Would Kidney Stones Cause Back Pain? Causes and Signs

Wondering would kidney stones cause back pain, or if something more serious is hiding behind that sharp, lingering ache? Many people overlook early warning signs until the pain becomes impossible to ignore. In this article, you’ll discover the surprising ways kidney stones trigger back discomfort, the subtle symptoms most people miss, and when that pain could signal something urgent.

Consult a back pain specialist in Brooklyn, NY for guidance.

TL;DR:

Kidney stones can cause sharp, shifting back or flank pain that radiates toward the lower abdomen or groin, often accompanied by urinary changes, nausea, or fever if infection is present. Stones form when concentrated urine allows minerals to crystallize and grow, influenced by factors like low fluid intake, diet, metabolic issues, and certain medical conditions. Diagnosis relies on imaging, urine and blood tests, and stone analysis to confirm stones, assess obstruction, and guide long-term prevention.

What Are the Common Symptoms of Kidney Stones?

Kidney stones can cause a wide range of symptoms, and these often depend on the stone’s size, its location, and whether it is moving or blocking the flow of urine. The most classic symptom is intense, intermittent pain that begins in the flank and may radiate toward the lower abdomen and groin as the stone travels through the ureter. This sharp, cramping sensation, often referred to as renal colic, typically occurs when a stone is large enough to obstruct urine flow.

Not all stones cause noticeable discomfort. Small stones may pass quietly without producing any symptoms, while larger or obstructing stones tend to trigger more severe pain. In addition to pain, many people experience visible blood in the urine, a frequent urge to urinate, burning or pain during urination, and the sensation of passing only small amounts of urine. Urine may also appear cloudy or have a foul odor.

Severe pain from kidney stones can lead to nausea and vomiting. In cases where infection is present, symptoms may include fever and chills. 

How Kidney Stones Form and Affect the Body

These stones develop when substances that normally dissolve in urine become overly concentrated and begin to crystallize. This process follows several stages: urine supersaturation with stone-forming salts, the initial formation of crystals (nucleation), the growth and clumping of those crystals, and their retention within the kidney where they can enlarge into stones. Factors that influence these stages include metabolic abnormalities, urinary pH, low urine volume, dietary habits, genetic tendencies, certain medications, and specific medical conditions. Contemporary summaries note that recurrence is common and that metabolic evaluation can help identify causes that may be corrected to prevent repeated episodes.

Once formed, stones can affect the body in multiple ways. They may block the flow of urine, creating back pressure and triggering ureteral spasm, which produces significant pain. Stones can also irritate or injure the lining of the urinary tract, causing bleeding and inflammation. When obstruction occurs alongside infection, the situation can become serious and may require urgent medical attention.

Typical Locations and Types of Pain Experienced

Pain from kidney stones often shifts as the stone moves through the urinary tract:

• Renal (flank) pain: When the stone is located in the kidney or at the ureteropelvic junction, the pain is usually a deep, intense ache or a sharp, colicky sensation felt in the flank and back on the affected side.
  
• Ureteral pain (radiating): As the stone travels down the ureter, it commonly produces wave-like, colicky pain that radiates from the flank toward the lower abdomen and groin. In some cases, the pain may extend toward the testicle in men or the labia in women.
  
• Suprapubic or urinary-tract pain: When the stone reaches the lower ureter or approaches the bladder, symptoms often shift to pelvic pressure, urinary urgency, increased frequency, or discomfort during urination rather than severe flank pain.
  

Intense pain episodes may be accompanied by nausea, vomiting, sweating, and restlessness. If severe, continuous pain occurs along with fever, this may indicate infection and warrants urgent evaluation. The sudden onset, severity, colicky nature, and shifting location of the discomfort are characteristic patterns that often lead individuals to seek emergency care.

Factors That Increase the Risk of Kidney Stones

Several modifiable and non-modifiable factors can raise the likelihood of developing kidney stones. The most significant modifiable contributor is low fluid intake, which results in concentrated urine and increases supersaturation of stone-forming substances.

Common risk factors include:

• Low fluid intake / concentrated urine: The primary modifiable risk; low urine volume increases stone-forming supersaturation.
  
• Dietary patterns:
  
  • High sodium intake (raises urinary calcium)
  • Very high animal-protein intake (increases uric acid and lowers urinary citrate)
  • Excessive dietary oxalate
  • Inadequate calcium at meals, which can increase calcium-oxalate stone risk
    
• Obesity and metabolic syndrome: Both are linked to a higher risk and certain stone types.
  
