尿管結石の痛み：効果的な対処法と、決して放置してはならない症状

最終更新日： 8月 22, 2026

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Ureteric colic is among the most severe pains the human body produces. It arrives suddenly, peaks within an hour or two, comes in waves, and leaves people unable to find any position that helps. Most men who have had it describe it as the worst pain of their lives — and most of them, understandably, want to know what they can do about it before they are seen.

There is an honest answer to that, and it comes with something more important attached: the dangerous version of this does not hurt more than the ordinary version. It comes with a fever. So the emergencies go first.

• 泌尿器センター バンコク病院 タイ オンライン予約 02-310-3009 bhquro@bdms.co.th
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Go to an Emergency Department Now If Any of These Apply

• Fever or chills with flank pain. This is the one that matters most. A blocked kidney that is also infected can become life-threatening within hours, and it is not treated with antibiotics alone — the kidney has to be drained urgently. Antibiotics cannot sterilise urine trapped behind a stone.
• Vomiting so persistent that you cannot keep fluids or tablets down
• Passing little or no urine at all — which may mean both sides are obstructed, or that a single working kidney is blocked
• You have only one kidney, a transplanted kidney, or known kidney impairment
• You are pregnant
• Pain that simple painkillers do not control, or that keeps returning in severe waves

In Thailand the emergency number is 1669. And a caution worth stating plainly: severe flank or abdominal pain is not always a stone. A leaking aortic aneurysm, a twisted testicle and several other conditions can present the same way, which is another reason a first attack is assessed rather than self-diagnosed.

What Is Actually Happening

The ureter is a muscular tube about 25 cm long carrying urine from kidney to bladder, and its channel is only a few millimetres wide. A stone that leaves the kidney and lodges in it blocks the flow; pressure builds behind the obstruction, and it is that pressure — not the stone scraping — that produces the pain. Stones tend to stick at three narrow points: where the kidney joins the ureter, mid-way, and at the entry to the bladder, which is the tightest of the three.

Where the pain travels gives a rough hint about where the stone is — loin pain radiating to the testicle suggests a stone higher up, pain going into the groin suggests one lower down, and a stone right at the bladder entrance often causes urgency and a burning sensation that gets mistaken for a urinary infection. It is only a hint, not a diagnosis; the imaging decides.

What Genuinely Helps Before You Are Seen

An anti-inflammatory painkiller (NSAID) is the most effective simple option — more effective than paracetamol for this particular pain, because it lowers the pressure in the obstructed system as well as relieving pain. But NSAIDs are not harmless, and in ureteric colic several of the cautions apply at once. Do not take one if you have kidney impairment, an ulcer or previous gastrointestinal bleeding, asthma that is worsened by these drugs, heart failure, or if you are pregnant — and be careful if you take a blood thinner, or blood pressure medication of the ACE-inhibitor or diuretic type, where the combination with dehydration can injure the kidneys. If you are dehydrated from vomiting, that is itself a reason to be cautious and to be seen rather than to dose yourself further. Paracetamol is the fallback where NSAIDs are unsuitable.

A warm compress or hot shower over the loin genuinely eases the muscle spasm for some people and carries no risk. It is worth trying while you arrange to be seen.

A correction: drinking heavily does not flush the stone out

An earlier version of this article advised drinking plenty of water during an attack to help move the stone, and stated that US and European guidelines recommend it. That was wrong on both counts, and it is corrected here. There is no good evidence that forcing fluids during acute colic speeds stone passage or reduces pain, and pouring more urine into a system that is already obstructed can make the pain worse. Guidelines recommend high fluid intake to prevent stones forming — which it does, better than anything else — not as treatment for an attack in progress.

What is true is that you should not become dehydrated: drink normally to thirst, and if vomiting is preventing even that, you need to be seen, because the fluid then goes in through a drip. For the prevention side, which is where fluid genuinely earns its reputation, see the eight habits that prevent kidney stones.

One more thing not to do: do not strain and then discard. If a stone passes, keep it. Analysing what it is made of is what makes prevention specific rather than generic.

How the Stone Is Found

Non-contrast CT is the most accurate test, and it answers the four questions that decide what happens next: where the stone is, how big it is, how obstructed the kidney is, and how dense the stone is — density predicts how well it will respond to shockwave treatment. Low-dose protocols are used where possible, since the radiation is not nothing.

