What Kidney Stones Feel Like
Kidney stones typically cause severe, colicky flank pain that comes in waves—intense cramping followed by periods of less severe discomfort—often accompanied by frequent urination, blood in the urine, and sometimes nausea. 1, 2
Primary Pain Characteristics
The pain from kidney stones has distinct features that help differentiate it from other conditions:
- Colicky nature: The pain occurs in waves of severe intensity followed by periods of relative relief, caused by internal pressure from obstruction of the collecting system rather than continuous discomfort 1, 3
- Location: Pain typically presents in the flank (side of the back between ribs and hip) and may radiate to the groin area 2, 4
- Severity: Patients describe it as one of the most severe pains they've experienced, often requiring complete pain relief and urgent medical attention 2, 5
Associated Symptoms
Beyond the characteristic pain, kidney stones produce several accompanying symptoms:
- Urinary symptoms: Frequent urination, dysuria (painful urination), and oliguria (reduced urine output) commonly occur 2, 4
- Hematuria: Blood in the urine results from irritation and trauma to the ureter as the stone passes 6, 4
- Nausea and vomiting: These frequently accompany the severe pain episodes 2
- Fever: When present, this suggests infection and requires urgent intervention 7
Important Distinguishing Feature
A critical diagnostic clue is that kidney stone pain does NOT worsen with external pressure applied to the flank area. 1 This distinguishes it from:
- Pyelonephritis (kidney infection): Pain significantly worsens with external flank pressure 1
- Perinephric abscess: Also worsens with external pressure 1
Pain Mechanism and Variability
The pain mechanism helps explain when stones hurt and when they don't:
- Obstruction causes pain: Pain results from distension of the collecting system when urine flow is blocked, not from the stone's mere presence 3
- Asymptomatic stones: Stones remaining in the kidney without causing obstruction may produce no symptoms and are discovered incidentally on imaging 3
- Location matters: Stone size and location determine likelihood of spontaneous passage—larger stones (>5mm) and more proximally located stones are less likely to pass spontaneously and more likely to cause prolonged symptoms 6, 2
Triggers and Precipitating Factors
Certain conditions can precipitate acute renal colic episodes:
- Dehydration and reduced urine output 2
- Increased protein intake 2
- Heavy physical exercise 2
- Various medications 2
When to Seek Immediate Care
Certain presentations require urgent evaluation beyond routine stone management: