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Lower Right Back Pain: Causes & Treatments

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Last updated March 1, 2021

Lower right back pain questionnaire

Use our free symptom checker to find out what's causing your pain.

Read about the top ten causes of lower right sided back pain, including kidney stones, herniated disks, UTIs, pelvic inflammatory disease and arthritis.

Lower right back pain questionnaire

Use our free symptom checker to find out what's causing your pain.

Lower right back pain symptom checker

Lower right back pain symptoms

The back provides both strength and stability to the entire body, leaving it vulnerable to many kinds of injury. It's possible for even severe back pain to be confined to just one side of the back. When the pain is entirely on the lower right side, it may suggest a specific type of injury or illness, and it's important to have it examined. Low back pain is also called lumbago or sciatica.

Common characteristics of lower right back pain

Characteristics of lower right back pain may include the following.

  • Sharp and tight
  • Dull and throbbing
  • Shooting: You may feel shock-like sensations that travel from the low back down the leg

Who is most often affected?

People who are most likely to experience lower right back pain include the following.

  • Right-handed individuals: When the right hand is dominant, this causes the right side of the body to receive more use and become stronger. This can throw the body out of balance and cause additional strain and injury on the right side.
  • People over 50: Wear-and-tear of the spinal discs are more common among those in this age group.
  • People under 50: Ruptured spinal discs are more common among those in this age group.
  • People who play a strenuous sport
  • People who sit often
  • People who are overweight or obese
  • Workers who lift heavy objects
  • Weightlifters
  • Anyone in a car accident

Is lower right back pain serious?

Lower right back pain can vary in severity. You will probably have the best idea of your pain level and when you should see a physician.

  • Not serious: Mild pain may come on fairly suddenly after exercise and responds to rest and over-the-counter pain relievers.
  • Moderately serious: In some cases, an injury that at first seems minor can become worse over time. Back injuries can easily become chronic if not treated quickly.
  • Serious: If your back pain interferes with your normal activities and is becoming severe, you should see a physician as soon as possible.

Lower right back pain causes

Many conditions can cause the symptom of lower right back pain. The following details may help you better understand your symptoms. If your back pain worsens or persists, you should see a physician.

Soft tissue injury

Soft tissue injuries on the right side can lead to pain.

  • Strain: Muscle pain can occur from a strain, which is when the muscles and/or tendons are overstretched or torn.
  • Sprain: Ligament pain can occur from a sprain, which means the ligaments have been overstretched or torn.

Skeletal disease or injury

Skeletal disease or injury affecting the nerves on the right side of the back can lead to pain.

  • Cartilage deterioration: This is wearing away of the cartilage at the ends of the bones, due to either age (as in osteoarthritis) or disease.
  • Bony growths: Small overgrowths of bones in the spine may crowd the spinal cord and cause pain and numbness or pinch other nearby structures. A general narrowing of the spinal canal is known as spinal stenosis.
  • Scar tissue: This may form due to injury or the result of spinal surgery.
  • Injury or disease of the discs: These are the "cushions" between each of the spinal vertebrae. A disc may be partly pushed out of place, causing pressure on a nerve. A disc may also rupture and lose some of its contents, causing pain and pressure on the surrounding nerves (called a herniated disk).

Poor posture and/or muscle tone

Weakness and loss of muscle tone from a sedentary lifestyle and too little exercise cause a loss of support for the structures of the back. Poor posture, especially while sitting, can throw the back out of alignment and cause muscle spasms, muscle strains, and ligament sprains.

Other illnesses

Other various illnesses can cause back pain, such as the following.

  • Kidney disorders: Infections of the kidneys often cause pain on one side of the back, along with nausea, vomiting, fever, and chills. Crystallized deposits may form in the kidneys, causing pain as they move down into the urinary tract, known as kidney stones.
  • Colon disorders: Inflammation of the appendix, which is near the colon, can manifest as back pain. Inflammation of the inner walls of the large intestine can also be a cause.
  • Female reproductive tract: Overgrowth of menstrual tissue or menstruation each month can lead to back pain. Benign growths within the walls of the uterus can sometimes cause pain or discomfort.
  • Cancer: Tumors may cause pain that begins in the abdomen and radiates to the back, sometimes on one side.

