1. What is Kidney Stone Pain?
Kidney stones form when minerals or acid salts crystallize in the urine. These stones can either remain in the kidneys or travel to the ureters. If kidney stones are too large to move out of the kidneys, they can become lodged in the ureters, causing pain. Various medical conditions can lead to the formation of kidney stones, such as ureteropelvic junction obstruction, polycystic kidney disease, medullary sponge kidney, ureteral stricture, vesicoureteral reflux, hydronephrosis, renal tubular acidosis, hyperparathyroidism, and gastrointestinal diseases like Crohn's syndrome, granulomatous disease, chronic diarrhea, urinary tract infections, malabsorption syndromes, and gastric bypass surgery for weight loss.
When kidney stones are present in the kidney, the urinary tract may spasm and constrict, causing blockages. Urine stagnation increases pressure on the renal pelvis, leading to severe kidney stone pain.
The characteristic symptom of kidney stone pain is intense, colicky pain starting from one side of the lower back or both flanks, radiating to the lower abdomen or groin, and sometimes extending to the genital area. If the stones are small or medium-sized in the renal pelvis or ureter, they cause mild, dull pain in the lower back and hips. Stones in the bladder neck or urethra cause pain along with urinary retention. If the stones grow larger, you may feel pain during prolonged sitting or sudden position changes due to the pressure of the stones on the surrounding tissue. The pain can last from 20 to 60 minutes or even hours and may be accompanied by hematuria, chills, and fever.
2. How to Use Pain Relievers for Kidney Stone Pain
Pain relief and addressing obstructions, blood clots, or pus due to infection are essential for treating kidney stone pain. Below are the medications prescribed by doctors for alleviating kidney stone pain:
2.1 Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
Renal colic pain is relieved by commonly used NSAIDs such as intramuscular Piroxicam, intravenous Efferalgan, and rectal Indomethacin.
If NSAIDs are ineffective, stronger opioid pain relievers are used. Doctors may administer intravenous Lidocaine, which is effective within the first 3-5 minutes for renal colic pain that does not respond to conventional pain relief methods. The protocol involves diluting 120 mg of Lidocaine in 100 ml of saline solution, administered continuously over 10 minutes to treat pain.
2.2 Muscle Relaxants and Antispasmodics Intravenous
Morphine or other antispasmodics may be used to relieve renal colic pain when mild pain relievers are ineffective.
2.3. Treating Infections with Antibiotics
Infection treatment with antibiotics commonly involves the use of Ciprofloxacin 200mg intravenously, 2 vials per day, or Norfloxacin, 2 tablets per day divided into 2 doses, or Ceftriaxone 1g intravenously, 2 times per day if Quinolone is contraindicated. This treatment is applied in cases of kidney stones with urinary tract infections, fever, or pyuria.
2.4. Diuretics
If renal colic occurs due to kidney stones that are small in size, diuretics such as Thiazide diuretics (Hydrochlorothiazide, Bendroflumethiazide, Chlorthalidone) can be used to help expel the stones through the urinary tract.
In summary, during severe kidney stone pain, patients should not self-treat at home but should seek emergency care at a hospital. A specialist can accurately diagnose the cause, perform necessary tests and imaging, and provide timely treatment to avoid dangerous complications.
2.4. Diuretics If renal colic occurs due to kidney stones but the size of the stones is small, it is possible to use more Thiazide diuretics such as Hydrochloro thiazid, Bendroflumethiazide, Chlorthalidone to let the stones pass through the urinary tract.
In short, when there is severe kidney stone pain, the patient is not allowed to self-treat at home, but needs an emergency at the hospital for a specialist to distinguish, accurately conclude the cause, perform tests. and diagnostic imaging for timely treatment, avoiding dangerous complications.
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