Table of ContentsView AllTable of ContentsStagesStage 1 SymptomsStage 2 SymptomsStage 3 SymptomsStage 4 SymptomsOther CausesHas It Passed?No SymptomsSigns in Others
Table of ContentsView All
View All
Table of Contents
Stages
Stage 1 Symptoms
Stage 2 Symptoms
Stage 3 Symptoms
Stage 4 Symptoms
Other Causes
Has It Passed?
No Symptoms
Signs in Others
The symptoms ofkidney stonesvary little among the sexes. The sharp pain radiating into the groin may be felt in thelabia(vaginal pain) or in thetestes(testicular pain).Recognizing the early signs of kidney stones can help you seek the appropriate diagnosis and treatment based on the size and location of the stone.
The symptoms of kidney stones closely align with thefour stagesthat a kidney stone is passed:
This process can take days or weeks, depending on the size of the stone. Kidney stones between 1 and 5 millimeters (mm) usually take eight to 12 days to pass; those that are even smaller may pass without any symptoms.
Large stones over 5 mm take an average of 22 days or longer to pass and may require medical intervention if they cause an obstruction.
Symptoms: Stage 1 (Kidney Stone Formation)
While theacute(sudden, severe) symptoms of kidney stones are more common during stage 2, subtle symptoms may start to develop as early as stage 1.
Most of the time, the formation of a kidney stone doesn’t cause pain until it dislodges from the soft interior portion of a kidney, called therenal pelvis. This is the part of a kidney where urine collects before being passed to a ureter—and the site where most kidney stones commonly form.
The pain may be dull, like a back strain, or intense, like a kidney punch. The episodes tend to last one to four hours.
Many people will have no symptoms during stage 1, even with stones as large as 15 mm. Moreover, stones can remain in the kidneys for years without causing symptoms. They may manifest pain when they pass into the ureter.
Symptoms: Stage 2 (Before Passing)
Stage 2 is when people typically experience the “classic” symptoms of kidney stones, due to the complete or partial blockage of the ureter.
The passage of a stone can set off sudden, severe bouts of renal colic, which some experts describe as one of the strongest pain sensations known. The pain can sometimes be so intense that emergency treatment is needed.
Accompanying the acute pain may be symptoms like:
Where It Hurts
With renal colic, thepain is mainly felt in the flank—the area on the side of the body that’s just below the rib cage and above the waist. In addition to flank pain, the passage of a stone into the ureter simultaneously triggers downward waves of radiating pain to the groin or inner thigh.
The radiating pain, known asreferred pain, is caused when pain signals are transferred to nerves in the spine, calledsplanchnic nerves. These are the nerves that provide motor and sensory function to the abdomen and pelvis.
The acute waves of pain can last for 15 to 45 minutes.
In most cases, the acute pain will start to ease after 24 hours as tissues surrounding the stone begin to relax. Severe pain lasting more than three days is likely to require medical intervention.
Symptoms: Stage 3 (Bladder Obstruction)
As the kidney stone makes its way into the bladder, the pain may almost entirely cease. With that said, the reprieve tends to be short-lived as the refilling and emptying of the bladder pushes the stone toward the narrow passage, called the bladder neck, that connects to the urethra.
If the stone becomes stuck at this junction, you may feel intense pressure in the middle of the lower abdomen near your pelvis. This can lead to symptoms such as:
When to Call 911
Symptoms: Stage 4 (Passing a Kidney Stone)
The final journey involves the passage of the stone into the urethra and out of the body. This can take several hours or days. To aid with the passage, your healthcare provider may prescribe a drug calledFlomax (tamsulosin), which relaxes the smooth muscles of the urethra.
Pain is the central feature, although it tends to be far less severe than what was experienced in stage 2. There may also be pain with urination and minor bleeding as the stone scrapes against the walls of the urethra. Pain may linger for a couple of days after the stone has passed.
When Is Pain Not a Kidney Stone?
