In fact, Lower back is the leading cause of disability on a global scale. When that pain occurs in specific locations, it can sometimes be a clue to its underlying cause.
Pain in the lower right side of the back can point to a variety conditions—including kidney issues, infections, appendicitis, and even pregnancy.
In this article, I’ll outline some of the potential causes of back pain on the lower right side.
I’ll also help you determine if your pain is an emergency, and when to talk to your primary care provider or another healthcare professional.
Kidney stones are hard deposits of minerals—like calcium, phosphate, and magnesium—that form inside your kidneys.
These crystalline masses develop when mineral content in urine becomes too concentrated, leading to a buildup in the kidneys.
When the sharp, rigid surface of a kidney stone begins shifting inside the kidneys or begins transitioning into the bladder, it can be very painful.
This usually causes severe, crampy pain that comes and goes.
Since the kidneys are located just below the ribcage on either side of the spine, it’s not uncommon for kidney stone pain to be experienced in the back.
While it’s possible to develop stones in both kidneys, it’s more common to develop stones in one kidney.
In this case, you would experience back pain localized on one side of your back—such as the lower right side.
The stones eventually make their way out through the urinary tract and can cause severe pain.
Most kidney stones will pass on their own with no specific treatment.
In some cases, you may need a procedure to help you pass the stone, pain or nausea medication, or an antibiotic to treat infection.
If you believe you have a kidney stone, talk to your doctor or a healthcare provider.
Kidney infections typically cause pain under your ribs in the mid-back on either side.
But they can also cause significant lower back pain that radiates to the lower abdomen.
If your right kidney is infected, you’ll feel the pain on your lower right side.
The pain may feel dull and achy at first, but it may also become sharp and stabbing.
This pain is usually accompanied by other symptoms of a UTI, such as burning with urination, more frequent urination, fever, malaise, and nausea.
The kidneys are vital internal organs, so an untreated infection can lead to serious complications such as chronic kidney disease or sepsis, when bacteria enter the bloodstream.
The appendix is a small, finger-like pouch attached to the large intestine.
Its purpose is not agreed upon—historically, it has been thought to have no purpose at all.
Some researchers believe the appendix may help your immune system fight harmful bacteria.
When the appendix becomes inflamed, a painful condition called appendicitis can occur.
Appendicitis is a common cause of lower right side pain, and may cause some pain in the right lower back as well.
Pain from appendicitis generally begins suddenly and worsens as the condition quickly progresses.
Once infected, the appendix can rupture as quickly as 48 to 72 hours after the onset of initial symptoms, and can be fatal if not treated in time.
The risk of an appendix rupturing increases every 12 hours.
Appendicitis is an emergency medical condition that often requires surgery, so it’s important to seek medical care immediately if you suspect you might have appendicitis.
Other warning signs of appendicitis include:
- Abdominal pain when you cough, sneeze, inhale or move
- Swollen belly or bloated feeling
- Constipation or diarrhea
- Loss of appetite
- Low-grade fever
- Nausea and vomiting
Muscle strain or sprain
Some of the most common causes of lower back pain on the right side are muscle strains or sprains.
Muscle strains are caused by strenuous activities like lifting something heavy, twisting too hard, or participating in high-impact activities like sports.
These injuries can happen from something as simple as throwing out your back during heavy lifting—like moving boxes—or from an incident as severe as a car accident.
Acute low back pain from muscle strain typically starts suddenly and can be accompanied by inflammation, redness, swelling, soreness, or bruising.
The severity of your strain determines how long it takes for your symptoms to subside, which can range from a few days to weeks.
You can generally treat a muscle strain at home with rest, ice, warmth, and over-the-counter treatments.
Spinal injuries, overgrowth of the bones in your spine, injury, and herniated discs can cause the spinal canal—the space in your spine that protects your spinal cord—to narrow.
This is called spinal stenosis, and it can create compression, crowding, or pinching of the spinal column.
This can create pressure on your spinal cord or on nerves that go from your spinal cord to your muscles.
Spinal stenosis tends to develop as people age—typically after age 50.
The condition is more common in men than women, and typically affects the neck or lower back.
Aside from natural wear and tear from aging, injuries to the spine, spinal tumors, rheumatoid arthritis, and certain bone diseases can cause spinal stenosis.
Common treatment options for spinal stenosis include medication, physical therapy, and surgery.
A herniated disc, also known as a slipped or ruptured disc, can cause intense pain in the lower back.
Between the vertebrae of your spine, cushioned discs allow the bones of your spine to rotate and bend without rubbing against one another.
But sometimes, these discs can be pushed out of place—by heavy lifting, bending, or for unknown reasons.
This out-of-place disc is herniated. When this happens, the bulge from the disc creates pressure on the spine’s nerve roots.
A herniated disc is typically caused by one of two things: trauma or overuse.
Injuries or accidents can cause damage to the intervertebral discs, including disc herniation.
If you live a sedentary lifestyle or are overweight, you may also be at greater risk of getting a herniated disc.
The location and type of pain you experience depends on which part of your spine has been affected.
For example, herniated discs in the low back can create pressure on the sciatic nerve.
This nerve originates at the base of the spinal column, then runs through your hips and buttocks, and down each leg.
When this nerve is affected by a herniated disc, it can cause sciatica, an intense, sharp pain that radiates down your leg, and may affect your right lower back.
