Free Module 4 · Urinary stone disease

Initial management of renal colic

Author and medical review: Dr. Leonardo Romeo, urologist (physician) · Last updated: September 29, 2026

Introduction

Learning objectives

Know the first-line analgesic for renal colic.
Identify which other clinical findings must be evaluated besides pain.
Understand that controlling pain is not the same as having solved the problem.

Video lesson

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Video pending upload (embedded YouTube)

Summary

Controlling pain

The first goal in renal colic is to control pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) are the first-choice analgesic treatment when there are no contraindications.

Opioids may be used as a second option in certain situations.

The EAU 2026 maintains NSAIDs as the first choice and notes that they have better analgesic efficacy than opioids in renal colic.

What else should we evaluate

In addition to treating pain we must assess:

temperature;
general condition;
renal function;
urine output;
presence of infection;
solitary kidney;
ability to tolerate oral intake.

Clinical pearl

Treating pain does not mean the problem has been solved. After providing analgesia we must decide whether the patient can continue conservative treatment or needs intervention.

PDF

⬇ Download lesson summary

Downloadable PDF pending upload.

Practical algorithm

Content pending upload The practical algorithm for renal colic is developed in the lesson "When is a kidney stone an emergency?".

Clinical case

Content pending upload Progressive presentation of the case — the student makes decisions as it unfolds.

Self-assessment

1. What is usually the first analgesic option for renal colic if there are no contraindications?

A. Antibiotics B. Corticosteroids C. NSAIDs D. Alpha-blockers

Show answer

Correct: C.