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You're probably already aware that passing a kidney stone can be incredibly painful. Perhaps you've heard someone compare the pain to childbirth. Or maybe someone mentioned their experience with kidney stones completely recalibrated how they rate pain. Ouch. But while the most-discussed kidney stone symptom is often the pain — where it's felt and how bad it can get — it's not the only symptom to be aware of. "Kidney stones are fairly common and often painful, but they're also treatable and even preventable," says Dr. Chris Kannady, urologist at Houston Methodist. "If you think you might have a kidney stone, it's important to see your doctor as soon as possible since delaying care for a kidney stone can lead to serious complications." But, when all you've heard about kidney stones is how much they hurt, how can you tell if your pain might be kidney stone pain? What are the symptoms of kidney stones?"A kidney stone is a hard mass that's made up of minerals (usually calcium), certain salts and other byproducts. They can form when these substances accumulate in the area of your kidneys where urine is produced," explains Dr. Kannady. Kidney stones can be as small as the point of a pen or as large as a ping pong ball. "Typically, a person doesn't start noticing the symptoms of a kidney stone until it moves from the kidney into the ureter, which is the tube that carries urine from your kidney to your bladder," Dr. Kannady adds. Kidney stone symptoms include:
Where is kidney stone pain located?The sharp pain associated with a kidney stone moves as the stone progresses through your urinary tract. The most common places to feel pain are in your:
However, while pain is certainly the most noticeable symptoms of kidney stones, it's not always the earliest sign — or even the most telling sign, for that matter. "The pain associated with a kidney stone typically isn't felt until after its already formed and is passing through your urinary tract," explains Dr. Kannady. "In addition, due to differences in anatomy, men and women describe kidney stone pain slightly differently. Not to mention that pain itself is relative and everyone has a different threshold for it." Plus, the intensity of the pain isn't necessarily a measure of how problematic the kidney stone might be or become. Smaller stones that are likely to pass on their own can still be very painful. And not every kidney stone that requires medical intervention comes with gut-wrenching pain. "Any time you're experiencing pain, it's important to see your doctor. But if you're experiencing pain, even if it's only mind, in combination with the kidney stone symptoms above — and, in particular, if you have a fever or severe trouble urinating — it's definitely important to see your doctor," warns Dr. Kannady. Can kidney stone symptoms come and go?The length of time a stone can hang around is the primary reason that a person may feel like kidney stone symptoms come and go. Once you start feeling the pain of a kidney stone, it can take anywhere between one to four weeks for the stone to actually pass. In the meantime, the pain can seem sporadic. Here's why: "During a bout of kidney stones, the initial pain is typically caused by the stone making its way through your very narrow ureter tube. There can also be pain if the stone lodges itself there and blocks urine flow out of the kidney, which results in pressure buildup and painful swelling," explains Dr. Kannady. As your body tries to move the kidney stone through your ureter, some of your pain may also be from the waves of contractions used to force the kidney stone out. The pain may also move as the kidney stone moves along your urinary tract. "Once the stone makes it to your bladder, the pain might subside to some degree and you may notice urinary symptoms in its place. The final push from your bladder to outside of your body can reignite sharp feelings of pain, as the stone is now passing through another narrow tube called your urethra," says Dr. Kannady. How long do kidney stone symptoms last?As mentioned, the time frame for these symptoms can be as short as a week or up to a month and beyond. So, even if it feels like your kidney stone pain has subsided, it's important to reach out to your doctor since sporadic pain is common with this condition. "While some kidney stones pass on their own, others require treatment — such as medications or procedures to help break up the stone or even surgical removal. Your doctor can perform the tests needed to determine whether the stone is likely to pass on its own or if you might need treatment. In addition, your doctor can help you manage the pain associated with passing the stone," adds Dr. Kannady.
