Causes of Lower Right Back Pain and Tips for Relief

Woman holding back in pain
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Dealing with any type of back pain is tough because it often seems worse than it is.

This is good news and bad news. The good news is, as alluded to above, the reason you have back pain may not be as serious as you think when you’re in the midst of it.

And now for the bad news: Because the pain can be such a bear, some medical providers may be a little too thorough when diagnosing and treating it. In this case, along with taking your medical history and doing a physical exam, your doctor may order a complete battery of diagnostic imaging tests.

Experts have, in recent years, recommended against the initial taking of films unless you’ve been involved in an accident, fall, have sustained other trauma to your spine, or you have neurological symptoms. Neurological symptoms include things like pins and needles, pain, weakness, numbness and/or electrical sensations that travel down one leg. (You may be more familiar with these symptoms by their non-medical name, sciatica.)

An overzealous doctor might also prescribe narcotic pain medication (opioids) as a first line treatment—even before physical therapy and home exercise. But this may be unnecessary; opioids are some very strong drugs, and they come with the risk for addiction.

Is your back pain really so bad that you need the strongest acting medication around?

For many, working with a physical therapist on a home exercise program makes an excellent adjunct and/or alternative to strong medication.

In fact, it often restores spine patients to their former condition without the help of narcotics at all.

And finally, because back pain can be unbearable, some doctors may pre-maturely steer you toward surgery. Again, giving a course of physical therapy a chance to work (and this means doing your exercises daily) may help you avoid the “knife.”

All this to say that back pain – even when you can barely tolerate it – is often what they call “non-specific,” meaning that tests and exams can’t or don't reveal a cause. Reasons for non-specific back pain can range from soft tissue damage or muscle imbalances to pain that’s referred from other areas, including trigger points in nearby (and faraway) muscles.

Right Side Back Pain

Things might become more worrisome if you notice that your pain is limited to one side or the other. Even if it isn’t, the cause may be serious; this is why seeing your doctor if it keeps you up at night, it lasts longer than a week or if you’ve had pain previously, you’ve had an injury and/or you’ve had cancer is recommended. Note that these are just a few of the signs that your back needs medical attention; there are a number of other ones as well.

In this article we’ll talk specifically about right side back pain—what may be causing it and when you should talk to your doctor about it, as well as a few tips for getting relief.

That said, if your right sided back pain is due to anything other than the common non-specific variety discussed above, your best course of action will likely be to work with your doctor and/or physical therapist.

Serious underlying health problem can cause right side back pain, although this is rare. In such cases, even though you feel it in your back, the problem that actually needs the treatment will likely be located elsewhere in your body. For this reason, it’s very important to work with your doctor, and probably a specialist. Going to see a chiropractor, taking pain meds and waiting for the pain to go away and/or trying exercise may not fully resolve the issue (nor resolve it to your satisfaction.)

Here is a list of common systemic and/or serious underlying causes of right side back pain.

Cysts and Tumors

Two potentially very serious causes of right side back pain are cysts and tumors.

Although they are different from one another medically, one thing they do share in common is that they can press on your spine.

Cysts are related to degenerative changes in the spine. They can press on the spinal nerve root, which may result in radiculopathy symptoms. Radiculopathy is suggested when pain, weakness, numbness, tingling, electrical sensations and/or pins and needles that go down one leg.

Other symptoms of a spinal cyst may include neurogenic claudication, which is cramping and discomfort in your legs, especially when you walk for anything other than short distances. Neurogenic claudication is related to posture and tends to accompany spinal stenosis.

Symptoms of cauda equina, while rare, may also be caused by a cyst that presses on your spine. Cauda equina may result in bowel or bladder dysfunction, progressive weakness in your legs as well as other symptoms. Generally, immediate surgery is recommended in cases of cauda equina.

It’s important to seek medical attention for any and all of the symptoms discussed above.

Tumors, on the other hand, may press on your spinal cord (which is different than your spinal nerve root.) Whether or not it does, as well as the type of symptoms you’ll experience, depend on the location of the mass.

Symptoms include back pain that may radiate to other areas, difficulty walking, loss of sensation, decreased sensitivity to pain, disrupted bowel or bladder functioning, muscle weakness and more.

Tumors in the spine may be non-cancerous or cancerous. Regardless, speaking with your doctor as soon as you can is your best course of action if you have the symptoms listed above or you otherwise find out you have a spinal tumor.

Kidney Stones

One common type of non-spine back pain is caused by kidney stones. They cause pain in the left or right side of your back because of the location of this organ which is in the upper abdominal area (but in back.) The kidneys are situated right next to the spinal muscles in that area.

