A Keck Medicine of USC urologist discusses ways you can tell if your backache is a sign of a kidney stone.
Your back is achy, yet you don’t remember hurting it; that painkiller doesn’t seem to be helping, and no matter what position you take, the pain continues. Could it be a kidney stone? Here are some things to pay attention to in order to determine if your back pain actually is a kidney stone.
1. Kidney stone pain location
Your kidneys are located just below the rib cage, one on each side of your spine. If your pain is focused more on one side of your lower back or on the sides, underneath your ribs, it may be an indication of a kidney stone.
General back pain, on the other hand, can be felt anywhere on your back. So, if the pain is in your middle back or shoulders, chances are it’s not a kidney stone.
2. Waves of pain
You may feel pain that comes and goes in waves and changes in intensity. That’s because as the kidney stone moves through your urinary tract, you’ll feel pain differently. With a backache, though, the pain is usually constant.
“Kidney stone pain typically starts high up, near the kidney, migrates toward the abdomen and then eventually moves down toward the groin as the stone moves further down the ureter,” says Mike Nguyen, MD, a urologist with USC Urology, part of Keck Medicine of USC.
3. Persistent pain
If you are experiencing pain that doesn’t go away when you move, that might be a sign of a kidney stone.
If it’s a backache, a change of position may momentarily alleviate the pain. With kidney stones, the pain won’t disappear when you move, and changing positions usually makes no difference.
4. Severe pain
Backache pain can range from mild to severe, while kidney stone pain is almost always severe. Kidney stones are rumored to be as painful as childbirth.
“Kidney stone pain is typically severe and can be sharp or dull,” Dr. Nguyen says. “It usually occurs suddenly, without any provoking events.”
5. Blood in your urine
Kidney stones can cause blood in your urine. Sometimes, the blood is visible and can even turn the toilet water pink, red or brown. Other times, it can only be detected by urine testing or under a microscope. There are many possible causes of blood in the urine, including urinary tract infections, prostate bleeding, injury to the kidney or bladder, kidney stones, tumors and more. You should always be evaluated by a urologist if you have blood in your urine, especially if there is no pain associated with it.
6. Painful urination
Kidney stones can also cause discomfort, pain or burning when urinating. Pain may be felt in different parts of the urinary tract, such as where it leaves the body, in the prostate or the bladder. This pain is usually caused by infection or inflammation in the urinary tract.
7. A need for frequent urination
Kidney stones can make you feel like you need to urinate more often than usual. The urge can be quite strong, making it difficult to delay using the toilet. When you do go, you may only go a little, which can be frustrating.
“When a stone is almost ready to come out into the bladder, patients may feel the urge to urinate,” Dr. Nguyen adds.
8. Urine changes
Kidney stones may cause cloudy, discolored or foul-smelling urine. These symptoms may also be due to a urinary tract infection, especially when not associated with flank pain.
9. Nausea and vomiting
The urge to vomit or feeling sick to your stomach are symptoms of kidney stones. Though they are caused by many common problems like food allergies or infections of the stomach or bowels, they are also symptoms of kidney stones.
10. Fever and chills, along with your back pain
Kidney stones can cause back pain, and when accompanied by fever and chills, which are possible signs of infection, they could also mean that you have a urinary tract infection.
If you have any of these symptoms along with your back pain, you should call your doctor right away, as having an infection with a stone can be dangerous.
Kidney stones are treated based on size, location and type. After a thorough examination and testing, in milder cases your doctor may recommend allowing the kidney stone to pass without treatment. If your discomfort is severe, there are several more invasive ways to remove a kidney stone or break it into smaller pieces, allowing it to pass in your urine.
Once you know the type of kidney stone you had, your doctor can help you make changes to your diet and nutrition that can help prevent them in the future.
Kidney stone complications
Complications associated with kidney stones are rare if you seek treatment from a health care professional before severe problems occur. However, if kidney stones are not treated, they can cause:
- Hematuria, or blood in the urine
- Severe pain
- UTIs, including kidney infections
- Scarring in the urinary drainage system
- Loss of kidney function
Kidney stone risk factors
About 14% of the population can get kidney stones, and studies show the number is growing. If you have previously had a kidney stone, you are 50% more likely to experience a recurrence within five years. Men are nearly twice as likely to develop kidney stones, but this difference in frequency between the genders is shrinking as women, particularly young women, are developing kidney stones more often.
Risk factors for developing kidney stones include:
- Age (peak risk at 20 to 40 years old)
- Being male (particularly non-Hispanic white men)
- Dehydration and low fluid intake
- Family history of kidney stones
- Living or working in hot climates
- Medical conditions (hypertension, diabetes, gout)
- Obesity
- Poor diet (high in sodium, animal protein and sugar)
- Previous kidney stones (50% recurrence rate)
How to prevent kidney stones
Strategies to help reduce the risk of kidney stones include staying well hydrated by drinking six to eight glasses of water daily (more during hot weather or exercise) and consuming some citrus juice for its protective citrate content. Those with a history of kidney stones may need to increase their fluid intake further based on their doctor’s guidance.
Maintaining a healthy weight also helps reduce stone risk, as does limiting sodium and animal protein by following, for example, the DASH diet, which emphasizes fruits, vegetables, whole grains and low-fat dairy products. Finally, stay informed about dehydration signs and consult your doctor about personalized prevention strategies, particularly if you take medications that might increase risk.
By recognizing the symptoms of kidney stones, you can seek timely medical help and prevent more serious problems. If you don’t have kidney stone symptoms but have some of the risk factors, implementing prevention strategies can reduce your risk and maintain better urinary health.
If you experience severe kidney stone pain, and especially “if your pain is unbearable, is associated with fevers or chills or you have nausea and vomiting that is preventing you from keeping down fluids or medications, you should seek immediate medical attention,” Dr. Nguyen says. cations, you should seek immediate medical attention,” Nguyen says.
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