You wake up with severe pain radiating from your back to your side. Is it a kidney stone, or could it be something else? Approximately 1 in 10 Americans will experience a kidney stone in their lifetime, but several conditions can produce symptoms remarkably similar to kidney stone pain. Understanding the differences could help you seek appropriate treatment faster.

What Are Kidney Stones?

Kidney stones are hard deposits of minerals and salts that form inside your kidneys. These crystallized masses develop when your urine contains more crystal-forming substances than the fluid in your urine can dilute. According to the National Kidney Foundation, more than half a million people visit emergency rooms for kidney stone problems each year.

Common Kidney Stone Symptoms

You might experience these symptoms if you have kidney stones:

• Sharp, intense pain in your back, side, lower abdomen, or groin

• Pain that comes in waves and fluctuates in intensity

• Urge to urinate more frequently than usual

• Difficulty urinating or passing only small amounts

• Cloudy or foul-smelling urine

• Pink, red, or brown urine (indicating blood)

• Nausea and vomiting accompanying the pain

• Fever and chills if an infection is present

To monitor your kidney health proactively, consider using at-home kidney function tests that help detect problems early.

Conditions That Mimic Kidney Stone Pain

While kidney stones cause distinctive symptoms, several other health conditions can produce similar pain patterns and symptoms, often leading to confusion. Here are the most common conditions that might be mistaken for kidney stones:

1. Urinary Tract Infections (UTIs)

UTIs affect approximately 150 million people worldwide each year, making them one of the most common bacterial infections. Because UTIs impact your urinary system, their symptoms can closely resemble those of kidney stones.

How UTI Symptoms Compare:

• Pain location: Lower abdomen, groin, or bladder (vs. back/flank pain with kidney stones)

• Urination changes: Burning sensation during urination, which is less common with kidney stones

• Additional symptoms: UTIs may cause fever but typically don't cause the intense, wave-like pain characteristic of kidney stones

According to a 2023 study published in the Journal of Urology, approximately 28% of patients initially diagnosed with kidney stone pain were later found to have UTIs instead.

Knowing the most common causes of UTIs can help you identify and manage them effectively.

2. Kidney Infections (Pyelonephritis)

When bacteria from a UTI travel up the ureters to your kidneys, a kidney infection can develop. Kidney infections affect about 250,000 Americans annually and require prompt treatment to prevent complications.

How Kidney Infection Symptoms Compare:

• Pain pattern: More constant, steady pain (unlike the waves of pain with kidney stones)

• Fever: Higher fevers (often above 101°F) are more common with kidney infections

• Systemic symptoms: More likely to cause whole-body symptoms like fatigue and weakness

If left untreated, kidney infections can lead to permanent kidney damage or sepsis, a life-threatening complication that affects over 1.7 million Americans each year.

People experiencing frequent UTIs should read about recurring UTIs and how to manage them.

3. Appendicitis

Appendicitis affects approximately 5-9% of the population at some point in their lives. This inflammation of your appendix can sometimes be confused with kidney stones, particularly when the pain radiates.

How Appendicitis Symptoms Compare:

• Pain progression: Typically starts around your navel and shifts to the lower right abdomen

• Movement sensitivity: Pain worsens with movement, coughing, or pressure (less movement-dependent with kidney stones)

• Gastrointestinal symptoms: More likely to cause loss of appetite and digestive issues

Studies show that approximately 7% of patients with right-sided abdominal pain who are suspected of having kidney stones are later diagnosed with appendicitis.

4. Muscle Strain or Injury

Back muscle strains account for up to 80% of all back pain cases and can sometimes mimic the discomfort of kidney stones.

How Muscle Strain Symptoms Compare:

• Trigger events: Often follows physical activity or lifting

• Pain characteristics: Worsens with movement and improves with rest and anti-inflammatory medications

• Associated symptoms: No urinary symptoms, which typically accompany kidney stones

5. Gynecological Conditions

For women, several gynecological conditions can produce pain similar to kidney stones:

Menstrual Cramps

Approximately 80% of women experience menstrual pain at some point, with 5-10% experiencing pain severe enough to disrupt daily activities.