This typically starts with what is known as the STONE score. This system predicts the likelihood of kidney stones on a score of 0 to 13. The STONE scoring is based on five factors commonly seen in people with kidney stones, namely:
A STONE score of 10 to 13 is highly predictive of kidney stones, with an accuracy of up to 89.6%.
Even so, additional tests may be needed to definitively diagnose a kidney stone and rule out other causes. This may involve a physical exam,urinalysis, and imaging studies like anabdominal ultrasound,X-ray, orcomputed tomography (CT)scan.
Differential Diagnosis
There are many conditions commonly explored in thedifferential diagnosisof kidney stones, some of which are far more serious. Testing for these ensures they are not missed.
These include common and uncommon conditions like:
A Note of Gender and Sex TerminologyVerywell Health acknowledges thatsex and genderare related concepts, but they are not the same. To accurately reflect our sources, this article uses terms like “female,“ “male,” “men,” and “women” as the sources use them.
A Note of Gender and Sex Terminology
Verywell Health acknowledges thatsex and genderare related concepts, but they are not the same. To accurately reflect our sources, this article uses terms like “female,“ “male,” “men,” and “women” as the sources use them.
Female Differential Diagnosis
The symptoms of kidney stones don’t vary much between people of any sex. However, kidney stones tend to be less common in females (due in part to the hormoneestrogen, which reduces the crystallization of minerals that lead to stones).
Even so, evidence suggests that the gender gap is closing, with the incidence of kidney stones rising among females, especially young adult and adolescent females.
Among the conditions that can mimic kidney stones in females are:
Male Differential Diagnosis
In addition to being at a greater risk of the disease, males are vulnerable to kidney stones when seasonal temperatures are hot, suggesting a “kidney stone season” in men.
This is thought to be due to differences in male kidneys, which allow for greater water reabsorption during hot weather to avoiddehydration. This retention of fluid, in turn, increases pressure within the renal pelvis, which can dislodge a stone.
Studies have shown that, among men, emergency room visits for kidney stones are higher in the summer and lower in the winter. The same is not seen with women.
Among the conditions that can mimic kidney stones in men are:
How to Tell If a Kidney Stone Has Passed
The passing of a kidney stone is almost invariably met with a notable drop in pain and gradual normalization of urine color, usually within a couple of days. You may also find the stone or fragments of the stone when urinating.
When a kidney stone is passing, providers will often recommend that you pee through a tea strainer to catch any pieces. This confirms that the stone has passed and allows the stone to be analyzed in the lab to see what it is made of. This can help determine why the stone formed and what can be done to prevent stones in the future.
Although there may be lingering pain, it will also gradually subside. If it does not, see a healthcare provider, as you may have developed an infection or have more than one stone.
Research suggests that around 86% of kidney stones pass spontaneously without medical procedures. When a stone is large (over 6 mm in size), the likelihood of this drops to around 59%.
When You Have No Symptoms
The absence of symptoms does not mean that you are clear of kidney stones. In fact, many people have stones without knowing it, often for years or decades. If and when they do pass, they may be small enough to cause few, if any, symptoms.
According to a 2021 review inCurrent Urology Report,males are more likely than females to havecalcium oxalate stones, which are far harder than other types of kidney stones and less likely to break up. Females, on the other hand, are more likely to have struvite stones, which are larger but have a soft, crumbly texture.
Stone size is a key factor as to whether kidney stones areasymptomatic(without symptoms) or symptomatic (with symptoms). By and large, symptoms tend to occur with stones larger than 2 mm.
Do Asymptomatic Kidney Stones Need Treatment?If a kidney stone is found during an imaging study, it doesn’t necessarily need treatment if it is asymptomatic. Instead, abdominal ultrasound may be recommended every six to 12 months.If the stone grows or symptoms develop, you may be referred to a urologist for treatment. Treatment may also be considered for stones over 10 mm or if you intend to conceive in the near future.Between 10% and 25% of “silent” kidney stones become symptomatic each year.
