Kidney stones are hard deposits made up of minerals and salts that form inside the kidneys. When stones move into the ureter, the tube that connects the kidneys to the bladder, they can become stuck and cause severe pain.
What are the symptoms of a stuck kidney stone?
The main symptom of a stuck kidney stone is sudden, severe pain in the side and back, below the ribs. The pain may spread to the lower abdomen and groin. Other symptoms can include:
- Pain that comes in waves and fluctuates in intensity
- Pain on urination
- Urgent need to urinate
- Pink, red or brown urine
- Cloudy or foul-smelling urine
- Nausea and vomiting
- Restlessness and inability to find a comfortable position
- Sweating and chills
What does the pain from a stuck stone feel like?
The pain caused by a stuck kidney stone is often excruciating. Many people describe it as one of the worst pains they have ever experienced. The pain typically begins suddenly when the stone moves from the kidney into the ureter, where it can become lodged.
The pain often starts in the side and back, just below the ribs. It then spreads to the lower abdomen and groin. The pain generally comes in waves, increasing in intensity and then subsiding temporarily before building again. This pattern repeats over and over.
People describe the pain as sharp, stabbing and cramping. The intensity can fluctuate but is often so severe it is difficult to find a comfortable position. Even a light touch or small movement can worsen the pain.
What causes the severe pain?
The severe pain is caused primarily by the lodged kidney stone obstructing the flow of urine and causing swelling and spasms in the ureter. The ureter is a narrow muscular tube about the width of a straw. When a stone becomes stuck, it blocks the passage of urine, leading to a buildup of pressure in the kidney.
The stretching of the ureter triggers painful spasms as it tries to squeeze the stone out. The swelling and spasms continually stimulate pain receptors in the ureter, sending intense nerve signals of pain to the brain.
Can the pain come and go?
The waves of pain caused by a stuck kidney stone are related to the stone’s position in the ureter. As the ureter contracts and relaxes, it causes the stone to shift position slightly. This allows temporary release of some pressure and urine drainage past the stone, providing brief relief until the stone lodges again.
So while the overall episode of pain continues until the stone is passed, the intensity can fluctuate in cycles of increasing and decreasing pain. Some people report pain that comes and goes over a period of hours to days during a kidney stone episode.
What makes the pain worse?
Any movement or activity that increases pressure in the urinary tract or causes the stone to shift position can worsen the pain. Factors that tend to intensify the pain include:
- Urination – Passing urine causes waves of pain or intensified pain as the stone shifts and urine flows past it.
- Physical activity – Exercise or physical exertion can increase pressure in the urinary tract and make the pain worse. Even simple actions like walking, bending or twisting can worsen the pain.
- Coughing, sneezing – Sudden movements or pressure changes from coughing or sneezing can stimulate more intense waves of pain.
- Touching the area – Light palpation of the back and abdominal area over the obstructed kidney can trigger increased pain and discomfort.
- Dehydration – Reduced fluid intake and dehydration can make the urine more concentrated and intensify the pain as it passes the stone.
Sitting still or lying down in a comfortable position helps minimize pressure and movement in the urinary tract, providing some relief from the pain.
What makes the pain better?
While it’s difficult to completely relieve the pain caused by a stuck kidney stone, some measures may provide temporary relief or help make the pain more tolerable. These include:
- Pain medication – Over-the-counter NSAIDs like ibuprofen or naproxen can help reduce inflammation and provide modest pain relief. Stronger prescription narcotics may be needed for adequate pain control.
- Warm bath or heating pad – Applying warmth to the back with a heating pad or soaking in a warm (not hot) bath may ease some of the muscular pain and spasms.
- Hydration – Drinking water and staying well hydrated can help dilute the urine and facilitate stone passage.
- Change positions frequently – Shifting positions periodically while resting may help temporarily relieve pain from pressure on the stone.
- Meditation, breathing – Relaxation techniques can help reduce anxiety and distract from the pain.
- Passage of the stone – The pain completely resolves once the stone passes out of the ureter into the bladder.
When does the pain start to decrease?
