If you’re stuck between “Is this a UTI or a kidney stone?” you’re not alone—because the two can overlap in annoying ways: urinary urgency, burning, lower abdominal discomfort, even blood in the urine.
Here’s the practical clinical truth: the pain pattern and “system symptoms” (fever, chills, vomiting, feeling very ill) usually tell the story fastest, and a urine test ± imaging confirms it.
Educational only. Not medical advice or a diagnosis.
UTI vs Kidney Stone (quick answer)
It’s more likely a UTI if…
- Burning when you urinate plus frequent urination and lower pelvic pressure/cramping are the main features. The CDC lists these as common bladder infection (cystitis) symptoms.
- You may see blood in urine, and symptoms can feel “irritating” more than “wave-like.”
It’s more likely a kidney stone if…
- Pain is severe, often one-sided (flank/side/back), and tends to come in waves and move/radiate. Mayo Clinic describes kidney stone pain that can fluctuate and radiate, often toward the lower abdomen/groin.
- You may also have nausea/vomiting and blood in urine. NIDDK lists sharp pain (often lower back), blood in urine, nausea/vomiting among common kidney stone symptoms.
Symptom comparison
Pain location and pattern
- UTI (bladder infection): discomfort tends to stay low (lower abdomen/pelvis) with burning and urgency.
- Kidney stone: pain is often side/back (flank), may be intense, and can radiate toward the groin and worsen in waves.
Fever and chills change the priority
If you have fever + chills + back/side pain (and especially nausea/vomiting), clinicians worry more about kidney infection (pyelonephritis), which needs prompt evaluation. The CDC lists kidney infection symptoms as fever, chills, lower back/side pain, nausea/vomiting.
Blood in urine can happen with both
- CDC lists bloody urine as a possible bladder infection symptom.
- Kidney stones commonly cause blood in urine as well.
Can you have both a UTI and a kidney stone? Yes.
This is where people get confused—and it’s a legitimate overlap.
- Bacterial infections can cause struvite stones, and
- Kidney stones can increase risk for kidney infection and frequent UTIs.
So if symptoms are mixed (stone-like pain plus infection symptoms), it’s not “either/or.” It can be both—and that’s a scenario clinicians take seriously.
What tests actually tell the difference?
Urine testing
The CDC notes diagnosis may include urine tests (if needed) after symptom review and exam.
A urine culture can be used to check for bacteria/germs in urine when evaluating a suspected UTI.
Imaging (when a stone is suspected)
If a kidney stone is suspected, imaging is often used to confirm it. Mayo Clinic notes imaging tests (including CT) can show kidney stones in the urinary tract.
Cleveland Clinic summarizes that providers use imaging + blood and urine tests to diagnose kidney stones.
Who is more prone to UTIs or kidney stones?
UTI risk tends to be higher if…
The CDC notes UTIs are more common in females due to anatomy, and lists risk factors such as prior UTIs, recent sexual activity, pregnancy, menopause-related flora changes, older age, and structural issues (e.g., enlarged prostate).
Kidney stone risk tends to be higher if…
Kidney stones are often linked to urine chemistry and hydration status. Cleveland Clinic notes stones form when urine has too many stone-forming substances and too little liquid, and highlights dehydration as a risk factor.
Warning symptoms that shouldn’t wait
If you’re trying to decide whether to “watch it” or get checked, these are the symptoms that shift the risk:
- Fever or chills with urinary symptoms
- Back/side (flank) pain plus nausea/vomiting
- Severe pain that is escalating or unmanageable
- Inability to keep fluids down (dehydration risk)
- Confusion, severe weakness, or feeling rapidly worse (especially with fever)
If infection is suspected, remember: UTIs are typically treated with antibiotics prescribed by a clinician.
If you’re in Houston and your symptoms fit the “warning symptoms that shouldn’t wait,” it’s reasonable to get evaluated—especially if fever/chills or severe flank pain is in the picture.
Post Oak ER states it is a freestanding ER in the Post Oak/Galleria area with board-certified physicians available 24/7.
They also state they’re located off San Felipe St. near The Galleria and Uptown Park, serving patients across Houston (including areas like Uptown, Energy Corridor, Westchase, Midtown, and the Heights).
For diagnostics, Post Oak ER describes on-site labs and imaging, including CT, X-ray, and ultrasound.