Kidney Stone Pain Pattern: How to Recognize Flank Pain From a Stone and What Treatment Typically Involves

A sudden, sharp pain in your side can be alarming. Many people describe kidney stone pain as one of the most intense pains they have ever felt. But flank pain—pain in the side of your body between your ribs and your hip—can come from many causes, not just kidney stones.

Understanding the typical kidney stone pain pattern, how it changes over time, and what usually happens during evaluation and treatment can make an unfamiliar and frightening experience feel more manageable.

This guide explains how kidney stone pain often behaves, how it’s different from other kinds of flank or back pain, and what people commonly encounter when they seek medical care.

What Exactly Is a Kidney Stone?

A kidney stone is a small, hard deposit that forms inside the kidneys. It is made from minerals and salts that crystallize in the urine, such as:

• Calcium-based stones (most common)
• Uric acid stones
• Struvite stones
• Cystine stones (less common, often linked to inherited conditions)

Many stones form quietly and never cause symptoms. Pain usually appears when a stone:

• Moves into the ureter (the tube that carries urine from kidney to bladder)
• Partially or completely blocks urine flow
• Irritates the lining of the urinary tract and causes spasms

This movement and blockage create the classic kidney stone pain pattern.

Where Kidney Stone Pain Usually Starts and How It Feels

Typical Location of Kidney Stone Pain

Kidney stone pain usually:

• Starts in the flank: the side of the body between the lower ribs and the hip
• Is often felt just below the rib cage on one side
• May be slightly more toward the back than the front

As the stone moves, pain can shift:

• From flank and back
• Down to the side of the abdomen
• Then toward the lower abdomen, groin, or genital area

This “moving pain” pattern along the path of the urinary tract is a key feature of kidney stones.

How People Commonly Describe Kidney Stone Pain

People often describe kidney stone pain as:

• Severe: Frequently intense enough to make it hard to sit still or find a comfortable position
• Sharp or cramping: Sometimes like a stabbing pain, sometimes like strong waves or spasms (renal colic)
• Colicky: Comes in waves, with periods of intense pain followed by brief relief

Unlike some types of muscle or joint pain, kidney stone pain often does not get better with:

• Rest
• Changing position
• Applying heat or cold

Instead, people may pace, twist, or move constantly in search of relief and still feel very uncomfortable.

Kidney Stone Pain vs. Other Common Flank or Back Pain

Flank pain does not always mean a kidney stone. Other conditions can cause pain in a similar area, such as muscle strain, spinal problems, or infections. Comparing patterns can help people understand when a kidney stone might be more likely.

Quick Comparison: Kidney Stone vs. Muscle/Back Pain

These are general patterns, not rules. Different conditions can overlap. Persistent or severe pain usually needs professional evaluation.

The “Pain Journey”: How Kidney Stone Pain Often Changes Over Time

Kidney stone pain can evolve as the stone moves. Many people notice recurring patterns rather than one continuous sensation.

Stage 1: Stone in the Kidney

When the stone is still in the kidney:

• It may cause no pain at all
• Sometimes a dull ache in the back or side is felt
• Pain might come and go mildly, especially after drinking a lot of fluid or being active

Many small stones are found incidentally during imaging for other reasons because they cause few or no symptoms.

Stage 2: Stone Enters the Ureter (Renal Colic)

This is when pain often becomes severe.

Typical experiences:

• Sudden onset of strong pain in the flank or back
• Pain can become intense very quickly
• Pain may come in waves, lasting minutes to longer, then partially easing, then returning
• People may feel a constant baseline pain with sharp spikes

During this phase, people often also notice:

• Nausea and sometimes vomiting
• Sweating, restlessness, or difficulty staying still
• Urgent need to move around, change positions, or pace

Stage 3: Stone Moves Lower Toward the Bladder

As the stone moves down the ureter toward the bladder:

• Pain may shift from the flank to the lower abdomen, pelvis, groin, or genitals
• Men may feel pain in the testicle or penis
• Women may notice discomfort in the labia or deep in the pelvis

At this stage, urinary symptoms often increase:

• More frequent urges to urinate
• A feeling of incomplete emptying
• Possible burning with urination

Stage 4: Stone Near or Inside the Bladder

When the stone reaches the bladder:

• Severe flank pain often improves or stops
• People may still feel:
  • Irritation in the bladder area
  • Urgent, frequent urination
  • Occasional discomfort during urination

Smaller stones may then pass out of the body with urine. Sometimes people do not see the stone, especially if it is tiny, and only notice that the pain has resolved.

