Kidney stones are one of the most painful conditions you can experience. Many people who’ve had them describe the pain as worse than childbirth or broken bones. But here’s what most people don’t realize: kidney stones don’t always start with dramatic symptoms.
Sometimes the warning signs are subtle. You might feel a slight ache in your side, notice your urine looks different, or experience changes in how often you need to use the bathroom. Other times, the pain hits suddenly and intensely. Knowing what to look for can help you get treatment before the discomfort becomes unbearable and prevent potential complications.
What Are Kidney Stones?
Kidney stones are hard deposits made of minerals and salts that form inside your kidneys. They develop when your urine contains more crystal-forming substances like calcium, oxalate, and uric acid than the fluid in your urine can dilute. These crystals can stick together and grow into stones ranging in size from a grain of sand to a golf ball.
Small kidney stones may pass through your urinary tract without causing any symptoms. However, larger stones or stones that become lodged in the narrow tubes of your urinary system can cause significant pain and complications. The stones themselves don’t hurt while sitting in your kidney. The pain begins when they start moving through the ureter (the tube connecting your kidney to your bladder).
The First Signs of Kidney Stones
Kidney stones often develop without any symptoms at first. However, once a stone begins to move or grows large enough to cause problems, you may notice several telltale signs:
Sudden, Severe Pain That Comes in Waves
The most characteristic sign of kidney stones is intense pain that fluctuates in severity. This pain, often called renal colic, typically begins suddenly and comes in waves as the stone moves through your urinary tract. The pain may start in your side or back, just below your ribs, and radiate to your lower abdomen and groin.
Many people describe this as the worst pain they’ve ever experienced. The pain can be so severe that it causes nausea and vomiting. Unlike muscle pain that might improve when you change positions, kidney stone pain remains constant regardless of how you move or rest.
Pain in Your Side and Back
One of the earliest signs is a persistent, dull ache in your side or back, typically on one side of your body. This flank pain occurs in the area between your ribs and hip. As the stone moves, the pain location may shift from your back to your lower abdomen, groin, or even down into your genital area.
The pain pattern often follows the stone’s path through your urinary system. You might feel it start in your back, move to your side, then shift toward your lower abdomen as the stone travels toward your bladder.
Changes in Urination
You may notice several urination-related symptoms as early signs of kidney stones:
- Frequent urination: Feeling the need to urinate more often than usual, particularly when a stone is near the bladder
- Urgent need to urinate: Sudden, strong urges to urinate that are difficult to control
- Painful urination: Burning or sharp pain when urinating, especially if the stone is in the lower urinary tract
- Difficulty urinating: Decreased urine flow or feeling like you can’t fully empty your bladder
- Small amounts of urine: Urinating only small amounts despite feeling the urgent need to go
Blood in Your Urine
Hematuria, or blood in the urine, is a common early sign of kidney stones. The stone can scratch and irritate the lining of your urinary tract as it moves, causing bleeding. Your urine may appear:
- Pink
- Red
- Brown
- Cola-colored
Sometimes the blood isn’t visible to the naked eye and is only detected during a urine test. Any blood in your urine warrants a visit to your doctor, as it can indicate kidney stones or other serious conditions.
Cloudy or Foul-smelling Urine
If your urine appears cloudy, murky, or has a strong, unpleasant odor, it could signal kidney stones. Cloudy urine may indicate the presence of pus (pyuria) or could be caused by an infection that sometimes accompanies kidney stones. Infections can develop when stones block urine flow, creating an environment where bacteria thrive.
Nausea and Vomiting
The intense pain from kidney stones often triggers nausea and vomiting. This happens because of shared nerve connections between the kidneys and the gastrointestinal tract. If you’re experiencing unexplained nausea along with back or side pain, kidney stones could be the culprit.
Fever and Chills
While not always an early sign, fever and chills can develop if a kidney stone leads to an infection. This is a medical emergency. If you have flank pain along with fever above 100.4°F (38°C), chills, or feel generally unwell, seek immediate medical attention. A kidney infection can become serious quickly and requires prompt antibiotic treatment.
Feeling Restless or Unable to Get Comfortable
Many people with kidney stones find it impossible to get comfortable. The intense pain makes it difficult to sit still or find a position that provides relief. You might pace, shift positions constantly, or feel the need to curl up. This restlessness is a telltale sign that differentiates kidney stone pain from other types of back pain, which often improve with rest or certain positions.