Do Asymptomatic Kidney Stones Need Treatment?
If a kidney stone is found during an imaging study, it doesn’t necessarily need treatment if it is asymptomatic. Instead, abdominal ultrasound may be recommended every six to 12 months.If the stone grows or symptoms develop, you may be referred to a urologist for treatment. Treatment may also be considered for stones over 10 mm or if you intend to conceive in the near future.Between 10% and 25% of “silent” kidney stones become symptomatic each year.
If a kidney stone is found during an imaging study, it doesn’t necessarily need treatment if it is asymptomatic. Instead, abdominal ultrasound may be recommended every six to 12 months.
If the stone grows or symptoms develop, you may be referred to a urologist for treatment. Treatment may also be considered for stones over 10 mm or if you intend to conceive in the near future.
Between 10% and 25% of “silent” kidney stones become symptomatic each year.
Recognizing Signs in Someone Else
The “classic” signs of kidney stones may be readily recognized in someone you know, but not everyone has “classic” signs. In some people, the symptoms may be nonspecific (meaning they can be attributed to many conditions) and include things like dull lower back pain, fatigue, loss of appetite, and gastrointestinal symptomslike diarrhea.
In the absence of hallmark symptoms, the two things to watch out for are changes in urination and flank pain that comes and goes.While neither of these will lead to a diagnosis of kidney stones, they may provide ample justification for a medical visit.
Factors that raise the likelihood of developing kidney stones include:
Having these risk factors doesn’t mean that kidney stones are the cause—only a medical evaluation can determine that—but neither does the absence of risk factors mean that you are “safe” from kidney stones.
In the end, if you have flank pain and urinary symptoms you cannot explain, see your healthcare provider or ask for a referral to a urologist for a comprehensive evaluation.
Summary
Telltale signs of kidney stones include the sudden, severe onset of flank pain radiating to the groin or inner thigh. There may also be nausea, vomiting, frequent urination, changes in urine color, and reduced urination. Depending on the size of the kidney stone, it may take one to three weeks or more for the stone to pass on its own.
Kidney stones that are large, cause severe obstruction, or do not pass on their own within three to four weeks may need medical treatment to either break them up or remove them physically.
How Kidney Stones Are Treated
22 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & causes of kidney stones.Penn Medicine.Kidney stones.Urology of Greater Atlanta.What are the stages of passing a kidney stone?.University of California Irvine.How long does it take to pass a kidney stone?Noh TI, Pyun JH, Shim JS, et al.A comparison between asymptomatic and symptomatic ureteral stones.Sci Rep.2023;13:2757. doi:10.1038/s41598-023-29866-5Song L, Maalouf NM.Nephrolithiasis.In:Endotext.South Dartmouth (MD): MDText.com; 2020.Golzari SEJ, Soleimanpour H, Rahmani F, et al.Therapeutic approaches for renal colic in the emergency department: a review article.Anesth Pain Med.2014;4(1):e16222. doi:10.5812/aapm.16222Almaghlouth AK, Alqutay HM, Bohamed AH, Almarzooq AJ, Alamer MA.Urolithiasis symptoms and risk factors among the general population of Alahsa, Saudi Arabia.Cureus. 2023;15(5):e39645. doi:10.7759/cureus.39645Gillies M, AlDujaili T.Acute colonic pseudo-obstruction secondary to renal calculus: a case report and review of pathophysiology.Cureus. 