Why Do I Have Lower Back Pain On My Right Side — Different Conditions That Cause Lower Right Side Back Pain

If you're experiencing lower back pain, you're not alone. It's one of the most common reasons for missed days of work and doctor visits.¹

Your spine provides both stability and strength to your whole body. Since lower back pain is a very common type of back pain, a lot of individuals will experience it at least once in their lifetime.

Around 97% of back pain is due to some type of mechanical problem and will recover quickly.² Some people may only have mild lower back pain, but others have to deal with chronic (long-lasting) and severe lower back pain that keeps them from being able to perform their day-to-day functions.

Lower back pain isn't the only type of back pain people experience. In fact, if you're asking yourself, "why do I have lower back pain on my right side," again, you're not alone.

There are various types of back pain caused by different conditions. Certain conditions can contribute to lower back pain on the right side, including conditions that affect your:

  • Bones

  • Organs

  • Muscles

  • Nerves

When your doctor can get an understanding of what's causing your lower right back pain, it will help them figure out what the underlying injury or condition is that's responsible for your pain. It can also help them come up with a treatment plan for optimal recovery. Below you'll learn about the different potential causes of lower back pain on the right side.

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What causes lower back pain on the right side?

So, what conditions or specific injuries can contribute to pain on the right side of the lower back? Some include:

1. Spinal stenosis

Between 250,000 to 500,000 individuals in the US deal with spinal stenosis.³ This condition is compression or narrowing of your spinal canal (the area inside your spine where your spinal cord is). The narrowing adds pressure on your spinal cord, causing pain and numbness that can radiate to your buttocks, legs, and lower back.

Some people don't experience symptoms, but others experience the following:

Treatment options for spinal stenosis

Spinal stenosis treatment options may include:

If your spinal stenosis is severe enough, your doctor may suggest surgery.

2. A herniated disc

These are common in individuals who are in their 30s and 40s.⁴

Herniated discs, also known as slipped discs, form when a disc herniates through the intervertebral disc's delicate wall or when there's a ruptured disc protrusion. This causes the jelly disc interior material to spill into your spinal canal, which produces extreme pain from pinching on delicate nerves on one body side. Generally, disc herniation stems from age-related, gradual wear and tear, known as disc degeneration.

Herniated disc symptoms you experience will depend on what level in your spine it is and if the disc presses upon a nerve or not. Common symptoms individuals with a herniated disc may experience include:

  • Pain in the calf, thigh, and buttocks

  • Muscle weakness that affects stability and your ability to hold or lift items

  • Tingling or numbness from the nerves that are affected

Treatment options for a herniated disc

Herniated disc treatment options may include:

  • Physical therapy and massage

  • Anti-inflammatory medicine

  • Steroid injections

If your herniated disc is severe enough, your doctor may suggest surgery.

3. Lumbar radiculopathy

Radiculopathy develops with a pinched nerve root. It's referred to as lumbar radiculopathy (sciatica) when it develops in the lower back. Frequently, it's caused by a herniated disc, spinal stenosis, or bone spurs. It's a common complaint spine surgeons hear and occurs in about 3% to 5% of the population.⁵

Symptoms of lumbar radiculopathy typically include numbness and pain that radiates down your legs (one or both) from your lower back. Often, the pain is described as constant burning pain or shooting pain.

Treatment options for lumbar radiculopathy

Lumbar radiculopathy treatment options usually involve physical therapy. The therapist will show you certain exercises designed to improve your lower body strength and core, stability, and flexibility.

Acupuncture and massage therapy may also be beneficial in certain cases.

4. Degenerative disc disease

This condition occurs with aging, where you have degeneration or a breakdown of your spinal discs separating the bones in your spine (your vertebrae). These rubbery discs work by acting as shock absorbers and providing cushioning between your vertebrae. They help your back twist, move, and bend comfortably.