If you’re wondering what kidney stones are, exactly, they are mineralized material (often containing calcium) that forms in the kidney. Small stones often pass through your urine. This can be very painful, but some small kidney stones are passed with no symptoms at all.

If your kidney stones give you pain, it will likely feel sharp and be localized to the area described above.

Obviously, right side back pain from kidney stones are not treated as traditional back pain because they don’t involve the spine. It’s best to see your doctor, and get a referral to a specialist, if need be.

Kidney stones may also cause abdominal discomfort and other symptoms.

Gallstones and Back Pain

Gallstones are similar to kidney stones (discussed above.) The main difference is that the stones are made of hardened digestive fluids that form in the gall bladder rather than the kidney. The gall bladder lives under the liver, and both organs are located on the right side of the body only.

Similar to kidney stones, gallstones are hard crystallized pieces that form in the organ and may cause problems. When gallstone symptoms make themselves known, they can include, among other things, pain under your right shoulder blade. 

Gall stones are likely related to a high fat diet, so one way to avoid this type of right side back (and abdominal) pain may be to change the way you eat.

And as with kidney stones, it’s best to work with your doctor to address gall stones.

Orthopedic and Neurological Reasons for Right Side Back Pain

And now for the muscles,bones and joint related reasons why the right side of your back may hurt. Here's the list:

Herniated Disc

Herniated disc occurs when the tough outer covering of the shock-absorbing cushion that's located in between two adjacent spinal bones frays or ruptures to the point where the soft, liquid-like substance on the inside begins to come out. In and of itself, that's not so bad, but problems generally arise when the escaped substance contacts a nearby spinal nerve root.

As you can imagine the spinal nerve root is very sensitive; anything it comes into contact with will likely irritate it and cause radiculopathy symptoms. Remember from above, radiculopathy symptoms include pain, weakness, numbness, electrical sensations and similar things that go down one leg.

These symptoms are, by nature, one-sided; herniated discs are generally "posteriolateral" meaning their direction of exit for the soft substance that escapes is a combination of back and side. (Posterior means back; lateral means side.)

While many people have surgery for their herniated discs (microdiscectomy) it's recommended to try a 6 week course of physical therapy first. This may abate symptoms and help you avoid the procedure. But if the pain, weakness, numbness and/or electrical feelings persist, surgery may make a good option for you.

Sacroiliac Joint Dysfunction

Similar to spinal discs, the sacroiliac joint has two areas—right and left—that can cause problems and pain. Unlike herniated disc, though, sometimes the two sides are related; in other words, if you have excess movement or locking on one side, you may feel it there, but you might also feel something the other side.

Another type of sacroiliac pain is caused by inflammation, and is an arthritic condition known as ankylosing spondylitis. Ankylosing spondylitis is a progressive, debilitating disease that over time can result in the fusion of the whole spine. The inflammation starts at the sacroiliac joints, though. Symptoms include stiffness, pain and immobility. If you experience these, try to get a diagnosis as early as you can to make managing this disease easier on you over the long haul.

Scoliosis

Scoliosis is a spinal deformity in which one or more areas of the spine curve to one side or the other. It's more complicated than this but when you look at the body from the back, this is what you'll see.

The curves (which are created by vertebrae that rotate,) lead to muscle imbalance on either side. On the concave side, muscles will likely get very tight and painful, while on the convex side of the curve, they'll likely become overstretched and weak. If you are an adult and you don't have a solid exercise plan for your scoliosis, over time, this can get worse, causing pain on one or both sides of your body.

Muscle Imbalances and Trigger Points

To help you sit, stand, walk, run and otherwise be active, the muscles, bones and joints of the body have an uncanny way of "robbing from Peter to pay Paul," so to speak.

It's all in the name of keeping you balanced and moving. But for whatever reason (and there are many potential ones) the balance that's established is often not the most ideal, leading to some muscles getting very tight, and others becoming overstretched and taut. In this case, you may develop painful spasms or trigger points on one side of the body or the other.

Muscles commonly affected include your quadratus lumborum which is your flank muscle and your gluteus medius which is located at the side of your hip, and plays a key role in keeping you from excessive side to side movement. Both can lead to pain on the right (or left) side of your back, depending on the nature of the imbalance.

A Word From Verywell

In sum, usually pain on the right side of the back is not serious. That said, it pays to be astute, as well as to check with your doctor about symptoms that linger, bother you or perplex you.

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