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8 reasons you're experiencing lower right back pain and what to do about it

Apr 6, 2022, 03:19 IST
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Pregnancy is one of the common causes of pain in the lower back that can sometimes focus on the right side.Ute Grabowsky / Contributor
  • Lower right back pain can be due to a sprain, infection, cancer, pregnancy, and much more.
  • To get proper treatment you need the right diagnosis so track any other symptoms you're having.
  • In many cases stretching, rest, and physical therapy can help you find some relief.
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Lower back pain is extremely common, affecting up to 70% of people at one time or another. When the pain is concentrated on one side of your body, it's known as unilateral back pain, says Nitin N. Bhatia, MD, chief of adult and pediatric spine surgery at the University of California Irvine School of Medicine.

Unilateral back pain can happen on the left side or the right side.

"It is most often caused by arthritis that is more predominant on that side or a muscle sprain on that particular side," Bhatia says. "However, in more rare instances, problems such as an issue within the abdomen or pelvis can cause one sided back pain."

The type of pain can vary from a dull ache to sharp pains, says Larry Nolan, DO, a primary care sports medicine physician at The Ohio State University Wexner Medical Center.

Your symptoms and the type of pain you're experiencing can help you identify the cause and find relief for lower right back pain. Here's what might be at play.

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1. Back muscle sprain or strain

Muscle strains and sprains are some of the most common cause of lower right back pain, says Rahul Shah, MD, a spine surgeon with Premier Orthapaedic Spine Associates.

Sprains occur when you overstretch the ligaments in the back, while strains happen when you overstretch a tendon. If this happens on the right side, you'll experience pain there.

"Folks are prone to sprains when not stretching or warming up properly before exercise, twisting or jerking the body, and lifting heavy objects," Shah says.

If you strain or sprain your back you'll likely experience a dull, aching pain, some swelling or bruising, and a loss of your range of motion. The pain often gets worse when you use the muscle you've injured.

What to do about it: In most cases you can care for a strained or sprained muscle at home by resting, gentle stretching, icing, and managing pain with over-the-counter medications including acetaminophen or naproxen, says Shah.

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Muscle strains and sprains can last for several weeks. If at-home remedies aren't working and the pain is keeping you from normal daily activities, it's time to visit a doctor. Once you're back to normal, strengthen your core and stretch regularly to prevent future injuries.

2. Spinal issues

Injuries to the spine or the muscles and ligaments that support it are another common cause of lower right back pain, says Bhatia. Conditions including arthritis, a degenerative or herniated disk, or an impact injury like from a car accident can harm the muscles or ligaments on one side.

This type of pain often feels deep and is painful to the touch, says Nolan. If it's accompanied by tingling or numbness, call your doctor immediately as this could indicate nerve damage that should be evaluated by a professional, Nolan says.

What to do about it: If you're dealing with a chronic condition like arthritis, or recovering from an injury, Bhatia recommends working with a physical therapist. They'll teach you exercises, stretches, and other treatments to increase core strength, which may help control lower back pain.

3. Sciatica

Sciatica is nerve pain, aka radiculopathy, caused by the compression of the sciatic nerve.

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People have two sciatic nerves, one on each side of the lower back, but sciatica usually only presents on one side, says Bhatia. That's because it happens when an injury like a herniated disk or bone spur puts pressure on the nerve.

Sciatica is characterized by a sharp, shooting pain that can range from mild to severe. It often starts in the lower back and then travels down the leg. It can be accompanied by weakness, numbness, and tingling in the back or leg.

What to do about it: During the first week of sciatic pain, try resting, gently stretching, and managing your pain with over-the-counter medications, says Bhatia. If you experience numbness or weakness in your leg, seek medical aid immediately.

Moreover, if the pain persists or returns frequently, see your doctor. Sciatica can be treated with medications, physical therapy, steroid injections, and — in severe cases — surgery.

