Back pain? It could be a sign of kidney stones

Back pain is common among working adults and is often blamed on long hours at a desk, poor posture or simple fatigue.

But in some cases, discomfort in the lower back or side may have another cause: kidney stones.

Urologist Dr S Sivaprakasam said it can be difficult for patients to distinguish between muscular pain and pain caused by stones based on location alone.

“Musculoskeletal back pain is usually triggered by movement or physical activity and often improves with rest, especially after lying down. It also tends to worsen towards the end of the day,” he said.

By contrast, pain caused by urinary tract stones can be sudden, severe and unpredictable, sometimes waking a person from sleep. It may also come in waves rather than remaining constant.

Persistent or recurring back pain that does not improve after several days of rest should not be ignored, he added.

A simple urine test can sometimes provide the first indication that a stone may be present.

“If a patient has back pain of uncertain origin and the urine test detects blood, even if it is not visible to the patient, it can be an early sign of a urinary tract stone,” Sivaprakasam said.

Patients may then be referred for imaging, with a low-dose non-contrast CT scan able to show the stone’s size and location and help doctors determine the most suitable treatment.

Treatment has also changed considerably over the years. Open surgery is now rarely needed, with many procedures instead using small instruments passed through the urinary tract.

Laser technology can break larger stones into smaller fragments for removal or natural passage, while smaller stones – typically under 5mm – may sometimes pass with medication and adequate fluid intake.

“These techniques significantly reduce pain and recovery time. In many cases, patients can return home the next day and resume normal activities within one or two days,” Sivaprakasam said.

Some patients may temporarily need a stent to help urine flow after treatment, with this usually removed during a follow-up procedure.

Kidney stones can affect anyone, but Sivaprakasam said inadequate fluid intake remains an important risk factor.

Office workers, in particular, may underestimate how much they need to drink because they spend much of the day in air-conditioned environments and sweat less than people working outdoors.

Low fluid intake makes urine more concentrated, increasing the chance that minerals may crystallise.

Busy schedules can also mean people delay going to the toilet, while coffee, tea and sugary drinks sometimes replace plain water altogether.

Sivaprakasam recommends adults aim for about 2.5 to three litres of fluids a day, depending on individual needs, with plain water making up most of that intake.

Diet may also play a role. High consumption of red meat, fast food and certain foods rich in oxalate may increase the likelihood of stone formation in some people.

Foods containing citrate, including lemons and limes, may help by making it harder for some crystals to bind together in the urine.

Ultimately, Sivaprakasam said one of the simplest preventive habits is also one of the most effective: drinking enough water throughout the day.

“Keeping the urine diluted and the urinary system active reduces the chances of crystals forming and eventually becoming stones,” he said.

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