As these cushions start degenerating or wearing away, your vertebrae can begin rubbing together, causing the formation of bone spurs. This puts pressure on your nerve roots or spinal cord.

One study showed degenerative disc disease occurred over the whole spine in 77% of women and 71% of men under the age of 50.⁶ It occurs in 90% of both women and men over the age of 50.

The main symptom of degenerative disc disease is back pain. In serious cases, you can experience numbness or weakness in your legs. Rarely, you may also experience incontinence if the affected nerve injury is particularly severe. It's important you seek medical attention immediately if you experience these symptoms.

Treatment options for degenerative intervertebral disc disease

Degenerative disc disease treatment options may include pain medications and physical therapy. Surgery may be needed in serious cases to file down the bony spurs or remove and replace the damaged disc.

5. Kidney stones

Non-spine-related back pain is commonly caused by kidney stones.¹ These are mineralized materials, usually calcium, that form in your kidney. You may pass smaller ones through your urine, which can cause a lot of pain, or you can pass them without experiencing any symptoms at all.

Because of where your kidney sits (your upper abdominal area close to your back muscles), you may feel kidney stone pain in the right or left side of your back.

If you do experience pain from kidney stones, the pain will probably be localized to the area mentioned above and will feel sharp. You may experience pain while you urinate and/or abdominal discomfort, along with other symptoms such as nausea and vomiting. With kidney stones, it's always a good idea to see your doctor to have the problem resolved.

Treatment options for kidney stones

Kidney stone treatment options may include:

Smaller stones

  • Drink two to three quarts of water daily

  • Pain relievers (naproxen, ibuprofen)

  • Alpha-blocker medical therapy (i.e., tamsulosin)

Larger stones and stones-causing symptoms

  • Extracorporeal shock wave lithotripsy (ESWL) or sound waves to break the stones up

  • Laser lithotripsy (using laser heat to break the stones up)

  • Ureteroscopic stone removal 

  • Parathyroid gland surgery

6. Appendicitis

Your appendix attaches to the first section of your large intestine and is a small organ. Its precise function isn't clear, but it could help support your digestive and immune systems.

When your appendix becomes inflamed, it's known as appendicitis and may occur due to an infection or a blockage. It occurs in around 5% of the US population.⁷

It usually leads to extreme pain in your abdomen on the right side, which can sometimes radiate to the right side of your back.

With appendicitis, you may experience symptoms, such as:

  • Loss of appetite

  • Excess gas or bloating

  • Vomiting

  • Nausea

  • Diarrhea or constipation

  • Abdominal swelling

  • Fevers

You require immediate medical care for appendicitis. Even if you just suspect you may have appendicitis, you need to seek medical care right away.

Treatment options for appendicitis

Appendicitis treatment involves surgical removal of your appendix (appendectomy).

7. Ulcerative colitis

This is a chronic condition that affects around 3 million individuals in the US.⁸ It leads to the lining of your colon or large intestine becoming inflamed.

It usually leads to ongoing diarrhea that can contain pus or blood. It may also lead to abdominal cramping and discomfort, which you may experience on one or both sides of your back.

You may experience other ulcerative colitis symptoms, such as:

Treatment options for ulcerative colitis

At present, there's no cure for this condition. The goal of treatment is remission, where you experience a sustained period of few or no symptoms.

Treatment options will depend on how severe your symptoms are but can include medication, such as:

  • Immunomodulators

  • Aminosalicylates

  • Biologic therapies

  • Corticosteroids

If your symptoms don't improve with treatment, your doctor may suggest surgically removing part of your colon.

8. Uterine fibroids (specific to women)

These are non-cancerous growths. They can develop in your uterus wall. When you have them, it doesn't mean you're at an increased risk of developing uterine cancer. In fact, between 20% to 70% of women in their reproductive years will develop them, but only 1% are actually harmful.⁹

Some individuals don't even realize they have uterine fibroids until their doctor detects them during an ultrasound or pelvic exam. They can vary in size.