Other Symptoms That Often Accompany Kidney Stone Pain

Kidney stones are rarely just about pain. Several other symptoms commonly appear and can help distinguish stones from other problems.

Urinary Symptoms

People with kidney stones may notice:

• Blood in the urine (pink, red, or brown urine, or blood detected on a urine test)
• Burning or stinging during urination
• Urgent or frequent urination, often passing only small amounts
• A feeling that the bladder does not empty fully

These symptoms depend on the stone’s size and location.

Whole-Body Symptoms

Because kidney stones can cause intense discomfort and the body responds to that stress, people often experience:

• Nausea and vomiting
• Sweating, clammy skin
• Restlessness or anxiety from ongoing pain

Warning Signs of Possible Infection or Complication

When a stone is present with infection or blocks urine flow significantly, more serious signs can appear, such as:

• Fever or chills
• Feeling very unwell or weak
• Pain that becomes constant and deep, sometimes with tenderness over the kidney
• Noticeable reduction in urine output

These patterns can suggest a higher-risk situation in which medical teams often act quickly to relieve blockage and manage infection.

How Kidney Stone Pain Differs From a Kidney Infection

Kidney stones and kidney infections can both cause flank pain, but their overall patterns often differ.

Kidney stone–type patterns commonly include:

• Very sudden, severe flank pain
• Pain that moves toward the groin
• Pain in waves (colicky)
• Often no fever unless there is also an infection

Kidney infection–type patterns often include:

• Dull, aching pain in the flank or back
• Fever and chills
• Feeling overall sick or fatigued
• Burning urination and urinary urgency
• Pain that is less “wave-like” and more steady

Both situations can be serious, especially if symptoms are intense or prolonged. Professional evaluation is usually needed to tell them apart reliably.

What Usually Happens During Medical Evaluation

When someone arrives at a clinic, urgent care, or emergency setting with suspected kidney stones, the team typically focuses on two main goals:

1. Understanding the cause and location of the pain
2. Checking for complications, such as infection or severe blockage

Typical Questions and History

Medical staff usually ask about:

• Location and timing of pain:
  • When it started
  • How it has changed
  • Whether it moves toward the groin
• Character of pain:
  • Sharp, dull, constant, in waves, or crampy
• Urinary changes:
  • Blood, frequent urination, burning, or difficulty urinating
• Whole-body symptoms:
  • Nausea, vomiting, fever, chills
• Personal history:
  • Previous kidney stones
  • Medical conditions like gout or metabolic issues
  • Fluid intake patterns
  • Family history of kidney stones

Physical Examination

A typical exam might include:

• Checking vital signs (blood pressure, heart rate, temperature)
• Gently tapping or pressing on the flank and abdomen
• Looking for tenderness or guarding
• Assessing signs of dehydration or illness

Common Tests

To clarify what is happening, teams often use:

• Urinalysis

  • Looks for blood, signs of infection, crystals, or other abnormalities

• Blood tests

  • Assess kidney function
  • Look for infection or other contributing factors

• Imaging tests, such as:

  • CT scan of the abdomen and pelvis: commonly used to locate stones and estimate size and position
  • Ultrasound: often used in certain populations (such as pregnancy) or when radiation exposure is a concern
  • X-ray (KUB): sometimes used for follow-up or for certain types of stones

These tools help determine:

• Stone size
• Exact location
• Number of stones
• Whether urine flow is blocked
• Whether there are signs of infection or kidney strain

What Treatment for Kidney Stones Typically Involves

Treatment usually depends on:

• Stone size
• Stone location
• Severity of pain and symptoms
• Presence of infection or other complications
• The person’s overall health

The goal is either to:

1. Allow the stone to pass on its own with support, or
2. Actively remove or break up the stone

Symptom Relief and Supportive Care

Symptom management is often the first step, especially in emergency settings.

Common approaches include:

• Pain management

  • Medications that reduce pain and help relax the urinary tract are commonly used
  • Options can range from non-opioid pain relievers to stronger medications in more severe cases

• Anti-nausea measures

  • Medications to control nausea or vomiting help people tolerate fluids and medications

• Hydration

  • Fluids may be given by mouth or intravenously, depending on nausea and hydration status
  • Hydration supports kidney function and may help urine flow, although fluid intake is tailored to each situation

• Observation

  • If the stone is small and symptoms are manageable, the strategy may be to wait and monitor while supporting comfort

When Stones Are Likely to Pass on Their Own

Smaller stones, especially those closer to the bladder, are more likely to pass naturally. Factors that often favor spontaneous passage include:

• Smaller size (typically the smaller the stone, the higher the chance it passes)
• Being located lower down in the ureter
• Symptoms that can be controlled with medication

People may be asked to:

• Strain their urine through a fine filter to catch the stone for analysis
• Track pain episodes, fever, and any changes in urination
• Follow up with a healthcare provider to confirm if the stone has passed

Medical Procedures Commonly Used for Kidney Stones

When stones are too large, too painful, or cause complications, more active interventions are often considered.