What Causes Kidney Stones?
Several factors can increase your risk of developing kidney stones:
- Dehydration: Not drinking enough water is the most common cause. Concentrated urine doesn’t have enough fluid to dilute stone-forming substances.
- Diet: High intake of sodium, protein, or sugar can increase stone risk. Foods high in oxalates (like spinach, nuts, and chocolate) may also contribute.
- Medical Conditions: Obesity, digestive diseases, urinary tract infections, and certain metabolic disorders increase stone risk.
- Family History: If kidney stones run in your family, you’re more likely to develop them.
- Certain Medications: Some supplements and medications can increase stone formation.
- Lack of Activity: Prolonged bed rest or a sedentary lifestyle can contribute to stone development.
Types of Kidney Stones
Not all kidney stones are the same. The type of stone you develop affects both treatment and prevention strategies:
- Calcium Stones: The most common type, usually in the form of calcium oxalate. These form when calcium combines with oxalate in the urine.
- Uric Acid Stones: Can develop in people who don’t drink enough fluids, lose too much fluid, eat a high-protein diet, or have gout.
- Struvite Stones: Often form in response to urinary tract infections. These can grow quickly and become quite large.
- Cystine Stones: Rare stones that form in people with a hereditary disorder that causes the kidneys to excrete too much of certain amino acids.
When to Seek Medical Care
Knowing when to see a doctor is important for preventing complications.
Seek Emergency Care If You Experience:
- Severe pain that makes it impossible to find a comfortable position
- Pain accompanied by nausea and vomiting that prevents you from keeping down food or water
- Fever and chills with flank pain (signs of possible infection)
- Blood in your urine with severe pain
- Difficulty urinating or complete inability to urinate
Schedule an Appointment Soon If You Have:
- Mild to moderate flank pain that persists
- Recurrent urinary tract infections
- Previous kidney stones (you’re at higher risk for developing more)
- Blood in your urine, even without pain
- Persistent changes in urination patterns
Don’t try to “tough it out” with kidney stone symptoms. While some small stones pass on their own, many require medical intervention. Your doctor can assess the size and location of the stone and recommend the most appropriate treatment.
How Kidney Stones Are Diagnosed
If you see a doctor for suspected kidney stones, they’ll likely use several diagnostic tools:
- Urinalysis: Checks for blood, infection, and stone-forming crystals
- Blood tests: Evaluate kidney function and identify factors contributing to stone formation
- Imaging: CT scans, ultrasounds, or X-rays can locate stones and determine their size
- Stone analysis: If you pass a stone, your doctor may analyze it to determine its composition and guide prevention strategies
What You Can Do
If you suspect you’re developing kidney stones or want to prevent them:
- Stay Hydrated: Drink plenty of water throughout the day. Aim for enough to produce about 2 liters of urine daily. Your urine should be pale yellow. This is the single most important prevention strategy.
- Watch Your Diet: Reduce sodium intake, limit animal protein, and avoid excessive vitamin C supplements. If you’ve had calcium oxalate stones, your doctor may recommend limiting high-oxalate foods.
- Don’t Ignore Symptoms: Even mild symptoms deserve medical attention. Early intervention can prevent a small problem from becoming a painful emergency.
- Follow Up If You’ve Had Stones Before: If you’ve had kidney stones previously, work with a nephrologist to identify why they formed and develop a prevention plan. Analysis of passed stones can guide dietary and medical interventions.
- Maintain a Healthy Weight: Obesity increases kidney stone risk, so maintaining a healthy weight through diet and exercise can help prevent stones.
- Limit Sodium and Animal Protein: A diet high in sodium and animal protein can increase your risk of certain types of kidney stones. Try to keep sodium intake below 2,300 mg per day.
- Get Enough Calcium: Contrary to popular belief, adequate dietary calcium can actually help prevent calcium oxalate stones. However, calcium supplements may increase risk, so get calcium from food sources when possible.
Expert Kidney Stone Care
At The Kidney & Hypertension Center, our nephrologists specialize in diagnosing and treating kidney stones, as well as helping you prevent future stones. We offer comprehensive evaluation and personalized prevention strategies. With convenient locations throughout Cincinnati and Greater Ohio, expert kidney care is always nearby.
If you’re experiencing symptoms of kidney stones or want to discuss prevention, request an appointment today.