And, not all people will experience symptoms either. Those who do may experience:

  • Leg pain

  • Lower back pain

  • Constipation

  • Frequent urination

  • Unusually long periods

  • Heavy bleeding or pain during periods

  • Pressure or pain in the pelvic region

Not all people will require treatment either.

Treatment options for uterine fibroids

If you do require treatment for uterine fibroids, this will depend on whether you are pre or post-menopause. Treatment may include:

  • Hormonal birth control

  • Over-the-counter pain relievers

  • Surgery (remove growths, your uterus lining, or your whole uterus)

  • GnRH agonists or antagonists

9. Endometriosis (specific to women)

This is a chronic female condition where your tissue resembling your uterus lining (endometrial tissue) grows outside your uterus. According to the Endometriosis Foundation of America, it affects one in 10 females in the US.¹⁰

If you have the tissue growing on your right fallopian tube or right ovary, it can aggravate your ovary and neighboring tissue, causing cramp-like pain that may radiate from the side and front of your body to your back.

Treatment options for endometriosis

Endometriosis treatment options may include laparoscopic surgery or hormonal therapy. Surgery is used to remove the growths. Hormonal therapy (i.e., low-dose birth control pills) helps shrink the growth.

10. Testicular torsion (specific to men)

This condition occurs when the male testicle rotates within the scrotum and causes twisting of the spermatic cord. When this occurs, it can decrease or totally block blood flow to the testicle, causing irreversible damage.

Nationwide studies show that out of 100,000 males between the ages of 1 and 25, there are 4.5 cases of testicular torsion each year, while there are 3.5 cases per 100,000 males over 25 years old.¹¹

Testicular torsion symptoms include:

  • Nausea

  • Vomiting

  • Unexpected and severe pain in the groin or testicle

  • Blood in the semen

  • Scrotum swelling

  • Pain that radiates to the left or right side of your back

This condition is a medical emergency, and if you experience these symptoms, it's important you seek medical attention right away.

Treatment options for testicular torsion

Treatment for testicular torsion is surgical to either remove the testicle or untwist the spermatic cord.

When should you see a doctor for your lower back pain?

If you're experiencing persistent, severe, or worsening lower back pain, you need to speak with your doctor right away. You'll also want to seek medical attention if your lower back pain accompanies:

  • Nausea

  • Vomiting

  • Painful urination

  • Fevers

  • Stools containing pus or blood

  • Irregular periods

  • Pain during or after sex

  • Bloody, cloudy, or foul-smelling urine

  • Severe groin pain

  • Weight loss

Most right-side lower back pain cases aren't medical emergencies. But, you should seek medical help immediately if your back pain is accompanied by:

  • Severe and sudden pain

  • Loss of bowel or bladder function

  • Pain accompanied by a rapid heartbeat, fever, nausea, vomiting, clammy skin, or another concerning symptom

  • Loss of sensation or weakness in your lower body

To identify any severe conditions that may be the cause of your pain, your doctor will perform a thorough physical exam and take a complete medical history. In most cases, imaging tests aren't needed, but the doctor may order them to rule out sinister conditions. Neurologic tests may be ordered as well to determine what's causing your pain and to come up with appropriate treatment.

Even with a thorough examination, in some cases, it can still be difficult for the doctor to determine the cause of lower back pain.

The lowdown

Generally, pain on the lower back right side is caused by an injury to your back like a pulled muscle. Since there can be many causes of lower right side back pain, it's important you don't ignore any symptoms you experience, particularly if the pain you're experiencing in your lower back comes on suddenly, is intense, or is accompanied by other worrisome symptoms.

Always consult with your doctor if you're worried about your lower back pain or if the pain you're experiencing affects your day-to-day activities. They'll assess the situation and diagnose the cause. Then they'll come up with an effective treatment plan tailored for your specific situation.

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