1. Shock Wave Lithotripsy (SWL)

What it is:
A non-invasive procedure that uses focused shock waves from outside the body to break a stone into smaller fragments.

Typical features:

• No incision
• Performed with imaging guidance
• Smaller fragments may pass out in the urine afterward
• Used more commonly for stones in certain sizes and positions

People may still experience crampy pain as fragments move, but stones can become easier to pass.

2. Ureteroscopy

What it is:
A thin, flexible instrument called a ureteroscope is passed through the urethra and bladder into the ureter to locate and treat the stone.

Key points:

• Allows direct visualization of the stone
• The stone may be:
  • Broken up using a laser
  • Removed with a small basket-like device
• Usually performed under anesthesia

A temporary stent (a small tube placed inside the ureter) may be left in place to keep urine flowing while the ureter heals and swelling decreases. This can cause temporary:

• Urinary urgency
• Discomfort
• Occasional blood in urine

3. Percutaneous Nephrolithotomy (PCNL)

What it is:
A more invasive technique used mainly for very large or complicated kidney stones.

Typical steps:

• A small incision is made in the back
• A channel is created directly into the kidney
• The stone is broken up and removed through this channel

Since this is more involved, it often requires a hospital stay and a recovery period.

4. Temporary Drainage Procedures

In situations where a stone is blocking urine flow, especially with infection or significant kidney strain, urgent drainage may be needed. Two common methods are:

• Ureteral stent placement: A small internal tube that bypasses the blockage
• Nephrostomy tube: A tube placed through the back into the kidney to drain urine externally

These techniques focus on protecting the kidney and reducing infection risk, sometimes before a later procedure removes or breaks up the stone.

Understanding Stone Analysis and Prevention Discussions

Once a stone is passed or removed, it is often analyzed to determine its composition. This information helps guide future prevention.

Common focus areas in prevention planning include:

• Hydration habits: Many healthcare teams encourage consistent fluid intake spread throughout the day
• Diet patterns:
  • Balancing intake of high-oxalate foods
  • Managing sodium and certain animal proteins
  • Ensuring appropriate calcium intake based on stone type
• Other medical conditions:
  • Gout
  • Metabolic or endocrine issues
• Medication review: Some medications can contribute to stone formation

Prevention strategies are usually personalized based on stone type, lab results, lifestyle, and medical history.

Quick-Glance Guide: When Flank Pain Might Be a Kidney Stone

Here is a practical overview of patterns that many people find helpful to recognize:

🧭 Possible Clues Suggesting a Kidney Stone Pattern

• ⚡ Sudden, intense flank pain on one side
• 🌊 Pain that comes in waves and may cause restlessness
• 🔄 Pain that moves from the side/back toward the lower abdomen or groin
• 💧 Blood in the urine (pink, red, or brown tint) or urine that looks cloudy
• 🚽 Frequent urination, urgency, or burning
• 🤢 Nausea or vomiting with the pain
• 😣 Pain that does not reliably improve with position changes, stretching, or rest

🚩 Features Often Considered Concerning

• 🌡️ Fever or chills along with flank pain
• 🌫️ Feeling very unwell, weak, or confused
• ⬇️ Noticeably less urine output
• ⚖️ Pain that is intense and unrelenting, with difficulty finding any relief
• 🩸 Large amounts of visible blood in urine

These patterns help highlight situations where urgent evaluation is often considered important.

Key Takeaways for Navigating Kidney Stone Pain

To wrap together the most practical points, here’s a summary table you can scan at a glance:

Bringing It All Together

Flank pain can be unsettling, especially when it appears suddenly and intensely. Kidney stones have a distinctive pain pattern: abrupt onset, severe intensity, a tendency to move from flank to groin, and a strong association with urinary and whole-body symptoms like nausea.

Understanding these common patterns does not replace professional evaluation, but it can:

• Help people recognize when flank pain might be related to a stone
• Clarify what is typically involved in testing and imaging
• Make upcoming treatments—whether watchful waiting, shock wave therapy, or minimally invasive procedures—feel less mysterious

Knowing what to expect can turn a frightening, unfamiliar episode into something more understandable and manageable, and it can help individuals feel more prepared to discuss options, questions, and concerns with their healthcare team.