Two exceptions matter: in pregnancy and in children, ultrasound is used first, to avoid radiation. Ultrasound is also a reasonable first look in anyone with a known stone history — it shows whether the kidney is swollen even when it cannot see the stone itself — but it is not accurate enough to plan a procedure around.

Size is what most often decides the plan: small stones frequently pass on their own with time and pain control, sometimes helped by medication — covered in medical expulsive therapy — while larger ones, or any stone in an infected or non-functioning system, are dealt with actively. The options are set out in 腎臓結石治療.

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What does ureteric stone pain feel like?

Sudden, severe, one-sided loin pain that peaks within an hour or two and comes in waves, usually with nausea or vomiting and an inability to keep still. It may travel to the testicle if the stone is higher up, or to the groin if it is lower; a stone at the bladder entrance often causes urgency and burning that gets mistaken for a urinary infection. The location of the pain is a hint, not a diagnosis.

When is ureteric stone pain an emergency?

Above all, fever or chills with flank pain — a blocked kidney that is also infected can become life-threatening within hours and needs urgent drainage, because antibiotics cannot sterilise urine trapped behind a stone. Also: vomiting that prevents keeping fluids down, passing little or no urine, having only one or a transplanted kidney or known kidney impairment, pregnancy, and pain that simple painkillers do not control. Attend an emergency department or call 1669 in Thailand.

Does drinking a lot of water help pass a stone during an attack?

No — this is a widespread belief and it is not supported. There is no good evidence that forcing fluids during acute colic speeds passage or reduces pain, and adding urine to an already obstructed system can worsen the pain. High fluid intake is the single best way to prevent stones forming, which is where the advice comes from, but it is not a treatment for the attack. Drink normally to thirst, and if vomiting prevents that, you need intravenous fluids rather than more effort at home.

Which painkiller works best for ureteric colic?

An anti-inflammatory (NSAID) is more effective than paracetamol for this pain, because it lowers pressure in the obstructed system as well as relieving pain. It is not suitable for everyone: avoid it with kidney impairment, ulcer or previous gastrointestinal bleeding, NSAID-sensitive asthma, heart failure, or in pregnancy, and take care alongside blood thinners or ACE-inhibitor and diuretic blood pressure medication, particularly when dehydrated. Paracetamol is the fallback. Pain not controlled by simple painkillers means being seen rather than taking more.

Why is a CT scan used rather than ultrasound?

Non-contrast CT shows where the stone is, how large it is, how obstructed the kidney is, and how dense the stone is — the four things that decide treatment, including whether shockwave treatment is likely to work. Low-dose protocols are used where possible. In pregnancy and in children, ultrasound is used first to avoid radiation, and ultrasound is a reasonable initial look in a known stone-former, but it is not accurate enough to plan a procedure around.

Should I keep the stone if it passes?

Yes. Strain your urine and keep whatever comes out. Knowing what the stone is made of is what turns generic prevention advice into a plan aimed at your particular stone type, and it is information that cannot be recovered once the stone is thrown away.

Book an Appointment

Dr. Soarawee Weerasopone treats kidney and ureteric stones at バンコク病院本部 and at Samitivej Sriracha Hospital, Chonburi — Urology department 088-022-1445. Questions about cost are answered by the hospital rather than by Dr. Soarawee — for Bangkok Hospital, by email to bhquro@bdms.co.th. An acute attack is not a clinic appointment — go to an emergency department.

バンコク病院の遠隔医療は、来院が困難な患者様（海外からの患者様を含みます）を対象にご利用いただけます。泌尿器科宛てに事前にメールでご手配ください。 bhquro@bdms.co.th. It is useful for reviewing imaging you already have and planning treatment, not for an attack in progress. Samitivej Sriracha is in-person only.

免責事項 This article is written and reviewed by Dr. Soarawee Weerasopone, a board-certified urologist at Bangkok Hospital Headquarters. It is educational only, is not medical advice, and does not create a doctor–patient relationship. It does not give medication doses, and no painkiller should be taken against the advice of your own doctor or pharmacist. Severe flank or abdominal pain has causes other than stones, some of them dangerous, so a first attack should be assessed rather than self-diagnosed. No diagnosis, prescription or individual medical advice is given through personal messaging channels or social media, and Dr. Soarawee operates no public social media account — any account offering private consultation in his name is fraudulent. Fever with flank pain, inability to pass urine, or uncontrolled pain means an emergency department, or 1669 in Thailand.