This list does not constitute medical advice and may not accurately represent what you have.

Low back strain

A strain is defined as a twisting, pulling, or tearing injury to a muscle, or to the tendon that connects the muscle to the bone. (A sprain is an injury to a ligament, which connects two bones together.)

Strains may be acute (happen suddenly) or chronic (show up gradually.) They are usually caused by overuse, improper lifting of heavy objects, or sports. Being overweight or having weak back muscles are both risk factors for back injury.

Symptoms may include a pop or tear at the time of injury; pain that is worse when moving; and sudden muscle cramping or spasm at the site of the injury.

Diagnosis is made through patient history, physical examination, and sometimes x-ray.

Treatment involves rest; ice packs; and over-the-counter pain relievers, followed by a gradual return to normal activities within two weeks. Prolonged immobility actually weakens the back and causes loss of bone density.

Proper lifting techniques, strengthening exercises, and good nutrition can be very helpful in preventing further injury.

Rarity: Common

Top Symptoms: lower back pain, back pain that gets worse when sitting, back pain that gets worse when straightening it, lower left back pain, lower right back pain

Symptoms that always occur with low back strain: lower back pain

Symptoms that never occur with low back strain: involuntary defecation, first time leaking urine, back numbness, toe numbness, foot numbness

Urgency: Self-treatment

Lower right back pain questionnaire

Use our free symptom checker to find out what's causing your pain.

Lower right back pain symptom checker

Unexplained acute low back pain

Unexplained low back pain means chronic pain that comes on gradually, over time, with no specific injury, event, or illness causing it.

Common causes:

  • Prolonged sitting and lack of fitness can weaken back muscles and cause pain from lack of support.
  • Ankylosing spondylitis, a form of arthritis.
  • Spinal stenosis, a narrowing of the spinal column that puts pressure on the spinal cord.
  • Certain types of cancer, in rare cases.

Those most susceptible are over 30, overweight and/or pregnant, and not physically fit. Smoking interferes with healing after any sort of stress to the back.

If there are additional symptoms, medical care should be sought: fever, unexplained weight loss, leg weakness or numbness, or trouble urinating.

An exact diagnosis is made through blood tests and through imaging such as x-rays, CT scan, or MRI.

Once more serious causes are ruled out, treatment may include medications to ease pain, swelling, and inflammation. Steroid injections are useful in some cases.

Overall, exercise and maintaining a healthy weight can be very helpful with easing chronic low back pain.

Rarity: Common

Top Symptoms: lower back pain, back pain that shoots to the butt, fever, back pain

Symptoms that always occur with unexplained acute low back pain:lower back pain

Symptoms that never occur with unexplained acute low back pain:buttocks numbness, thigh numbness, involuntary defecation, fever

Urgency: Self-treatment

Herniated (slipped) disk in the lower back

The backbone, or spine, is made up of 26 bones called vertebrae. In between the bones are soft disks filled with a jelly-like substance. These disks cushion the vertebrae and keep them in place. Although people talk about a slipped disk, nothing actually slips out of place. The outer shell of the disk ruptures, and the jelly-like substance bulges out. It may be pressing on a nerve, which is what causes the pain.A slipped disk is more likely to happen due to strain on the back, such as during heavy lifting, and older individuals are at higher risk.

Rarity: Common

Top Symptoms: lower back pain, moderate back pain, back pain that shoots down the leg, back pain that gets worse when sitting, leg weakness

Urgency: Primary care doctor

Iliolumbar syndrome

Iliolumbar syndrome is also known as iliolumbar ligament sprain or iliac crest pain syndrome (ICPS.)

The iliolumbar ligaments are tough, fibrous bands that brace the iliac crests – the tops of the "wings" of the pelvis – to the back of the lower spine. If these ligaments are overstretched or torn, pain can result.

