In many cases, kidney stones do not produce symptoms. However, if a stone becomes trapped (or lodged) in the ureter (the thin tube between the bladder and kidney), symptoms can be very severe. Often, symptoms vary depending on the stone's location and its progress.
Kidney stone attacks tend to be most common late at night or in the early morning, possibly because of minimal urine output or constriction of the ureters during the early morning hours. Kidney stone attacks are least common during the late afternoon.
- Pain usually begins abruptly on one side and then continues to be intense and consistent. (In some cases it lasts for a few minutes, disappears, and then returns after about 10 minutes.)
- The patient cannot find a comfortable position and usually stands, sits, paces, or reclines in a failed search for a position that will bring relief.
- If the stone is in the kidney or upper urinary tract, the pain usually starts in one flank area (to the side of the back near the waist). It typically radiates to the groin.
- If the stone is too large to pass easily, the pain follows the muscle contractions in the wall of the ureter as they try to squeeze the stone along into the bladder.
- Nausea and vomiting may occur.
- Blood may be present in the urine.
- As the stone passes down the ureter closer to the bladder, the person may feel the need to urinate more often or a burning sensation during urination.
- A fever suggests that the person may also have a urinary tract infection.
The size of the stone does not necessarily predict the severity of the pain. A very tiny crystal with sharp edges can cause intense pain, while a larger round stone may not be as distressing. Struvite stones can often occur without symptoms.
Review Date: 06/08/2010
Reviewed By: Reviewed by: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.