How Menstrual Cramp Symptoms Compare:

• Timing: Follows a predictable monthly pattern

• Location: Typically centered in the lower abdomen and pelvic region

• Additional symptoms: Often accompanied by other menstrual symptoms like bloating and breast tenderness

Ovarian Cysts

Affecting about 10% of women, ovarian cysts can cause sudden, severe pain when they rupture or twist.

How Ovarian Cyst Symptoms Compare:

• Pain onset: Often more sudden with cyst rupture versus the gradually intensifying pain of kidney stones

• Pain location: Usually more centralized in the pelvis

• Associated symptoms: May cause menstrual irregularities not seen with kidney stones

6. Gallstones and Biliary Colic

Gallstones affect approximately 10-15% of adults in the United States. When these stones block bile ducts, they can cause pain that mimics kidney stone discomfort.

How Gallstone Symptoms Compare:

• Pain location: Upper right abdomen or between shoulder blades (vs. lower back/flank with kidney stones)

• Timing relationship: Often occurs after fatty meals

• Duration: Episodes typically last 1-5 hours (similar to kidney stone episodes)

7. Viral Infections and Influenza

Seasonal influenza affects 8-10% of the U.S. population annually. While primarily a respiratory illness, the systemic effects can sometimes be confused with kidney stone symptoms.

How Viral Symptoms Compare:

• Body aches: More generalized rather than localized to the back/flank

• Additional symptoms: Respiratory symptoms like cough and congestion (absent in kidney stones)

• Fever pattern: More persistent fever compared to the intermittent fever sometimes seen with complicated kidney stones

8. Herniated Discs

Back problems, such as herniated discs, can cause lower back pain that mimics kidney stone pain. Without the presence of urinary symptoms, this condition can usually be ruled out through a medical examination.

How Herniated Disc Symptoms Compare:

• Pain pattern: Often radiates down the leg (sciatica) rather than remaining localized to the flank

• Neurological signs: Numbness, tingling, or weakness in limbs (not seen with kidney stones)

• Urinary symptoms: Typically absent, helping to distinguish from urological causes

When to Seek Medical Attention

You should see your doctor promptly if you experience:

• Severe pain that makes finding a comfortable position impossible

• Pain accompanied by fever over 101°F

• Inability to keep down fluids due to vomiting

• Bloody or extremely cloudy urine

• Difficulty urinating despite the urge

Seek emergency medical care if you experience:

• Pain so severe that you can't sit still or find a comfortable position

• Pain accompanied by nausea, vomiting, fever, and chills

• Blood in your urine

• Difficulty passing urine

You can also test from home using a UTI self-diagnostic kit to assess if infection is present.

How Kidney Stones Are Diagnosed

If you visit your healthcare provider with symptoms suggesting kidney stones, they will use several approaches to confirm the diagnosis:

Medical History and Physical Examination

Your doctor will begin by asking about your symptoms and medical history. They'll want to know:

• When your pain began

• Where it's located and if it moves

• What makes it better or worse

• Any changes in your urination patterns

• Previous history of kidney stones (approximately 50% of people who have had one kidney stone will develop another within 7 years)

Laboratory Tests

Various tests help confirm the diagnosis:

• Urinalysis: Examines your urine for blood, infection, and crystal-forming substances. Research shows that 85% of kidney stone patients have blood in their urine, even if not visible to the naked eye.

• Blood tests: Check kidney function and look for elevated levels of minerals that might contribute to stone formation.

• Stone analysis: If you pass a stone, analyzing it helps determine its composition, guiding prevention strategies.

Monitoring creatinine levels is crucial in assessing kidney function. For a comprehensive understanding, refer to this guide on creatinine levels.

Imaging Studies

According to the American College of Radiology, CT scans are now the gold standard for diagnosing kidney stones, with a sensitivity of 97%:

• CT scan: Provides detailed images that reveal the exact size, location, and number of stones.

• Ultrasound: Less sensitive than CT but avoids radiation exposure, making it ideal for pregnant women or children.

• X-ray: Can detect calcium-containing stones but may miss other types.

Sometimes, rapid urine tests can quickly screen for several of the symptoms mentioned in this guide.

