About 90% of people have lower back pain at some point. The pain can feel different from person to person depending on the cause.
Pain in the lower right side of the back can be due to many conditions that affect different parts of the body.
1. Musculoskeletal Problems
When lower back pain on the right side stems from musculoskeletal (muscle and spine) problems, you may have issues with any of the following body parts:
- Discs: Cushions between the spine’s bones
- Joints: Connections where bones meet
- Ligaments: Tissue connecting bones and stabilizing the spine
- Muscles: Tissues that move and support the spine
- Spinal cord: Nerves in the spine
- Tendons: Tissue connecting muscles to bones
- Vertebrae: Bones of the spine
2. Radiculopathy and Sciatica (Nerve Pain)
Radiculopathy occurs when something presses on a spinal nerve, causing a sharp, burning, shooting pain; numbness; or weakness along the nerve’s pathway. It can occur in the neck, upper back, or lower back.
Sciatica is a specific type of radiculopathy that affects the sciatic nerve in the lower back and legs. It causes sharp, burning, or shooting pain down one leg and often worsens when you sit, bend, or lift your legs straight up while lying down. In severe cases of nerve compression in the lower back, you may experience problems with bladder (peeing) or bowel (pooping) control.
While doctors may not always find an underlying cause, sciatica can occur with:
- Herniated discs: The inner part of the disc leaks and presses on nerves
- Spinal stenosis: Narrowing of the spinal canal
- Pelvic fractures: When one or more bones in your pelvis break
- Piriformis syndrome: Nerve irritation from the piriformis muscle, a muscle in the buttocks that helps you move your hip and leg out
3. Muscle Spasms
Muscle spasms are involuntary muscle tightening that causes intense discomfort. You can get them from:
- Bad posture
- Certain medications, like statins that lower cholesterol
- Chronic health conditions like Parkinson’s disease
- Dehydration (not getting enough fluids)
- Electrolyte imbalances (low potassium, calcium, or magnesium)
- Muscle strains and sprains
- Nerve compression (herniated discs, spinal stenosis)
- A hard workout
- Myofascial pain syndrome (sore spots in your muscles)
4. Posture Changes
Spine curvatures can make standing up straight difficult, causing lower right back pain. Posture changes can come from
- Scoliosis (spine goes side-to-side)
- Lordosis (spine goes inward)
- Kyphosis (spine grows outward)
In severe cases of ankylosing spondylitis, a type of arthritis that affects the spine, the vertebrae fuse, causing a stooped posture.
5. Issues With Your Internal Organs
Conditions related to the kidneys and the appendix can cause pain that radiates to the lower right back. These include:
- Kidney stones: These small, hard deposits can cause sharp, intense pain in the lower back, pelvis, or groin. The pain may come and go when the stones move through the ureters, tubes carrying pee from the kidneys to the bladder.
- Kidney infections: These can cause deep, dull lower right back pain. Kidney problems may also cause fever, nausea, vomiting, pain with urination (pee), and blood in the urine.
- Appendicitis: This condition occurs when the appendix, a small pouch on the large intestine, becomes inflamed. Initially, you may have a severe bellyache near the belly button that shifts to the lower right side. As appendicitis progresses, the pain worsens and may radiate to the lower right back.
6. Gynecological Conditions
Problems in the female reproductive organs can cause radiating pain to the lower right back. These conditions include:
7. Pregnancy
During pregnancy, the growing uterus strains the spinal muscles and the sacroiliac joint that connect the lower spine to the pelvis, leading to back discomfort. After childbirth, you may also experience back pain as muscles recover.
Depending on what’s causing it, the pain might feel like a dull ache or a sharp, intense pain. It could start suddenly and not go away, worsen slowly over time, or come and go. Moving or sitting may affect how it feels.
Someone with pain in the lower right side of the back may experience radiating pain. Radiating pain is a type of pain that spreads from one area of the body to another.
Some conditions are more commonly tied to certain types of pain. A doctor will consider how you’re experiencing the pain when making a diagnosis.
