What Causes Pain in the Lower Right Part of Your Back

Lower right back pain can be due to a variety of conditions involving the muscles, bones, or nerves of the spine as well as underlying illnesses that directly or indirectly cause pain. While dealing with this type of back pain can be frustrating, it is most often not due to a serious illness.

However, there are instances in which lower right back pain may be a sign of a serious condition in need of immediate medical attention, including surgery.

A woman holding her back in pain at the beach
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This article explores the various causes of lower right back pain as well as how the pain may be diagnosed and treated.

Causes

Most causes of lower back pain involve the bones and muscles that move the spinal column. Neurological causes can involve the lumbar nerve roots.

Although uncommon, other underlying health problems sometimes cause right-sided back pain. Even though you may feel pain in the lower back, the problem may actually be located elsewhere in your body.

Below is a list of some of the common conditions that can cause right-sided lower back pain.

Spinal Cysts and Tumors

Two potentially serious causes of back pain are spinal cysts and tumors. Cysts develop due to degenerative changes in the spine, while tumors can develop due to changes in cells.

A spinal cyst can press on a nerve root which goes to a different area of the body. This pressure can cause a type of nerve pain called radiculopathy.

Symptoms of radiculopathy include pain, weakness, numbness, or a pins-and-needles sensation that runs down one leg. There may also be cramping and discomfort while walking.

Spinal tumors, either cancerous or non-cancerous, can press on the spinal cord itself. Symptoms include back pain that radiates (spreads) to other areas, known as referred pain. There may also be muscle weakness, difficulty walking, decreased sensitivity to pain, and bowel or bladder incontinence.

Kidney Stones

Kidney stones are a common cause of non-spine-related back pain. Even a small kidney stone can be painful as it passes through the urinary tract.

Due to the location of the kidneys, pain from kidney stones may be felt deep within the left or right side of the back, depending on which kidney is involved. The pain will typically be sharp. There may also be lower abdominal pain, pain with urination, and nausea or vomiting.

Gallstones

Gallstones can also cause right-sided back pain due to the location of the gall bladder just under the liver on the right side of the body.

In addition, gallstones can cause sudden and intense pain in the upper abdomen, beneath the breastbone, between the shoulder blades, and in the right shoulder. Nausea or vomiting are also common.

Cauda Equina Syndrome

Cauda equina syndrome is a rare but serious condition that occurs when nerve roots in the lumbar spine are compressed, disrupting the function of the bladder, bowel, and legs. Causes include spinal trauma, tumors, infection, and spinal birth defects.

Symptoms of cauda equina syndrome may include severe low back pain, sciatica, leg numbness, an inability to urinate, bowel incontinence, sexual dysfunction, and the loss of reflexes in the legs. Immediate surgery is generally advised.

Herniated Disc

A herniated disc occurs when the shock-absorbing cushion between two adjacent vertebrae (spinal bones) bulges or ruptures. In many cases, a soft, liquid-like substance inside the disc can leak out.

Should the substance come into contact with a nerve root, it can "short circuit" electrical signals and trigger symptoms of radiculopathy (typically on one side of the body).

Most herniated discs don't require surgery, but about 10% don't improve with non-operative treatment. Physical therapy is often prescribed for disc hernations. A six-week course of therapy is typical.

Bone Spurs and Arthritis

Facet joints are interconnecting joints located at the back of the spine. Collectively, they give the spine its integrity by limiting spinal movement. Each spinal level has a right and left facet joint.

Facet joints are often where bone spurs develop. These abnormal bone growths may be triggered by arthritis, previous trauma, or other causes.

When spurs develop on a right facet joint, they cause right-sided pain. Other symptoms include leg weakness, numbness, tingling, and electrical sensations that shoot down one leg.

Sacroiliac Joint Disorders

The sacroiliac (SI) joint connects the pelvis to the sacrum, the triangular bone between the lower spine and tailbone. The locking or abnormal movement of these joints (due to trauma or other causes) can lead to back pain and referred pain.

Sacroiliac pain may also be caused by a form of arthritis called ankylosing spondylitis. Ankylosing spondylitis is a progressive, debilitating disease that can cause parts of the spine to fuse together. Symptoms include spinal stiffness, pain, and immobility.

Scoliosis

Scoliosis is the abnormal curvature of the spine that causes it to have an "S" or "C" shape. The abnormal curve can cause muscles to be tight and overstretched on one section of the spine and compressed on another.

Low back pain is common in adults with scoliosis and is often unilateral (occurring on only one side). Sciatica and muscle spasms are also common.

Recap

Right-sided lower back pain is often due to muscle-, bone-, or nerve-related problems involving the spine. These include spinal cysts or tumors, cauda equina syndrome, herniated discs, facet joint bone spurs, spinal arthritis, sacroiliac joint injuries, ankylosing spondylitis, and scoliosis.

Non-spine-related conditions may also trigger lower back pain. These include gallstones and kidney stones.

Diagnosis

The diagnosis of lower right back pain involves a physical exam and a review of your medical history. This may include a neurological exam to see if your reflexes are normal or to check for weaknesses or sensations that point to a nerve injury.

Based on the findings, your doctor may order imaging studies to look for abnormalities in the spine. This may involve an X-ray of the spine or computed tomography (CT) scan, in which multiple X-rays images are combined into a 3-D image. Magnetic resonance imaging (MRI) is another test that is better able to detect soft tissue damage.

A nerve conduction study, also known as electromyography, may also be ordered. This can show your doctor how well electrical signals are traveling through nerves.

Treatment

The treatment of right-sided low back pain can differ based on the underlying cause. If the cause is related to a systemic illness, efforts will be focused on resolving the underlying condition first and foremost.

Options for the treatment of lower back pain itself may include:

Summary

Right-sided lower back pain may be caused by muscle-, bone-, or nerve-related problems affecting the spine. These include herniated discs, facet joint bone spurs, spinal arthritis, ankylosing spondylitis, scoliosis, spinal cysts or tumors, and cauda equina syndrome. Other illnesses like kidney stones and gallstones can also cause lower back pain.

The diagnosis of lower back pain involves a physical exam and a review of your medical history as well imaging tests and nerve conduction studies if needed.

The treatment varies by the cause but may include prescription or over-the-counter painkillers, physical therapy, spinal manipulation, spinal steroid injections, and surgery.

A Word From Verywell

If low back pain keeps you up at night, lasts longer than a week, recurs, or affects your ability to move or function, see a doctor. In most cases, the cause will be relatively easy to treat or manage.

If a more serious underlying condition is involved, early diagnosis and treatment almost always translate to better results.

Frequently Asked Questions

  • How do I know if my back pain is kidney-related?

    Kidney infection or kidney stones can cause lower back pain on one or both sides. Pain from a kidney stone is usually felt in the flank—the area of the back between the ribs and hip bone—and radiates to the groin.

  • What can cause right-side lower back pain?

    Possible causes of right-side lower back pain include: 

    • Gallstones
    • Facet joint pain in the spine
    • Herniated disc
    • Kidney stones
    • Sacroiliac joint dysfunction
    • Scoliosis
    • Spinal arthritis
    • Spinal cysts
    • Spinal tumors
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  1. Penn Medicine. 4 reasons you may have back pain on only one side.