Kidney stones are infamous for being among the most painful medical conditions a person can experience, and they’re becoming more common in recent decades. Today, about one in 10 Americans will have a kidney stone at some point in their lives. Their painful reputation, combined with their growing prevalence, means people are interested in doing everything they can to avoid them. This attention has led to a lot of myths and misconceptions around kidney stones, what causes them and what can help prevent them.

Here are six of the most common myths surrounding kidney stones and what patients need to know to set the record straight.  

Myth #1 - All stones are painful

Fact - Kidney stones are hard masses that form in the urinary tract and may cause pain, bleeding, or an infection or block of the flow of urine. But they’re not always painful, especially when they first form. The first signs of the stones may be blood in the urine or minor back pain. In other cases, however, kidney stones can be excruciatingly painful and cause nausea and vomiting.

Myth #2 - Larger stones are always more painful

Fact - Size is only one factor in how painful – and potentially dangerous – a kidney stone can be. The location of the stone is the other element to consider. A smaller stone in the wrong place can create a blockage that is incredibly painful and requires a trip to the emergency room. Depending on the location of the stone, individuals may feel pain in their back or lower abdomen, or they may experience renal colic – excruciating, intermittent pain usually in the area between the ribs and hip on one side of the flank or back that spreads across the abdomen and often extends to the genital area. The pain tends to come in waves, gradually increasing to a peak intensity, then fading, over about 20 to 60 minutes.

Myth #3 – Kidney stones always require medical attention

Fact - Kidney stones often require urgent medical treatment, but not always. Some individuals, including those with a family history or associated medical conditions such as Crohn disease or ulcerative colitis, are more likely to have chronic or repeating kidney stones. These people can develop strategies for safely managing pain and passing stones at home. Individuals experiencing flank pain or who notice blood in their urine can see a family physician or urologist for a urinalysis and imaging to be sure they’re suffering from kidney stones and develop a treatment plan with their doctor.

However, there are several symptoms that do warrant emergency treatment. Individuals should head to the ER if they’re experiencing severe, persistent pain, nausea and vomiting, or a fever, which could indicate an infection.

Myth #4 – Kidney stones are more prevalent in men

Fact - A few decades ago, men were far more likely to develop kidney stones. That’s no longer the case. Many more women are suffering from kidney stones today, and men and women are just about equally as likely to develop them. Researchers believe there are many reasons for this shift, including people in the western world eating a more acidic diet today as well as an increase in the prevalence of obesity, diabetes and other risk factors.

Myth #5 – Iced tea causes kidney stones, and cranberry juice prevents them

Fact - Many people believe certain beverages increase the chances of developing kidney stones. Coffee, milk, soda, iced tea are all on the list of usual suspects. The reality is, triggers vary for everyone. Acidic drinks or those high in calcium or caffeine may be triggers for some, but they certainly aren’t for everyone. Individuals suffering from kidney stones should have a conversation with their doctor and undergo some tests before cutting out foods or beverages entirely.

When it comes to preventing kidney stones, lemon juice is actually better than cranberry juice. Citrus beverages have been shown to increase citrate levels in urine, which can minimize stone formation. However, research shows how much you drink has a much greater impact than what you drink. Aim to drink at least 100 ounces of fluids a day – whatever those fluids may be – to keep the kidneys flushed out and the concentration of stone-forming salts lower.

Myth #6 – If the pain goes away, you’ve passed your stone

Fact - Unfortunately, the relief that comes from subsiding pain does not necessarily mean the stone has passed. The level of pain can vary as the stone grows and moves. Studies show that of the stones that pass themselves, 95% will pass within four to six weeks. If the pain does not subside after about a month, the potential of the stone passing itself is reduced, and it’s worth talking to a doctor about other removal options.