The syndrome may be acute, which means the pain starts suddenly after some sort of trauma such as a car accident or sports injury. It may be chronic, where it begins gradually and is usually caused by repetitive bending or twisting movements. In both cases, it is often found in patients who already have generalized low back pain.

Symptoms include severe, radiating pain from the low back to the hipbones, especially when bending or twisting

Diagnosis is made through physical examination and simple neurological tests such as leg raises.

Treatment involves rest, ice, and the use of over-the-counter nonsteroidal anti-inflammatory drugs to relieve pain and reduce swelling. Steroid injections can also be tried in some cases.

Rarity: Common

Top Symptoms: lower back pain, back pain that shoots to the butt, severe back pain, back pain that shoots to the groin

Symptoms that always occur with iliolumbar syndrome: lower back pain

Urgency: Primary care doctor

Chronic low back pain of no specific origin

Low back pain is defined as pain, tightness, and stiffness between the lower end of the rib cage and the buttocks. "Chronic" means the pain has lasted for twelve weeks or longer, and "no specific origin" means the pain cannot be traced to any specific cause, incident, or injury.

Most susceptible are individuals who perform heavy physical work, especially when there is ongoing anxiety, depression, and emotional stress at the same time. The longer the stress and back pain continue, the more difficult it is to ease the symptoms and return the patient to normal functioning.

Treatment involves nonsteroidal anti-inflammatory drugs and sometimes opioid medications for pain, though both have risks when used long term. Antidepressants may also be tried, along with psychological counseling.

Corticosteroid injections for the back are effective for some patients, and fusion surgery is sometimes attempted. Lifestyle changes in the form of improved diet, exercise, and stress management are very helpful in most cases.

Rarity: Common

Top Symptoms: lower back pain, unintentional weight loss, back pain that shoots to the butt, fever, involuntary defecation

Symptoms that always occur with chronic low back pain of no specific origin: lower back pain

Symptoms that never occur with chronic low back pain of no specific origin: thigh numbness, buttocks numbness, lower back pain from an injury

Urgency: Primary care doctor

Lower back arthritis

Osteoarthritis, most often simply called arthritis, is a disease of cartilage. In joints, where bones touch and move against one another, cartilage helps provide lubrication for smooth movement, and acts as a shock absorber. Cartilage is also present in between vertebrae, which are the bones comprising the spine. Osteoarthritis of the spine, also known as degenerative joint disease, happens when the cartilage between vertebrae dries out and shrinks. The vertebrae are thus not as able to move smoothly against one another. The ability to walk and perform normal daily activities can be impaired due to inflammation and pain in the lower back.

Rarity: Common

Top Symptoms: lower back pain, spontaneous back pain, back pain that gets worse when straightening it, back pain from overuse

Urgency: Primary care doctor

Lower back (sacral vertebral) fracture

A sacral stress fracture is a small break in the sacrum. The sacrum is a large triangular bone at base of the spine. The sacrum connects to the pelvis.

Rarity: Rare

Top Symptoms: lower back pain, back pain that shoots to the butt, back pain that shoots down the leg, severe back pain, lower back pain from an injury

Symptoms that always occur with lower back (sacral vertebral) fracture: lower back pain from an injury

Urgency: Primary care doctor

Spinal stenosis

The spine, or backbone, protects the spinal cord and allows people to stand and bend. Spinal stenosis causes narrowing in the spine. The narrowing puts pressure on nerves and the spinal cord and can cause pain.

Rarity: Common

Top Symptoms: lower back pain, back pain that shoots down the leg, back pain that shoots to the butt, difficulty walking, thigh pain

Urgency: Primary care doctor

Pelvic inflammatory disease

Pelvic inflammatory disease, or PID, is the general term for a bacterial infection of a woman's reproductive organs.

PID is most often a complication of a sexually transmitted disease (STD) such as gonorrhea or chlamydia. However, it is possible to get PID from other causes.

Any woman can be affected. It is most often found in sexually active women under age 25, especially those who have had PID before, have multiple partners, and/or douche frequently.