2023;15(2):e34756. doi:10.7759/cureus.34756Gourlay K, Splinter G, Hayward J, Innes G.Does pain severity predict stone characteristics or outcomes in emergency department patients with acute renal colic?Am J Emerg Med. 2021;45:37-41. doi:10.1016/j.ajem.2021.02.049Hughes T, Ho HC, Pietropaolo, Soman BK.Guideline of guidelines for kidney and bladder stones.Turk J Urol.2020;46(Suppl 1):S104–S112. doi:10.5152/tud.2020.20315Sussman RD, Drain A, Brucker BM.Primary bladder neck obstruction.Rev Urol.2019;21(2-3):53-62.UCLA Health.Urological emergencies.University of Chicago.Why do kidney stones cause pain?Malik A, Mohkumuddin S, Yousaf S, Baig MAR, Afzal A.Validity of STONE score in clinical prediction of ureteral stone disease.Pak J Med Sci.2020;36(7):1693–1697. doi:10.12669/pjms.36.7.2625Moore CL, Bomann S, Daniels B, et al.Derivation and validation of a clinical prediction rule for uncomplicated ureteral stone-the STONCE score: retrospective and prospective observational studies.BMJ.2014;348:g2191. doi:10.1136/bmj.g2191MedlinePlus.Kidney stones.Fontenelle LF, Sarti TD.Kidney stones: treatment and prevention.Am Fam Physician.2019;99(8):490-496Frazier RL, Huppman AR.Educational case: urinary stones.Acad Pathol.2021;8:23742895211040209. doi:10.1177/23742895211040209Gillams K, Juliebo-Jones P. Juliebo SO, Somani BK.Gender differences in kidney stone disease (KSD): findings from a systematic review.Curr Urol Rep. 2021;22(10):50. doi:10.1007/s11934-021-01066-6Fauvus MJ, Feingold KR.Kidney stone emergencies. In;Endotext.South Dartmouth (MA): MDText.com; 2020.Khalli P, Jamali Z, Sadeghi T, et al.Risk factors of kidney stone disease: a cross-sectional study in the southeast of Iran.BMC Urol.2021;21:141. doi:10.1186/s12894-021-00905-5
22 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & causes of kidney stones.Penn Medicine.Kidney stones.Urology of Greater Atlanta.What are the stages of passing a kidney stone?.University of California Irvine.How long does it take to pass a kidney stone?Noh TI, Pyun JH, Shim JS, et al.A comparison between asymptomatic and symptomatic ureteral stones.Sci Rep.2023;13:2757. doi:10.1038/s41598-023-29866-5Song L, Maalouf NM.Nephrolithiasis.In:Endotext.South Dartmouth (MD): MDText.com; 2020.Golzari SEJ, Soleimanpour H, Rahmani F, et al.Therapeutic approaches for renal colic in the emergency department: a review article.Anesth Pain Med.2014;4(1):e16222. doi:10.5812/aapm.16222Almaghlouth AK, Alqutay HM, Bohamed AH, Almarzooq AJ, Alamer MA.Urolithiasis symptoms and risk factors among the general population of Alahsa, Saudi Arabia.Cureus. 2023;15(5):e39645. doi:10.7759/cureus.39645Gillies M, AlDujaili T.Acute colonic pseudo-obstruction secondary to renal calculus: a case report and review of pathophysiology.Cureus. 2023;15(2):e34756. doi:10.7759/cureus.34756Gourlay K, Splinter G, Hayward J, Innes G.Does pain severity predict stone characteristics or outcomes in emergency department patients with acute renal colic?Am J Emerg Med. 2021;45:37-41. doi:10.1016/j.ajem.2021.02.049Hughes T, Ho HC, Pietropaolo, Soman BK.Guideline of guidelines for kidney and bladder stones.Turk J Urol.2020;46(Suppl 1):S104–S112. doi:10.5152/tud.2020.20315Sussman RD, Drain A, Brucker BM.Primary bladder neck obstruction.Rev Urol.2019;21(2-3):53-62.UCLA Health.Urological emergencies.University of Chicago.Why do kidney stones cause pain?Malik A, Mohkumuddin S, Yousaf S, Baig MAR, Afzal A.Validity of STONE score in clinical prediction of ureteral stone disease.Pak J Med Sci.2020;36(7):1693–1697. doi:10.12669/pjms.36.7.2625Moore CL, Bomann S, Daniels B, et al.Derivation and validation of a clinical prediction rule for uncomplicated ureteral stone-the STONCE score: