms and inflammation in the urinary tract. Given the often nonspecific presentation, imaging plays a crucial role in the diagnosis of stones and assessment of alternative diagnoses, complications, and appropriateness of potential therapies 1.
From the Research
Definition of Pain in the Flank Caused by a Kidney Stone
- The pain caused by a kidney stone in the flank is commonly referred to as renal colic or stone colics 2, 3, 4.
- Renal colic is characterized by severe, diffuse pain in the flank, often accompanied by autonomic reflexes and referred to the body wall 2.
Characteristics of Renal Colic
- The pain is often intense and may be more severe in patients with recurrent stones due to sensitization of the nervous system 2.
- Painful diseases in the reproductive organs can also enhance stone colics 2.
- The pain is usually sudden in onset and may be accompanied by other symptoms such as hematuria 4.
Diagnosis and Management of Renal Colic
- The diagnosis of renal colic is often made based on clinical symptoms, but confirmatory exams such as non-contrast CT or ultrasound may be performed to rule out other causes of flank pain 4, 5.
- The management of renal colic typically involves analgesic and nonsteroidal anti-inflammatory drugs, with the goal of reducing pain and facilitating spontaneous passage of the stone 2, 3, 4.
- In some cases, medical expulsion therapy with alpha-adrenoceptor antagonists or calcium channel antagonists may be used to increase the rate of spontaneous stone passage 3.