Treatment Approaches

Treatment strategies vary based on the stone's size, location, and your symptoms:

For Smaller Stones (Less Than 5mm)

Studies show that 90% of stones smaller than 4mm will pass on their own with proper hydration:

• Increased fluid intake: Drinking 2-3 liters of water daily helps flush out smaller stones

• Pain management: Over-the-counter or prescription medications

• Medical expulsive therapy: Alpha-blockers like tamsulosin can increase passage rates by 29%, according to recent clinical trials

For diabetics or at-risk patients, monitoring blood glucose regularly can prevent uric acid stones.

For Larger Stones (Greater Than 5mm)

Larger stones often require medical intervention:

• Extracorporeal shock wave lithotripsy (ESWL): This non-invasive procedure uses shock waves to break large stones into smaller fragments. Success rates range from 70-90%, depending on stone location and composition.

• Ureteroscopy: A thin scope is passed through the urinary tract to remove or break up the stone. This approach has a success rate of over 95% for ureteral stones.

• Percutaneous nephrolithotomy: This minimally invasive surgical procedure has a clearance rate of approximately 90% for very large stones.

Prevention Strategies

After experiencing a kidney stone, taking steps to prevent future occurrences is essential. Without preventive measures, recurrence rates can be as high as 50% within five years.

Dietary Modifications

Research-backed dietary changes include:

• Increase fluid intake: Studies show that drinking enough to produce 2.5 liters of urine daily can reduce stone recurrence by 50%

• Reduce sodium: High sodium intake increases calcium in urine by as much as 30%

• Moderate animal protein: Excessive protein can increase urine acidity, promoting stone formation

• Maintain adequate calcium: Despite common misconceptions, normal calcium intake (1,000-1,200 mg daily) actually helps prevent stones

You might also consider a blood sugar test kit if you're managing diabetes or insulin resistance.

Medications for Prevention

For recurrent stone formers, medications may be prescribed:

• Thiazide diuretics: Can reduce calcium excretion by up to 50%

• Potassium citrate: Increases urine citrate, inhibiting calcium stone formation

• Allopurinol: For those with uric acid stones, this medication can reduce stone formation by up to 60%

The Bottom Line

While kidney stone pain is distinctive, several conditions can produce similar symptoms. Paying close attention to the pain location, associated symptoms, and timing can help you and your healthcare provider determine the underlying cause.

If you're experiencing symptoms that concern you, don't hesitate to seek medical evaluation. Early intervention often leads to better outcomes and can prevent potential complications. According to the American Urological Association, proper diagnosis and timely treatment can resolve kidney stone symptoms in over 98% of cases.

 

Written by Abel Tamirat, MD
Dr. Abel Tamirat is a licensed General Practitioner and ECFMG-certified international medical graduate with over three years of experience supporting U.S.-based telehealth and primary care practices. As a freelance medical writer and Virtual Clinical Support Specialist, he blends frontline clinical expertise with a passion for health technology and evidence-based content. He is also a contributor to Continuing Medical Education (CME) programs.

Related Resources

• Hydration & Stone Prevention
  Learn how staying hydrated helps prevent kidney stones.

• At-Home Kidney Tests
  Monitor kidney health from home with easy-to-use test kits.

References

Clinic, C. (2023, September 6). Flank Pain: Causes, Symptoms, Diagnosis & Treatment. Retrieved May 8, 2025, from Cleveland Clinic website: https://my.clevelandclinic.org/health/symptoms/21541-flank-pain 

Devi, A. T., Nagaraj, R., Prasad, A., Lakkappa, D. B., Zameer, F., & Nagalingaswamy, N. P. M. (2023). Nephrolithiasis: Insights into Biomimics, Pathogenesis, and Pharmacology. Clinical Complementary Medicine and Pharmacology, 3(2), 100077. https://doi.org/10.1016/j.ccmp.2022.100077 

Iftikhar, N. (2019, March 7). What Causes Left Kidney Pain? Retrieved May 8, 2025, from Healthline website: https://www.healthline.com/health/left-kidney-pain 

Kidney. (2023, September 8). Kidney Stones: Causes, Symptoms, Diagnosis & Treatment. Retrieved May 8, 2025, from Cleveland Clinic website: https://my.clevelandclinic.org/health/diseases/15604-kidney-stones 

Leslie, S. W., Sajjad, H., & Murphy, P. B. (2024, April 20). Renal Calculi, Nephrolithiasis. Retrieved May 8, 2025, from Nih.gov website: https://www.ncbi.nlm.nih.gov/books/NBK442014/