• Medical conditions:
  
  • Gout
  • Inflammatory bowel disease (increases oxalate absorption)
  • Chronic diarrhea
  • Some renal tubular disorders
  • Prior intestinal bypass surgery
    
• Certain medications: Examples include specific diuretics, antiretrovirals, and topiramate, which can alter urine chemistry.
• Family history and prior stones: A previous personal stone episode greatly increases recurrence risk, and family history suggests genetic susceptibility.
• Urinary tract infections: Infections with urease-producing organisms increase the risk of struvite stones.
  

Public health and guideline sources emphasize that prevention focuses on lifestyle modifications, especially increasing fluid intake, combined with targeted dietary and medical strategies based on identified metabolic abnormalities.

Diagnostic Tests Used to Detect Stones

Diagnosing kidney stones relies on combining patient history with targeted diagnostic tests designed to confirm stones, determine their location, and assess for obstruction. The primary imaging tools include non-contrast CT scans, which are the most sensitive and specific for identifying stone size and location, along with ultrasound, often preferred when radiation should be minimized. A KUB X-ray can also help detect radiopaque stones and is sometimes used for follow-up.

Evaluation also involves urine-based studies. Urinalysis can reveal hematuria, pyuria, crystalluria, or signs of infection, while a urine culture is obtained when infection is suspected. For patients at risk of recurrence, 24-hour urine collections measure metabolites to uncover abnormalities that can be corrected with diet or medication. These tests help identify preventable contributors to stone formation.

Blood work and stone-specific testing further strengthen the diagnostic process. A basic metabolic panel assesses kidney function, while levels of calcium, uric acid, or parathyroid hormone may be checked when systemic contributors are suspected. When a stone is passed or removed, stone analysis determines its chemical composition, allowing for targeted prevention strategies. Identifying stone type is considered essential for long-term management and reducing recurrence.

Key Takeaways

1. Kidney stones often cause sharp, intermittent back or flank pain that can radiate to the lower abdomen or groin, with symptoms ranging from urinary changes to nausea, vomiting, and fever when infection is present.
   
2. Stones form when substances in urine become overly concentrated and crystallize, progressing through stages of nucleation, growth, and retention.
   
3. The pain varies by stone location, presenting as deep flank pain in the kidney, radiating colicky pain in the ureter, or pelvic pressure near the bladder.
   
4. Multiple risk factors increase the likelihood of stone development, including low fluid intake, dietary habits, obesity, metabolic syndrome, certain medical conditions, medications, and family history.
   
5. Diagnosis relies on imaging, urine tests, blood work, and stone analysis, with non-contrast CT being the most sensitive method. Urinalysis and 24-hour urine studies uncover metabolic contributors, while blood tests assess kidney function and systemic factors.

FAQs: 

How to tell if back pain is from a kidney stone?

 Kidney stone pain usually starts suddenly in the flank (side of the back) and may radiate to the lower abdomen or groin. It often comes in waves (colicky pain) and may be accompanied by urinary changes, nausea, or restlessness.

What are 5 symptoms of having kidney stones?

 Intense flank pain, pain radiating to the groin, blood in the urine, burning or frequent urination, and nausea or vomiting.

When to go to the ER for kidney stones?

 Go to the ER if you have severe, unrelenting pain, fever with chills (possible infection), difficulty urinating, vomiting that prevents hydration, or signs of infection along with obstruction.

How do I confirm if I have kidney stones?

 Diagnosis is confirmed through imaging, most reliably a non-contrast CT scan, or ultrasound when radiation should be minimized. Urinalysis and blood tests support diagnosis, and stone analysis helps guide prevention if a stone is passed.

Sources. 

Tamborino, F., Cicchetti, R., Mascitti, M., Litterio, G., Orsini, A., Ferretti, S., Basconi, M., De Palma, A., Ferro, M., Marchioni, M., & Schips, L. (2024). Pathophysiology and Main Molecular Mechanisms of Urinary Stone Formation and Recurrence. International journal of molecular sciences, 25(5), 3075. https://doi.org/10.3390/ijms25053075 

Peerapen, P., & Thongboonkerd, V. (2023). Kidney Stone Prevention. Advances in nutrition (Bethesda, Md.), 14(3), 555–569. https://doi.org/10.1016/j.advnut.2023.03.002