Stay up-to-date Please Enter Email Please Enter Valid Email Not all kidney stone pain is the same. For example, the location of pain can change as the stone moves from the kidney to the bladder, says Lieske. When a stone is moving into the ureter, people may feel pain in their flank, or side, or their back, he says. Notably, if the stone is stuck where the kidney connects to the ureter, the pain can be severe, says Ralph V. Clayman, MD, a professor in the department of urology at the University of California in Irvine. On a scale of 1 to 10, “pain can be a 10,” he says. “There is no position in which the person is comfortable.” This type of pain has a tendency to come and go in 10- to 30-minute cycles. It can also radiate to the groin area and the front of the thigh, he adds. Once the stone has moved down to the part of the ureter closer to the bladder, a person tends to have pain in the abdomen or groin, says Lieske. Men sometimes feel pain at the tip of their penis. (3) As the stone moves down the ureter, it can also mimic the pain of other conditions, says Clayman. For example, if the kidney stone is on the right side of the body, it may feel like appendicitis, or inflammation of the appendix. If the stone is on the left side, people may mistake the pain for diverticulitis, inflammation, or an infection within the small or large intestine, he says. And as the kidney stone migrates into the bladder, symptoms can be similar to a urinary tract infection, says Dr. Clayman. People may experience painful urination, along with frequent urination, and the urgent need to urinate, he adds. Fortunately, from this point, the stone can usually pass from the bladder out the urethra, which is typically twice the diameter of the ureter, says Clayman. 1Division of Surgery and Interventional Science, University College London, London, UK 2Urology Department, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK Find articles by Saiful Miah 3Urology Department, Raigmore Hospital, Inverness, UK Find articles by Charlotte Gunner 4Psychiatry Department, Highbury Hospital, Nottingham, UK Find articles by Lucy Clayton 5Urology Department, Chesterfield Royal Infirmary, Chesterfield, UK Find articles by Suresh Venugopal 5Urology Department, Chesterfield Royal Infirmary, Chesterfield, UK Find articles by Nigel R Boucher 6Urology Department, Rotherham General Hospital, Rotherham, UK Find articles by Bo Parys Author information Copyright and License information Disclaimer 1Division of Surgery and Interventional Science, University College London, London, UK 2Urology Department, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK 3Urology Department, Raigmore Hospital, Inverness, UK 4Psychiatry Department, Highbury Hospital, Nottingham, UK 5Urology Department, Chesterfield Royal Infirmary, Chesterfield, UK 6Urology Department, Rotherham General Hospital, Rotherham, UK Correspondence: Saiful Miah, Division of Surgery and Interventional Science, 4th Floor, University College London Medical School Building, 21 University Street, London, WC1E 6AU, UK, Tel +44 20 7679 9060, Email Copyright © 2017 Miah et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Renal colic is often described by patients as the worst pain ever experienced.1 Pain during childbirth is also similarly described.2 To date, no study has comparatively evaluated the pain of renal colic to that of childbirth in female patients who have experienced both. Furthermore, no such study has evaluated the perception that men with renal colic have with respect to the pain experienced during childbirth. Here we present our cross-sectional observational study to address these questions. The primary objectives of our study were to answer these questions and highlight the severity of renal colic which is not always faced and treated aggressively. Fifty-nine patients across two centers (Rotherham General Hospital, UK and Chesterfield Royal Hospital, UK) were asked to complete a visual analog scale questionnaire to assess the severity of their renal colic (minimum: 1, maximum: 10). All patients had confirmed ureteric stones on CT imaging and were asked if their renal colic was the most painful condition they have ever suffered. All primiparas and multiparas females were asked if their renal colic was more painful than childbirth. All men were asked to provide an opinion on what they imagined would be more painful – their renal colic or the pain associated with childbirth. The study gained ethical approval from Chesterfield Royal Hospital Research and Ethics Department. All patients provided written consent to in order to participate in the study. Thirty-six male and 23 female patients fully completed the questionnaire with age, stone size, and numerical pain rating score recorded (Table 1). There were no statistically significant differences in these parameters between male and female patients (p>0.05, Student’s t-test). From the male cohort of patients, 88.9% (n=32) stated that it was the worst pain they had ever experienced and for the female cohort this was 78.2% (n=19). Results from the visual analog scale questionnaire
From the female cohort of patients, 19 had given birth previously with 63.3% (n=12) saying that renal colic was more painful and a further 15.7% (n=3) felt that the intensity of pain was similar. Twenty-one percent of (n=4) female patients who had experienced both childbirth and renal colic stated that childbirth was a more painful experience. In contrast, the majority of male patients imagined that the pain from their renal colic was less painful (40%) or comparable (23.4%) to that of childbirth. The results of our study suggest that renal colic was the worst pain for the majority of female patients who have experienced both forms of pain. In contrast, 63.4% of men imagined that the pain of childbirth is worse or as severe as that from their renal colic. Renal colic should be managed by a swift stepwise and progressive analgesia regime. Pain associated with childbirth is well recognized and follows involvement of the pain team or anesthetist in pain control during labor. In contrast, renal colic pain is managed generally in the acute setting by either emergency care practitioners or the urologist. Optimal pain management in renal colic patients in the shortest possible time is vital as this group can on occasion be left with inadequate analgesia for lack of understanding of the intensity pain.3 Our study has several limitations. They include limitations in numbers with only 19 women who experienced both renal colic and childbirth. We assessed labor pain retrospectively which will include an element of recall bias. Further work could potentially include assessing female patients in their acute pain phase of labor and who have experienced renal colic pain prior to childbirth. To conclude, our study underlines and highlights the urgency and importance required when administering effective analgesia for female and male patients presenting with renal colic as that would be expected from those experiencing childbirth. Disclosure The authors report no conflicts of interest in this work. 1. Golzari SE, 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. [PMC free article] [PubMed] [Google Scholar] 2. Yerby M. Pain in childbearing: key issues in management. 6th ed. London: Elsevier Health Sciences; 2000. Pain relief: past and present; p. 5. [Google Scholar] 3. Behzadnia MJ, Javadzadeh HR, Saboori F. Time of admission, gender and age: challenging factors in emergency renal colic - a preliminary study. Trauma Mon. 2012;17(3):329–332. [PMC free article] [PubMed] [Google Scholar] Articles from Journal of Pain Research are provided here courtesy of Dove Press |
What is kidney stone pain comparable to
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