kidney stone that worsens lying down

Overview

A kidney stone is a small, hard deposit that forms inside your kidneys. When a stone moves or gets stuck, it can cause sharp pain. Some people find that lying down makes the pain worse, possibly because the stone shifts or puts more pressure on the kidney or ureter (the tube that carries urine from kidney to bladder).

Yes, kidney stones are quite common. Many people will experience a stone at least once. Pain that changes with position, including worsening when lying down, is a known pattern.

Kidney stones can affect people of any age, but they are most common in adults between 30 and 60. Men are slightly more likely to get stones than women. People with a family history of stones or who don't drink enough water have a higher risk.

Symptoms

Common symptoms

• Sharp, severe pain in your side and back, below the ribs
• Pain that comes in waves and changes in intensity
• Pain that worsens when lying down, especially on one side
• Pain that spreads to your lower belly and groin
• Pain or burning when you urinate
• Pink, red, or brown urine (blood in urine)
• Feeling the need to urinate more often
• Nausea and vomiting

Symptoms in children

• Children may not be able to describe the pain clearly. Look for fussiness, crying during urination, or holding the belly.
• Blood in the urine (pink or red) is a key sign.
• A child with a kidney stone may vomit or have a fever if there is an infection.

Symptoms in older adults

• Older adults may have more subtle symptoms like vague back or belly pain that gets worse when lying down.
• They may also have confusion or changes in urination, especially if there is an infection.
• Blood in the urine is still common but may be missed if they aren't checking.

Causes

Main causes

• Kidney stones form when minerals and salts in your urine crystallize and stick together. This can happen when your urine is too concentrated (not enough water).
• Stones can vary in size; small ones may pass unnoticed, while larger ones can get stuck and cause pain.
• The pain may worsen when lying down because the stone can press on the kidney's drainage area or cause pressure changes.

Risk factors

• Not drinking enough fluids (especially water) – the most common cause
• A diet high in salt, sugar, or animal protein
• Being overweight or obese
• Certain medical conditions like gout, urinary tract infections, or inflammatory bowel disease
• Family history of kidney stones
• Taking certain medications (like some diuretics or calcium-based antacids) – talk to your doctor if you're concerned

When to see a doctor

See a doctor urgently if:

• You have severe pain that doesn't improve after a few hours
• You have pain with fever or chills
• You cannot pass urine
• You have constant nausea and vomiting

Book a routine appointment if:

• You have mild pain that comes and goes but doesn't get better with home care (like drinking water)
• You notice blood in your urine but no severe pain
• You have had a kidney stone before and want to discuss prevention

Diagnosis

Your doctor will ask about your symptoms, do a physical exam, and order tests to confirm the stone and its size and location.

Tests that may be done

• Urine test (urinalysis) to check for blood or infection
• Blood test to check kidney function and look for high levels of minerals like calcium
• Imaging tests: usually a CT scan (low-dose) or ultrasound to see the stone

What to expect at your appointment

These tests are quick and usually done in the emergency department or a clinic. You may be asked to drink extra fluids to help produce urine for the test. The imaging is painless. Your doctor will explain the results and discuss next steps.

Treatment

Treatment depends on the size of the stone, its location, and whether it is causing symptoms. Small stones often pass on their own. Larger stones may need medical help to break them up or remove them.

Self-care at home

• Drink plenty of water – aim for 2 to 3 litres a day unless your doctor tells you otherwise
• Take over-the-counter pain relief such as paracetamol or ibuprofen (but check with your pharmacist or doctor first; they can recommend one that is safe for you)
• Apply a warm compress to the painful area
• Try gentle movement – sometimes walking or changing position can help the stone move

Medical treatments

Your doctor may prescribe medication to help relax the muscles in your ureter, making it easier for a small stone to pass. For larger stones, procedures like shock wave lithotripsy (using sound waves to break the stone), ureteroscopy (a thin scope to remove or break the stone), or laser treatment may be used. These are done in a hospital or clinic.

When is surgery considered?

Surgery is only needed for stones that are very large, stuck, causing severe symptoms, or blocking the flow of urine. Your doctor will discuss the best option for you.

Living with this condition

While you are passing a kidney stone, you may have episodes of pain that come and go. Rest when you need to, but gentle activity can help. Keep drinking water. Most stones pass within a few days to weeks.

Lifestyle tips

• Stay well hydrated – make water your main drink
• Reduce salt in your diet – avoid processed foods
• Limit foods high in oxalates (e.g., spinach, rhubarb, nuts) if your doctor advises it
• Maintain a healthy weight through balanced eating and exercise

Diet and exercise

No special diet is needed for everyone, but your doctor may suggest changes based on the type of stone you had. Regular exercise (like walking) is fine and may help prevent stones by keeping your body healthy.

Mental health and emotional wellbeing

Dealing with kidney stone pain can be stressful and anxiety-provoking. It's normal to feel worried. If you are feeling overwhelmed, talk to your doctor or a counsellor. You are not alone.

Prevention

Yes, in many cases. Drinking enough water is the most effective way to prevent new stones. Depending on the type of stone, your doctor may also recommend dietary changes or medication to reduce stone-forming substances in your urine.

Complications

If left untreated

• A stone that blocks urine flow can cause kidney swelling (hydronephrosis) and damage the kidney
• Infection can develop behind the stone (urinary tract infection), which can spread to the blood (sepsis) if not treated quickly
• Scarring inside the urinary tract, which may cause long-term problems

Long-term outlook

The outlook for most people with kidney stones is very good. With proper care, stones pass or are treated successfully. Once you've had a stone, you have a higher chance of getting another, but prevention steps like drinking more water and adjusting your diet can greatly reduce that risk. Most people return to normal life without lasting damage.

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