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Very small stones can pass out of your body without you noticing. But if you do get symptoms, the most likely one is pain.

The pain might begin as a dull ache in your side while the stone is in your kidney. It won't become severe unless the stone leaves the kidney.¹

When a stone starts to move down one of the tubes (ureters) from the kidney toward your bladder, you can get a bad pain in your back or side. This will probably come on suddenly.²

This pain can be so intense that it feels like the worst you've ever had. It is called renal colic.

The pain comes from your muscles trying to squeeze the stone through the ureter and into the bladder.³

The pain is sharp and cramping. It tends to come and go as the stone moves. It will probably start in your back or side, and might spread down to your belly or groin. It is the kind of pain that makes you move around a lot, rather than lying still, as you try to find a more comfortable position.

You might get other symptoms with the pain. You might:

• Feel sweaty or sick to your stomach
• Vomit
• Find blood in your urine. This is caused by the stone rubbing against the walls of the ureter
• Need to urinate more often or feel a burning sensation when you urinate. This is more likely as the stone gets closer to the bladder.³

Your doctor may suspect you have a kidney stone if you have sudden severe pain in your side and blood in your urine.

Your doctor should send you to a radiology center or hospital for one or more tests. These tests can:

• Confirm that you actually have a kidney stone
• Rule out other possible causes of the pain
• Show where the stone is stuck and how big it is.

You will probably have an X-ray. Most kidney stones show up on an X-ray. You might also have an ultrasound scan. But if these tests don't show a stone, the doctor will probably scan you using one of the following tests:^{2 3}

• A CT scan (computed tomography scan). This is a type of X-ray. It takes several detailed pictures of the inside of your body from different angles
• An IVP (intravenous pyelogram). For this test, the doctor injects a dye into your bloodstream. The dye collects in your kidneys and helps any kidney stones to show up on the X-ray.

The results of these tests will also help your doctor to decide on the best treatment for you.

Many people with kidney stones have no symptoms at all. They may find out about them only if they have an X-ray for some other reason. But often, these stones go on to cause problems. About half of small stones found in the kidneys start to produce symptoms within five years.⁴

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment. ©BMJ Publishing Group Limited 2008. All rights reserved.