<s>[INST] I've had 8 lithotripsy treatments on my left side in 2 1/2 years.  Now I have chronic lower left back pain.  Never had back problems before the lithotripsies.  Walking or just standing for more than 15 minutes makes the pain worse.  Laying down on my right side sometimes helps temporarily relieve the pain.  I still have several  4-5 mm kidney stones in my left kidney.  My urologist says the pain isn't from the kidney stones and I shouldn't have pain months after lithotripsy.  Yet there isn't anything wrong with my spine and I'm very careful not to injure my back.  What should I do? [/INST] Hello and welcome to ‘Ask A Doctor’ service.  I have reviewed your query and here is my advice. Most small stones in patients with relatively mild hydronephrosis can be treated with observation and acetaminophen. More serious cases with intractable pain may require drainage with a stent or percutaneous nephrostomy. Treatment of nephrolithiasis involves emergency management of renal (ureteral) colic, including surgical interventions where indicated, and medical therapy for stone disease. In emergency settings where concern exists about possible renal failure, the focus of treatment should be on correcting dehydration, treating urinary infections, preventing scarring, and identifying patients with a solitary functional kidney.  Wish you a good health.Regards,Dr. Ivan R. Rommstein </s>