Renal Colic

What is renal colic?

Renal colic is pain that may occur when a stone gets stuck in part of your urinary tract. Other urinary tract disorders, such as infection, spasm, or stricture may also cause pain. Stones form when minerals or other substances build up, stick together and create crystals. These stones can be located in any part of your urinary system — your kidneys (kidney stones), bladder (bladder stones) or ureters (ureteral stones). Depending on the size and location of the stone, renal colic can range from mild to severe.

How does renal colic affect my body?

A stone in your urinary tract can be as small as a grain of sand or as big as a golf ball. The larger the stones grow, the more painful they may become.

How common is renal colic?

It’s estimated that 5% to 15% of the population experiences renal colic.

Can I have renal colic without stones?

Yes. Sometimes ureteral or bladder spasms can cause renal colic. These spasms occur when your ureter or bladder muscles contract suddenly, resulting in burning or cramping pain. Ureteral or bladder spasms can happen with or without urinary stones.

What are the symptoms of renal colic?

The most common warning sign of renal colic is intense flank pain on the affected side of your body, between your lower ribs and hip. This pain can radiate to your back, groin or lower abdomen. Renal colic can come in waves, and it’s often accompanied by nausea and vomiting.

Other symptoms that might appear in combination with renal colic include:

• Painful urination (pain when you pee).
• Blood in your pee.
• Cloudy urine.
• Urine changes, like foul-smelling pee, peeing more or less than usual or an urgent need to pee.
• Crystals in your urine.
• Fever.
• Chills.

What causes renal colic?

Urinary stones are the main cause of renal colic. If the stone restricts your flow of urine, it can cause increased pressure and inflammation.

Stones can form in your urinary tract for several reasons, including:

• Dehydration.
• Excess calcium in your pee.
• Excess protein in your diet.
• Certain medications.
• Conditions of your gastrointestinal tract, such as ulcerative colitis or Crohn’s disease.
• Hyperparathyroidism.

There are other things that can cause renal colic. If stones aren’t found to be the source of your pain, your healthcare provider may refer you to a urologist for further testing.

How is renal colic diagnosed?

Your healthcare provider will perform an examination and ask about your symptoms and medical history. To confirm a renal colic diagnosis, they may perform:

• A computed tomography (CT) scan of your urinary tract (with or without contrast).
• A kidney ultrasound.
• Abdominal X-rays.
• A renal scan, which shows how your kidneys work.

What is the best pain reliever for kidney stones?

Pain relievers such as acetaminophen, ibuprofen and naproxen sodium can help ease mild renal colic. If you have severe pain, your healthcare provider may prescribe stronger pain medication. If renal colic is due to ureteral spasms, your provider can give you medications to relax your muscles and reduce discomfort.

How do you relieve renal colic?

Renal colic treatment depends on the type of stone you have. There are several different types of urinary stones, including:

• Calcium stones (made of calcium oxalate or calcium phosphate).
• Uric acid stones (made of uric acid concentrates).
• Struvite stones (made of struvite, a mineral).
• Cystine stones (made from cysteine, a chemical that’s produced by a rare condition called cystinuria).

Treatment also depends on the size of your urinary stone:

Renal colic treatment for small stones

If you have a small urinary stone, you may be able to pass it when you pee. You should drink lots of fluids to help pass the stone, and your healthcare provider can prescribe medications to help with the pain. They might also ask you to pee through a strainer. This catches any urinary stone fragments so a lab can analyze them.

Renal colic treatment for large stones

It’s unlikely that you’ll pass larger stones when you pee. So, your healthcare provider may recommend a procedure to remove them, such as:

• Shock wave lithotripsy. During this procedure, shock waves are directed at your urinary stones to break them up into smaller pieces. You can then pass these smaller pieces when you pee.
• Ureteroscopy. Your surgeon inserts a thin, lighted tube with a tiny camera into your urethra. This helps them find and remove the stone or break it up into smaller pieces and remove the fragments.
• Percutaneous nephrolithotomy. Performed to remove kidney stones, this procedure involves making a small incision in your back to access your kidneys. This is typically reserved for larger stones.
• Ureteral stent. In some cases, your healthcare provider can place a stent in your ureter to reduce the blockage and help the stones pass.

In some circumstances, more than one surgery may be necessary to treat the stones.

Can I prevent renal colic?

To reduce the risk of renal colic, you’ll need to take steps to reduce the likelihood of urinary stones. Here are some helpful tips:

• Drink more water and cut back on dark soda.
• Reduce the amount of salt in your diet to less than 2,000 milligrams daily.
• Limit animal protein — such as beef, chicken, pork and fish — to a palm-size serving per day.
• Reduce your intake of foods that have high oxalate content, such as nuts and spinach.
• Do not restrict calcium in your diet. It’s important to get calcium from food sources like cheese, lentils and leafy greens.

If you’ve had urinary stones in the past, your healthcare provider may prescribe medications such as potassium citrate or thiazide diuretics. These drugs can help reduce the recurrence (return) of urinary stones.

What can I expect if I have renal colic?

If you have renal colic, you should see your healthcare provider right away. They can run tests to determine the source of your pain. Then they’ll recommend appropriate treatment to remove the stone and ease your symptoms.

How long does renal colic last?

Waves of renal colic can last anywhere from 20 to 60 minutes. In severe cases, the pain can last even longer. If you experience renal colic that doesn’t improve, go to your nearest emergency room.

Do kidney stones feel like muscle spasms?

Sometimes they can. Once a stone has moved out of your kidney, you might feel spasms as your urinary system works to push it out. Additionally, you may also experience severe, radiating pain below your ribs and above your hip.

How do you stop a ureter spasm?

Your healthcare provider can prescribe anti-spasm medications, such as tolterodine. Some people find that Kegels and other pelvic floor exercises are helpful for reducing ureteral and bladder spasms.

When should I see my healthcare provider?

If you develop flank pain that radiates to your groin, back or lower abdomen, then schedule a visit with your healthcare provider. They can find out whether your pain is because of renal colic or if it’s due to another condition. In many cases, your provider can give you medications that will quickly relieve pain associated with urinary stones.

Is renal colic an emergency?

If you have an infection as well as renal colic, then it’s an emergency. If you develop fever, chills or other symptoms of infection, call 911 or head to your nearest emergency room.

A note from Cleveland Clinic

Renal colic is a specific type of pain caused by urinary stones or other urinary tract disorders. Discomfort can range from mild to extremely severe. In some cases, renal colic can be so painful that it interferes with your quality of life. Prompt diagnosis and treatment are the first steps toward feeling better. If you have a history of urinary stones, ask your healthcare provider about ways to reduce your risk of recurrence.