retrospective and prospective observational studies.BMJ.2014;348:g2191. doi:10.1136/bmj.g2191MedlinePlus.Kidney stones.Fontenelle LF, Sarti TD.Kidney stones: treatment and prevention.Am Fam Physician.2019;99(8):490-496Frazier RL, Huppman AR.Educational case: urinary stones.Acad Pathol.2021;8:23742895211040209. doi:10.1177/23742895211040209Gillams K, Juliebo-Jones P. Juliebo SO, Somani BK.Gender differences in kidney stone disease (KSD): findings from a systematic review.Curr Urol Rep. 2021;22(10):50. doi:10.1007/s11934-021-01066-6Fauvus MJ, Feingold KR.Kidney stone emergencies. In;Endotext.South Dartmouth (MA): MDText.com; 2020.Khalli P, Jamali Z, Sadeghi T, et al.Risk factors of kidney stone disease: a cross-sectional study in the southeast of Iran.BMC Urol.2021;21:141. doi:10.1186/s12894-021-00905-5
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & causes of kidney stones.Penn Medicine.Kidney stones.Urology of Greater Atlanta.What are the stages of passing a kidney stone?.University of California Irvine.How long does it take to pass a kidney stone?Noh TI, Pyun JH, Shim JS, et al.A comparison between asymptomatic and symptomatic ureteral stones.Sci Rep.2023;13:2757. doi:10.1038/s41598-023-29866-5Song L, Maalouf NM.Nephrolithiasis.In:Endotext.South Dartmouth (MD): MDText.com; 2020.Golzari SEJ, Soleimanpour H, Rahmani F, et al.Therapeutic approaches for renal colic in the emergency department: a review article.Anesth Pain Med.2014;4(1):e16222. doi:10.5812/aapm.16222Almaghlouth AK, Alqutay HM, Bohamed AH, Almarzooq AJ, Alamer MA.Urolithiasis symptoms and risk factors among the general population of Alahsa, Saudi Arabia.Cureus. 2023;15(5):e39645. doi:10.7759/cureus.39645Gillies M, AlDujaili T.Acute colonic pseudo-obstruction secondary to renal calculus: a case report and review of pathophysiology.Cureus. 2023;15(2):e34756. doi:10.7759/cureus.34756Gourlay K, Splinter G, Hayward J, Innes G.Does pain severity predict stone characteristics or outcomes in emergency department patients with acute renal colic?Am J Emerg Med. 2021;45:37-41. doi:10.1016/j.ajem.2021.02.049Hughes T, Ho HC, Pietropaolo, Soman BK.Guideline of guidelines for kidney and bladder stones.Turk J Urol.2020;46(Suppl 1):S104–S112. doi:10.5152/tud.2020.20315Sussman RD, Drain A, Brucker BM.Primary bladder neck obstruction.Rev Urol.2019;21(2-3):53-62.UCLA Health.Urological emergencies.University of Chicago.Why do kidney stones cause pain?Malik A, Mohkumuddin S, Yousaf S, Baig MAR, Afzal A.Validity of STONE score in clinical prediction of ureteral stone disease.Pak J Med Sci.2020;36(7):1693–1697. doi:10.12669/pjms.36.7.2625Moore CL, Bomann S, Daniels B, et al.Derivation and validation of a clinical prediction rule for uncomplicated ureteral stone-the STONCE score: retrospective and prospective observational studies.BMJ.2014;348:g2191. doi:10.1136/bmj.g2191MedlinePlus.Kidney stones.Fontenelle LF, Sarti TD.Kidney stones: treatment and prevention.Am Fam Physician.2019;99(8):490-496Frazier RL, Huppman AR.Educational case: urinary stones.Acad Pathol.2021;8:23742895211040209. doi:10.1177/23742895211040209Gillams K, Juliebo-Jones P. Juliebo SO, Somani BK.Gender differences in kidney stone disease (KSD): findings from a systematic review.Curr Urol Rep. 2021;22(10):50. doi:10.1007/s11934-021-01066-6Fauvus MJ, Feingold KR.Kidney stone emergencies. In;Endotext.South Dartmouth (MA): MDText.com; 2020.Khalli P, Jamali Z, Sadeghi T, et al.Risk factors of kidney stone disease: a cross-sectional study in the southeast of Iran.BMC Urol.2021;21:141. doi:10.1186/s12894-021-00905-5
National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & causes of kidney stones.
