Mechanical problems with the spine, muscles, tendons, and ligaments are the most common causes of lower right back pain. Other causes may include infections, kidney stones, or appendicitis. The treatment for these issues varies depending on the cause, but it may involve physical therapy or surgery.

The lower back carries a significant amount of weight and is susceptible to injuries on both sides. It is also possible for conditions affecting other areas of the body, such as infections or inflammation, to cause lower right back pain.

The cause of lower right back pain can determine how it feels. In some cases, people may experience a dull ache that lasts a long time or comes and goes. In other cases, they may have sharp, shooting pain. The pain may be specific to the right-hand side, or it may be present in other areas of the back and legs too.

In this article, we discuss some of the potential causes of lower right back pain and their treatment options.

Sprains and strains

Man working in warehouse holding lower right back in pain
Heavy lifting can result in sprains and strains, which are common causes of lower right back pain.

These injuries are the most common cause of lower back pain. Sprains occur when there is an overstretching or tearing of ligaments in the back, while tears in the muscles or tendons of the back cause strains.

Sprains and strains can occur due to an injury, a sudden movement, or lifting a heavy object. The resulting damage can be painful and restrict movement in this area of the body. Either a sprain or strain can occur on the right side of the lower back.

The body can heal these injuries itself, but people may wish to take anti-inflammatory drugs, such as ibuprofen, to manage the discomfort. In some cases, physical therapy may aid recovery.

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Radiculopathy

Radiculopathy occurs when inflammation, compression, or injury affects the root of a spinal nerve. It can result in lower back pain, which may occur on either side.

The causes of radiculopathy vary. A herniated disc, where a disc in the spine slips out of place, is one potential cause.

The treatment for this condition will depend on its cause. Anti-inflammatory medications can often help manage symptoms. In more serious cases, steroid injections may be necessary to control inflammation and reduce pain.

If someone is overweight, losing weight will help reduce the pressure on the area. Physical therapy can also help by strengthening the surrounding muscles.

Spinal stenosis

This condition occurs when the space around the spinal cord narrows and puts pressure on the spine and nerves. This increased pressure can lead to pain and numbness in the lower back and legs. It is most commonly a result of arthritis.

Spinal stenosis has a range of different treatments that include:

  • nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen
  • physical therapy
  • steroid injections
  • surgery

Intervertebral disc degeneration

Woman having physical therapy stretching arms with doctor
Physical therapy can help treat intervertebral disc degeneration.

Intervertebral disc degeneration is a common condition in which the discs that support the bones, or vertebrae, in the spine degenerate.

This degeneration, which occurs most often in the lower back, increases the friction between the vertebrae. This friction can lead to pain in the back, neck, arms, and legs.

Intervertebral disc degeneration often occurs as a person ages. Treatments for the condition may include:

  • physical therapy
  • steroid injections
  • facet rhizotomy, which involves injecting joints to decrease nerve pain
  • pain medications, such as NSAIDs or steroids
  • surgery

Infections

Infections that may lead to lower back pain on either side can occur in several places in the body.

It is possible for the spinal cord, pelvis, or intervertebral discs to become infected and cause lower back pain. It is also possible for bacteria to reach the kidneys and cause an infection. The kidneys are in the lower back, where they sit slightly toward the right-hand side.

The cause of the infection will determine its treatment. Antibiotics are the standard treatment for bacterial infections.

Endometriosis

Endometriosis is a condition in which tissue that usually lines the uterus grows elsewhere in the body. It is possible for this tissue to appear around the right side of the abdomen, causing pain in the region.

There is no cure for endometriosis, but treatment can provide relief from the symptoms. Treatment options include:

  • pain medications, such as NSAIDs or acetaminophen
  • hormone therapy
  • surgery

Endometriosis can cause infertility. For this reason, some women with this condition may also wish to undergo in vitro fertilization or other methods that promote fertility.

Spinal tumor

A spinal tumor can grow on the spinal cord or spinal column.

The cause of most spinal tumors is unknown. In some cases, the tumor can be the result of cancerous cells aggressively replicating. The tumor can put pressure on the spine and its surrounding nerves, which can result in lower back pain on either side.

The treatment for a spinal tumor will depend on the cause. For cancers, it can involve radiation therapy or chemotherapy. In some cases, surgery may be necessary to remove the tumor.

Kidney stones

Large kidney stones can block the urinary track.
Large kidney stones can block the urinary tract.

Kidney stones are small, solid lumps of minerals that can form in one or both of the kidneys.

Smaller kidney stones are painless to excrete, but larger kidney stones can cause significant issues. They can become stuck and cause a lot of pain. If the stones affect the right kidney, this could cause lower right back pain.

It is important to remove large kidney stones immediately if they are blocking the urinary tract or causing significant pain.

Treatment will involve breaking the stone into smaller pieces for excretion. In some cases, this will require surgery.

Appendicitis

Appendicitis is the inflammation of the appendix, which is a small pouch next to the large intestine. Appendicitis causes pain in the abdomen that can travel down the right side of the body.

Treating appendicitis usually involves surgery to remove the appendix. It is not harmful to remove the appendix, and it will not affect how the body functions.

Outlook

The outlook for lower right back pain will depend on its cause.

Mechanical injuries to the spine or surrounding tissues can often heal without treatment, but this can take time. Physical therapy and other treatments may speed up the recovery process. Some conditions, such as disc degeneration and endometriosis, are lifelong and people will require ongoing treatment to manage the symptoms.

The outlook for infections or other causes will generally be better when people receive prompt and effective treatment.