Symptoms include fever, lower abdominal pain, foul-smelling vaginal discharge, pain and/or bleeding during sex, and pain on urination.

Untreated PID can cause infertility due to damaged tissue in the reproductive tract, as well as chronic pelvic and abdominal pain. Unprotected sex partners will be infected as well.

Diagnosis is made through symptoms, pelvic examination, vaginal and cervical swabs, and urine tests.

Treatment is with a course of antibiotics. Be sure to finish all of the medication as directed, even when you begin feeling better.

To prevent PID, have all partners (male or female) tested for STDs and avoid unprotected sexual contact.

Rarity: Common

Top Symptoms: fever, abdominal pain or unusual vaginal discharge, vaginal discharge, nausea or vomiting, vaginal bleeding, pelvis pain

Symptoms that always occur with pelvic inflammatory disease:fever, abdominal pain or unusual vaginal discharge

Urgency: In-person visit

Kidney stone

A kidney stone is a stone made up of various possible materials that forms in the kidneys. Factors that increase the risk of forming kidney stones include high levels of calcium, uric acid, and oxalate in the urine, low levels of citrate in the urine, abnormal urine pH, low urine volume, certain urin...

Lower right back pain questionnaire

Use our free symptom checker to find out what's causing your pain.

Lower right back pain symptom checker

Lower right back pain treatments and relief

As long as you are not in severe pain, treatment can begin at home. If pain worsens or persists, however, you should consult your physician.

At-home treatments

The following at-home remedies may be helpful in alleviating your lower right back pain.

  • Heat or cold: Try both hot compresses or cold packs, as one may provide more relief than the other.
  • Pain medication: Use over-the-counter, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin).
  • Keep moving: Stay as active as possible, since immobility weakens muscles and commonly makes any pain worse in the long run.
  • Stretch: Learn stretching exercises for your specific back pain.
  • Improve habits: Make changes in diet, sleep, and exercise to improve overall health and reduce stress.

When to see a doctor

You should see a physician if your pain doesn't resolve and starts to interfere with your daily activities. He or she may recommend the following treatments.

  • Steroid injections: These may help when directly applied to the site of the pain.
  • Physical therapy: This can increase strength and flexibility in the muscles supporting the back.
  • Alternative treatments: If other methods do not provide relief, you may consider massage therapy or acupuncture.

When it is an emergency

If you have right-sided back pain along with signs of the following, seek emergency treatment:

FAQs about lower right back pain

Here are some frequently asked questions about lower right back pain.

Is lower right back pain a sign of pregnancy?

Low back pain is a common early symptom of pregnancy, due to hormones relaxing the ligaments in preparation for the growing baby. It does not necessarily occur only on the right side, though there may be some other condition which makes the discomfort felt more strongly on the right.

Is lower right back pain a sign of cancer?

In some cases, yes. If there are tumors forming in the pancreas, liver, colon, ovaries, or spinal column, they may press on the nerves near the back and cause pain. However, this is rare, and there are many other reasons for low back pain on both the right and left sides.

If I have lower right back pain and numbness in my legs, is this a warning sign of paralysis?

It may be. There is a bundle of nerve roots in the spinal cord that runs through the low back, called the cauda equina. If this bundle is compressed or injured, it may cause low back pain and a loss of feeling in the legs.

Is lower right back pain a sign of autoimmune disease?

Not specifically on the right side; however, low back pain on one or both sides is often a symptom of ankylosing spondylitis — inflammation of the spine due to the immune system attacking itself. This condition can also affect other parts of the body, especially the joints and the eyes.

Can an abnormality in my knees or ankles cause lower right back pain?

Yes, because it can cause you to move in an abnormal way and will put a strain on one side of the back. If you have pain in your leg joints, you may walk and sit unevenly in an effort to protect the joint.

Questions your doctor may ask about lower right back pain

  • Does your back pain radiate anywhere?
  • What is your body mass?
  • Were you lifting weights or straining yourself right before your symptoms started?
  • Any fever today or during the last week?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

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Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP...
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