Penn Medicine.Kidney stones.
Urology of Greater Atlanta.What are the stages of passing a kidney stone?.
University of California Irvine.How long does it take to pass a kidney stone?
Noh TI, Pyun JH, Shim JS, et al.A comparison between asymptomatic and symptomatic ureteral stones.Sci Rep.2023;13:2757. doi:10.1038/s41598-023-29866-5
Song L, Maalouf NM.Nephrolithiasis.In:Endotext.South Dartmouth (MD): MDText.com; 2020.
Golzari SEJ, Soleimanpour H, Rahmani F, et al.Therapeutic approaches for renal colic in the emergency department: a review article.Anesth Pain Med.2014;4(1):e16222. doi:10.5812/aapm.16222
Almaghlouth AK, Alqutay HM, Bohamed AH, Almarzooq AJ, Alamer MA.Urolithiasis symptoms and risk factors among the general population of Alahsa, Saudi Arabia.Cureus. 2023;15(5):e39645. doi:10.7759/cureus.39645
Gillies M, AlDujaili T.Acute colonic pseudo-obstruction secondary to renal calculus: a case report and review of pathophysiology.Cureus. 2023;15(2):e34756. doi:10.7759/cureus.34756
Gourlay K, Splinter G, Hayward J, Innes G.Does pain severity predict stone characteristics or outcomes in emergency department patients with acute renal colic?Am J Emerg Med. 2021;45:37-41. doi:10.1016/j.ajem.2021.02.049
Hughes T, Ho HC, Pietropaolo, Soman BK.Guideline of guidelines for kidney and bladder stones.Turk J Urol.2020;46(Suppl 1):S104–S112. doi:10.5152/tud.2020.20315
Sussman RD, Drain A, Brucker BM.Primary bladder neck obstruction.Rev Urol.2019;21(2-3):53-62.
UCLA Health.Urological emergencies.
University of Chicago.Why do kidney stones cause pain?
Malik A, Mohkumuddin S, Yousaf S, Baig MAR, Afzal A.Validity of STONE score in clinical prediction of ureteral stone disease.Pak J Med Sci.2020;36(7):1693–1697. doi:10.12669/pjms.36.7.2625
Moore CL, Bomann S, Daniels B, et al.Derivation and validation of a clinical prediction rule for uncomplicated ureteral stone-the STONCE score: retrospective and prospective observational studies.BMJ.2014;348:g2191. doi:10.1136/bmj.g2191
MedlinePlus.Kidney stones.
Fontenelle LF, Sarti TD.Kidney stones: treatment and prevention.Am Fam Physician.2019;99(8):490-496
Frazier RL, Huppman AR.Educational case: urinary stones.Acad Pathol.2021;8:23742895211040209. doi:10.1177/23742895211040209
Gillams K, Juliebo-Jones P. Juliebo SO, Somani BK.Gender differences in kidney stone disease (KSD): findings from a systematic review.Curr Urol Rep. 2021;22(10):50. doi:10.1007/s11934-021-01066-6
Fauvus MJ, Feingold KR.Kidney stone emergencies. In;Endotext.South Dartmouth (MA): MDText.com; 2020.
Khalli P, Jamali Z, Sadeghi T, et al.Risk factors of kidney stone disease: a cross-sectional study in the southeast of Iran.BMC Urol.2021;21:141. doi:10.1186/s12894-021-00905-5
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