The severe pain usually persists and continues to increase in intensity until the stone passes out of the ureter into the bladder. This may take hours to days depending on the size and position of the stone. Smaller stones under 5 mm may pass within 24-48 hours, while larger stones may take up to a week or longer.
As the stone gets closer to the bladder, the episodes of intense pain tend to be shorter and farther apart. Once the stone is expelled from the ureter into the bladder, most people experience immediate and complete relief from the acute pain.
Some milder residual discomfort in the urinary tract may persist for a day or two afterwards. Passing the stone usually marks the end of the worst pain from a kidney stone episode.
When should someone go to the emergency room?
It’s important to seek prompt medical attention for suspected kidney stone pain. You should go to the emergency room or call 911 if you experience:
- Persistent vomiting or inability to keep fluids down
- Signs of a kidney infection like fever and chills
- Uncontrolled, excruciating pain
- Red, brown, or bloody urine
- Inability to pass any urine
Severe dehydration, kidney infection or complete urinary obstruction can be dangerous complications. Prompt emergency treatment is needed if the stone cannot be passed within 24-48 hours.
When to see a doctor?
You should make an appointment to see your doctor within a few days if you pass a kidney stone at home to determine the underlying cause. Bring the stone with you for analysis.
See your doctor promptly if:
- Pain lasts more than a few days without stone passage
- Fever, nausea or urinary symptoms persist
- Your urine remains reddish or brown after stone passage
- You have a history of kidney stones and experience similar symptoms
Your doctor can check for any complications and recommend steps to prevent future kidney stones based on the stone composition.
What tests help diagnose a stuck kidney stone?
If you go to the emergency room or doctor’s office with suspected kidney stone pain, some common tests used to diagnose a stuck stone include:
- Urinalysis – Checks urine sample for blood, protein, crystals.
- Blood tests – Evaluate kidney function and check for signs of infection.
- Imaging tests – CT scan, ultrasound or X-ray to visualize stone location.
- Urine straining – May be done after stone is passed to identify composition.
These tests help confirm the stone diagnosis and determine appropriate treatment steps.
How are stuck kidney stones treated?
Treatments for a stuck kidney stone aim to facilitate stone passage, relieve pain and prevent complications. Options may include:
- Pain relievers – Prescription NSAIDs, opioids to manage discomfort.
- Alpha blockers – Loosen ureter muscles to promote passing of stone.
- Fluids – IV fluids to relieve dehydration and facilitate stone passage.
- Strain urine – Sieve urine to try to capture passed stone.
- Lithotripsy – Sound waves to break up larger stones.
- Surgery – Rarely needed for stuck stones which often pass.
Most kidney stones 4 mm or smaller will eventually pass on their own with pain control and close monitoring.
What are complications from a stuck kidney stone?
Complications are unlikely with most small, transiently stuck kidney stones. However, potential risks if the stone does not pass include:
- Infection – Bacteria can get trapped behind stone and lead to kidney infection.
- Decreased kidney function – Ongoing obstruction reduces kidney function over time.
- Hydronephrosis – Buildup of urine in kidney causing swelling and damage.
- Sepsis – Serious, whole body infection if untreated urinary infection spreads.
- Chronic kidney disease – Repeated bouts of obstruction and infection.
Prompt emergency care is needed for fever, inability to pass urine or severe uncontrolled pain to prevent dangerous complications.
How can kidney stones be prevented?
Depending on the type of stone, some steps to help prevent kidney stones include:
- Drink plenty of fluids, especially water.
- Limit foods high in oxalate or calcium if instructed.
- Eat fewer animal proteins.
- Reduce salt and sodium intake.
- Maintain healthy weight.
- Take prescribed potassium citrate or thiazide diuretics.
Underlying conditions contributing to stone formation should be treated. Stay well hydrated and follow specific diet guidelines tailored to your stone type.
Conclusion
A stuck kidney stone can cause some of the most severe pain imaginable, comparable to childbirth or a heart attack. Excruciating waves of pain result as a stone lodged in the narrow ureter blocks urine flow and triggers spasms.
While difficult to bear, the pain often resolves once the stone passes into the bladder within a few days. Prompt medical attention is still vital to relieve symptoms, avoid complications and determine prevention steps based on stone analysis.