Acute Pain
Acute pain is sudden and lasts less than 12 weeks. It can result from sudden injuries or conditions such as:
- Compression fracture (break of a vertebra, or spinal bone)
- Herniated disc
- Muscle spasm
- Sciatica
- Spinal cancer (tumor on the spine)
- Spinal infection, which could be an abscess (collection of pus), osteomyelitis (bone infection), or discitis (disc infection)
- Spine curvature
- Sprains (ligament injuries)
- Strains (injury to muscles or tendons)
Chronic Pain
Chronic right lower back pain often develops gradually and lasts over 12 weeks. It stems from ongoing conditions or injuries that don’t heal properly. Examples of conditions that cause it include:
- Ankylosing spondylitis
- Degenerative disc disease (gradual wearing down of discs in your back)
- Myofascial pain syndrome
- Osteoarthritis (breakdown of cartilage in the joints)
- Piriformis syndrome
- Sacroiliac joint dysfunction, which is irritation of the joint that connects your lower spine to your pelvis (hip bone)
- Spinal stenosis
- Spondylolisthesis (vertebrae slip out of place over time)
- Spondylosis (discs get thin and less flexible with age)
- Wear and tear of the facet joints, the hinges that connect the bones in your spine
Pain That Doesn’t Get Better With Rest
Lower right back pain that does not improve with rest may indicate persistent underlying conditions such as:
- Arthritis, including ankylosing spondylitis
- Autoimmune disorders
- Cancer in the lower back
- Nerve compression
- Nerve diseases like multiple sclerosis (MS)
- Sprains, strains, or injuries that don’t correctly heal
Numbness, Tingling, or Weakness
Lower right back pain accompanied by numbness, tingling, or weakness often indicates nerve involvement in the spine or nearby structures. It can make it difficult to walk or stand. Some conditions that may cause this include:
- Herniated disc
- Fractures
- Diabetes
- MS
Reach out to a doctor if the pain:
- Gets worse or stops you from daily activities
- Lasts over a few days
- Occurs after you’ve had cancer
- Occurs with progressive numbness, tingling, or weakness
- Shoots down your leg or into your groin
- Occurs with a fever, painful urination, or blood in urine
- Occurs with redness, swelling, or warmth in the spine
Seek emergency care if you:
- Experience fever, nausea, and vomiting with the pain
- Experience sudden weakness, numbness, or can’t stand
- Have pain that follows an injury
- Have sudden, intense lower right belly or back pain
- Lose control of your bladder or bowels
Your doctor will probably ask questions about your medical and family history and do a physical exam to better understand the cause of lower right back pain. They may ask you questions like what the pain feels like, when the pain started, and how long you’ve had it.
They may also run tests to determine the cause of pain, including:
- Imaging test: This could be X-rays, magnetic resonance imaging (MRI), or computed tomography (CT), which take images or scans to get a better look at the area of your back that’s causing your pain.
- Blood tests: This can help identify any underlying medical conditions that could be causing your back pain. A complete blood count (CBC) or an erythrocyte sedimentation rate (ESR) are two types of blood tests that might be done to check if you have inflammation or an underlying medical condition related to your pain.
- Electrophysiological tests: These tests check the electrical activity of the muscles or nerves to determine if they’re functioning properly.
Once you have a proper diagnosis for your pain, your doctor will create treatment options to help relieve symptoms. Depending on the cause and severity of your lower right back pain, the types of treatment may include:
- At-home remedies: This can include using ice or heat packs to help relieve pain and inflammation.
- Medications: This includes over-the-counter medicines like nonsteroidal anti-inflammatory drugs (NSAIDs), such as Advil (ibuprofen), for pain or prescription medicines like anti-inflammatory injections or muscle relaxants. The type of medication you take will depend on the type of lower back injury and whether it’s acute or chronic.
- Physical therapy: This can include stretches and low-impact exercises to improve mobility, posture, and muscle strength after a back injury.
- Surgery: This is typically the last option if all other treatments aren’t helping relieve your pain.
Lower right back pain can stem from sprains, strains, back conditions, nerve compression, chronic health problems, or issues with internal organs. The pain can range from a dull ache to a sharp pain that may shoot down the leg. See a doctor if the pain in the lower right side of your back is severe, lasts more than a few days, worsens, or disrupts your day-to-day activities.
