Sometimes, lower back pain on the right side is caused by muscle pain. Other times, the pain has nothing to do with the back at all.
With the exception of the kidneys, most internal organs are located in the front of the body, but that doesn’t mean they can’t cause pain that radiates to your lower back. Some of these internal structures, including the ovaries, intestines, and appendix, share nerve endings with tissue and ligaments in the back. When you have pain in one of these organs, it could be referred to one of the tissues or ligaments that share a nerve ending. If the structure is located in the right lower portion of the body, you may have pain in the lower right side of your back, too.
Read on to learn about pain in the lower back, including possible causes, when to seek help, and how it’s treated.
Is it a medical emergency?
Most cases of lower back pain on the right side are not medical emergencies. However, don’t hesitate to get immediate medical help if you experience any of the following:
- pain so intense it’s disrupting your daily life
- sudden, severe pain
- intense pain accompanied by other symptoms, such as incontinence, fever, nausea, or vomiting
Back muscle or spinal issues
According to the National Institute of Neurological Disorders and Stroke (NINDS), 80 percent of adults in the United States will experience low back pain at some point in their lives. Much of that pain is caused by mechanical problems, such as:
- overstretching or tearing of a ligament due to improper lifting
- degeneration of a shock-absorbing spinal disc due to aging or normal wear and tear
- muscle tightness due to improper posture
Treatment varies depending on the cause and severity of your condition. Your doctor may initially recommend more conservative options like physical therapy or medications to reduce inflammation. If conservative treatment methods don’t help, or if your condition is severe, your doctor may recommend surgery.
The kidneys are located on either side of the spine, under the ribcage. The right kidney hangs a little lower than the left, making it even more likely to cause lower back pain if it’s infected, irritated, or inflamed. Common kidney problems include kidney stones and kidney infection.
Kidney stones are solid, pebble-like structures made up of excess minerals and salts normally found in urine. When these stones lodge in the ureter, you may experience a sharp, cramping pain along the back, lower abdomen, and groin. The ureter is a tube that carries urine from the kidney to the bladder.
With kidney stones, the pain comes and goes as the stone moves. Other symptoms include urination that is painful or urgent. You may also have difficulty fully emptying your bladder, or you may only produce a small amount of urine when you urinate. Urine may also be bloody due to the sharp-edged stone cutting tissue as it travels down the ureter.
For treatment, your doctor may recommend:
- drugs to help relax the ureter so the stone can pass more easily
- shock wave lithotripsy (SWL), which uses ultrasound- or X-ray-guided shock waves to break up a stone
- surgical procedures to remove or pulverize a stone
The most common cause of kidney infections is bacteria, such as E. coli, which lives in your bowel, traveling through your ureter into the bladder and kidneys. Symptoms are similar to those of other urinary tract infections, and include:
- back and abdominal pain
- burning urination
- feeling an urgent need to urinate
- cloudy, dark, or foul-smelling urine
With a kidney infection, you’re likely to also feel very sick, and you may experience:
Permanent kidney damage and a life-threatening blood infection can result from an untreated kidney infection, so seek prompt medical attention if you suspect a kidney infection. Your doctor will prescribe antibiotics to fight off the bacteria.
Your appendix is a small tube that attaches to the large intestine and sits in the lower right side of the body. In about 5 percent of people, usually between 10 and 30 years old, the appendix will become inflamed and infected. This is called an appendicitis.
This infection causes the appendix to swell. You may have tenderness and fullness in your abdomen that begins near the navel and gradually extends to the right side. The pain often worsens with movement or by pressing the tender areas. Pain can also extend around to the back or groin.
Other symptoms include nausea and vomiting.
If you have any of symptoms of appendicitis, get immediate medical help. If the appendix continues to swell it may eventually burst and spread its infected contents throughout the abdomen, creating a life-threatening situation.
Conventional treatment consists of surgical removal of the appendix. This is called an appendectomy, and it can be done via minimally invasive laparoscopic surgery in uncomplicated cases. In some cases, it may be possible to treat appendicitis with antibiotics alone, meaning you may not need surgery. In one study, nearly three quarters of people who received antibiotics for their appendicitis did not require a later appendectomy.
Causes in women
There are some causes unique to women.
If the tissue grows on the right ovary or fallopian tube, it can irritate the organ and surrounding tissue and cause a crampy pain that can radiate from the front and side of the body to the back.
Treatment consists of hormonal therapy or laparoscopic surgery. Hormonal therapy, such as low-dose birth control pills, can help shrink growths. Surgery can be used to remove the growths.
Causes in pregnancy
Low back pain, on either side of the spine, is common throughout pregnancy. Mild discomfort can generally be eased with:
- gentle stretching
- warm baths
- wearing low-heeled shoes
- acetaminophen (Tylenol) — before taking this medication, ask your doctor if it’s appropriate to use during your pregnancy
Low back pain can begin early in pregnancy, often because the body starts producing a hormone called relaxin to loosen the ligaments of the body in preparation for delivery. It can also be a symptom of miscarriage, especially if it’s accompanied by cramping and spotting. Talk to your doctor if you experience back pain with cramping or spotting.
Second and third trimester
There are several things that can lead to back pain in your second and third trimesters. As your uterus grows to accommodate your growing baby, your gait and posture can change, causing low backaches and pain. Depending on the location of your baby and your gait, the pain may be localized to the right side.
Round ligaments are another possible cause of pain. Round ligaments are fibrous connective tissue that help support the uterus. Pregnancy causes these ligaments to stretch.
As the ligaments stretch, nerve fibers, most commonly on the right side of the body, are pulled, causing periodic sharp, stabbing pains.
See your doctor if you’re pregnant and experiencing any symptoms of a UTI, including:
- burning urination
- abdominal discomfort
- cloudy urine
An untreated UTI in a pregnant woman can lead to a kidney infection, which can seriously affect both mom and baby.
Causes in men
In men, testicular torsion can lead to lower back pain on the right side. This occurs when the spermatic cord, which lies in the scrotum and carries blood to the testes, becomes twisted. As a result, blood flow to the testicle is severely reduced or even cut off altogether.
- severe, sudden groin pain, that can radiate to the back, either on the left or right side, depending on which testicle is affected
- swelling of the scrotum
- nausea and vomiting
While rare, testicular torsion is considered a medical emergency. Without proper blood supply the testicle can be irreversibly damaged. Doctors will have to surgically untwist the spermatic cord to save the testicle.
Consult your doctor whenever you have pain that is new, intense, or worrisome. Seek immediate help if the pain is so severe it interferes with day-to-day activities or is accompanied by other symptoms, such as fever or nausea.
In many cases, lower back pain on the right side can be managed with simple, at-home treatments or lifestyle modifications:
- Apply ice or heat for 20–30 minutes, every 2–3 hours to ease pain and inflammation.
- Take over-the-counter pain medication, such as ibuprofen (Advil, Mortin) or acetaminophen (Tylenol), with your doctor’s guidance.
- Drink at least eight 8-ounce glasses of water a day, and limit your intake of animal protein and salt to reduce your risk of kidney stones.
- When using the bathroom, wipe from front to back to prevent bacteria from the colon entering the urinary tract and causing an infection.
- Practice proper lifting technique. Lift things by bending low with your knees in a squat position, and hold the load close to your chest.
- Spend a few minutes every day stretching tight muscles.
In many cases, pain in the lower right side of your back may be caused by a pulled muscle or other injury to your back. It’s also possible that it’s caused by an underlying condition.
Talk to your doctor if you’re concerned about back pain, or if the pain is affecting your daily life.