4. UTI or kidney infection

Back pain isn't the most common symptom of a urinary tract infection, but as a UTI reaches your kidneys it can cause lower right back pain. This is often accompanied by other symptoms, like a burning sensation when you pee.

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Kidney stones can also cause lower right back pain that comes in intense waves as opposed to a constant soreness. Back pain from kidney issues usually presents higher up on the back, around where the kidneys are located.

What to do about it: See your doctor. If you have symptoms that suggest a UTI or kidney stone, your doctor will likely order blood and/or urine tests, says Bhatia. Once they diagnose the cause, they'll prescribe the appropriate treatment, like antibiotics for a UTI or pain medications for a kidney stone.

5. Appendicitis

Appendicitis is inflammation of the appendix, an organ that is part of the large intestine. The appendix is on the right side of the body, so appendicitis can lead to right lower back pain, says Shah.

The pain comes on suddenly, usually starting near the belly button and moving lower, possibly radiating through the back, Shah says. You'll likely experience other symptoms like fever, nausea, and vomiting.

What to do about it: Go to the ER, or see your doctor immediately if you think you have appendicitis. If left untreated, appendicitis can lead to your appendix bursting, which is a medical emergency.

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Appendicitis is typically treated by surgically removing the appendix in a procedure called an appendectomy.

6. Pregnancy

Back pain during pregnancy is common and not typically cause for concern, says Nolan. About at least half of pregnant people will experience lower back pain, which may be concentrated on one side.

"Women may experience this early which is typically intermittent, dull, and achy," says Nolan. "As the pregnancy progresses and hormones change, it may become more constant with sharp sensations."

What to do about it: The best cure for pregnancy-related back pain is delivery. In the meantime, staying active, stretching, and maintaining good posture can help. Some people find relief from supportive belts, acupuncture, or massage. A physical therapist can help if your pain is severe.

Quick tip: Acetaminophen (Tylenol) is considered safe during pregnancy and can be used to control pain, but avoid NSAID pain relievers like Advil, which are not safe during pregnancy.

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7. Cancer

In rare cases, lower right back pain can be a symptom of cancer. Pancreatic cancer in particular can cause lower back or belly pain on the right side, where the pancreas is located. This type of lower right back pain starts slowly and is felt deep within the back, says Nolan.

If you have pancreatic cancer, you may have other symptoms including jaundice, dark urine, weight loss, and nausea.

What to do about it: Call your doctor. Although cancer is not often the cause of lower right back pain, people with a family history of pancreatic cancer should talk to their doctor if they experience unexplained lower back pain.

Pancreatic cancer is treated with surgery, chemotherapy, targeted therapy, and other interventions.

8. Endometriosis or ovarian cysts

Endometriosis is a condition where the endometrium, a membrane which typically lines the uterus, grows in other areas of the body. In rare cases, endometriosis can affect the spine and lead to lower back pain, specifically on the right side if the right half of the abdomen is affected. Endometriosis only affects people with uteruses.

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"Generally, this can present as vague low back pain that is intermittent and associated with the menstrual cycle," meaning you're likely to experience the pain around the time of your period, says Nolan.

An ovarian cyst on the right ovary can also cause lower right back pain, says Shah.

What to do about it: Anti-inflammatory medications like Advil can help control lower back pain from endometriosis. Ultimately, you should see a doctor if you think your pain is caused by endometriosis or a cyst.

Hormone therapy and surgery can also be used to treat and control symptoms from endometriosis and cysts. If you have endometriosis, work with a gynecologist or reproductive endocrinologist to determine what treatment is right for you.

Insider's takeaway

Lower back pain is very common and can be exacerbated by both heavy lifting and leading a sedentary lifestyle.

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"While most often this pain will get better on its own within a few days or a few weeks, pain that is more persistent may require medical attention," says Bhatia.

If you frequently experience lower back pain, strengthening your core can help, says Nolan. Talk to your doctor about working with a physical therapist, who can give you exercises to help prevent future episodes of lower back pain.

"Don't wait too long to get evaluated and gain information to improve the quality of your life," Nolan says.

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