General symptoms of a herniated disc include pain, numbness, tingling, weakness, or stiffness in your back or legs.
You may even have trouble walking or standing for extended periods of time.
Potential Causes In Women
There are a few medical conditions that can cause lower back pain on the right side in females.
This may be a reason why the overall prevalence of low back pain is greater in women than in men.
Weight gain, changes in posture, and hormonal changes can all contribute to back pain during pregnancy.
The extra weight of the baby and placenta puts extra pressure on your pelvic muscles, which are responsible for lower back support.
At the same time, levels of relaxin and progesterone hormones may increase during pregnancy, causing ligaments and joints in the pelvic area to loosen.
Without as much support and with extra weight, this can lead to discomfort and back pain.
Treatments for back pain during pregnancy will vary depending on the individual’s current health status and medical history.
Treatments may include recommendations for staying as active as possible, using supportive garments, over-the-counter medications, or physiotherapy.
Endometriosis, a condition in which uterine tissue grows outside the uterus, is often misunderstood and misdiagnosed.
This chronic condition affects more than 11% of American women between the ages of 15 and 44, and can cause painful periods, fatigue, back pain, and infertility.
Lower back pain associated with endometriosis may be felt on the right side of the body or on both sides.
The location of the pain can vary—it may be felt in the lower abdomen or pelvis, but it also may radiate down the buttocks and into the legs.
There’s also some research that has found endometriosis in the bones of the lower back.
The pain typically gets worse around the time of your menstrual period.
Cases of spinal endometriosis have been rare, but could be an underlying cause of recurring back pain.
Endometriosis can be difficult to diagnose, as it typically requires a surgical procedure.
Your gynecologist can help you determine if endometriosis is the cause of your pain.
Uterine fibroids are noncancerous growths that develop in or around the uterus.
Fibroids develop when certain types of cells in the uterus multiply and grow because of an increase in estrogen levels or because of genetic factors that affect how your body processes estrogen.
They are the most common benign (noncancerous) tumors in women of reproductive age.
Uterine fibroids can be small with no symptoms at all.
In other cases, they can grow so large that they create pressure on the bladder or rectum, or press on the uterus itself.
This can cause severe cramping, heavy bleeding, abdominal bloating, painful sex, constipation, or lower back pain.
Pelvic inflammatory disease
Pelvic inflammatory disease (PID) is a serious infection of the reproductive organs.
It occurs when bacteria spreads from the vagina up through the uterus, fallopian tubes, and into the abdominal cavity.
PID can cause lower back pain. Other warning signs to look out for include lower abdominal pain, bleeding between periods, and abnormal vaginal discharge.
Treating PID successfully requires early diagnosis, so it’s important to know the symptoms associated with this condition.
Left untreated, PID can lead to serious long-term problems, like chronic pelvic pain, ectopic pregnancy, or infertility.
If you experience symptoms of PID, seek medical care as soon as possible for proper diagnosis and treatment.
Ovarian torsion occurs when one of your ovaries twists around, cutting off blood flow.
This causes sudden, sharp, severe pain that is typically located in your lower abdomen on one side, and often radiates to your lower back on the same side.
You may also experience nausea or vomiting.
Ovarian torsion is more likely if you have a large ovarian cyst or cysts on the affected side.
If you suspect ovarian torsion, seek emergency medical care immediately, as this requires emergency surgery to restore blood flow to the ovary.
Is it an Emergency?
Since lower back pain is so common, many people grapple with whether their pain is severe enough to warrant a visit to the doctor’s office.
If it’s not a medical emergency, is it even worth making an appointment with a health care provider?
Sometimes serious conditions won’t involve dramatic, alarming symptoms.
If you have back pain and are unsure about whether you need to visit the emergency room, you can connect with a healthcare provider on the phone any time of the day with online urgent care.
Your primary care provider is also a great resource to help decide if your back pain requires a medical visit or can be treated at home.
When to See a Doctor
It’s always a good idea to get in touch with a healthcare practitioner if you are experiencing back pain.
Some lower back pain symptoms signal serious problems. If you have any of the following symptoms, get medical attention as soon as possible:
- Blood in urine
- Blood in bowels
- Muscle weakness
- Fever and chills
- Loss of sensation in one or both legs
- Loss of bladder and bowel control
- Numbness, tingling, weakness, or radiating pain in your legs
Some of these symptoms may indicate a medical emergency that requires immediate treatment.
Depending on your diagnosis, your doctor may also prescribe a long-term treatment plan to manage and prevent chronic pain, like physical therapy, therapeutic exercises, steroid injections, or lifestyle changes.
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Global low back pain prevalence and years lived with disability from 1990 to 2017: estimates from the Global Burden of Disease Study 2017. (2020).
Symptoms & Causes of Kidney Infection (Pyelonephritis). (2017).
Lumbar Spinal Stenosis: Treatment Options for an Aging Population. (2012).
Ulcerative colitis. (2016).
Pregnancy-related low back pain. (2011).
Uterine Fibroids. (2013).
Pelvic Inflammatory Disease (PID) – CDC Fact Sheet. (2020).
Testicular torsion and risk factors for orchiectomy. (2005).
Increased low back pain prevalence in females than in males after menopause age: evidences based on synthetic literature review. (2016).