Causes of pain on the lower right side of the back range from strains and sprains to menstrual problems and kidney disease.

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Conditions that affect the muscles, bones, nerves, or organs can contribute to back pain on the lower right side.

This article explores the possible causes of back pain on the lower right side.

It also covers some causes specific to females and males and explains when to contact a doctor.

Ovarian tumors can be cancerous or noncancerous. According to the American Cancer Society, cancerous ovarian tumors can cause back pain.

Cancerous and noncancerous tumors can have similar symptoms, including:

  • abdominal pain
  • pelvic pain
  • gastrointestinal symptoms such as gas, constipation, and bloating
  • a quick feeling of fullness when eating
  • difficulty eating
  • frequent urge to urinate

When these symptoms occur as a result of cancerous ovarian tumors, they are usually persistent. If a person typically experiences any of these symptoms, the symptoms may become more severe or frequent when a cancerous tumor occurs.

Other symptoms of ovarian cancer are:

  • upset stomach
  • constipation
  • pain during intercourse
  • menstrual cycle changes
  • swelling of the stomach alongside weight loss
  • fatigue

A sprain occurs when a person overstretches or tears a ligament, whereas a strain is a torn tendon or muscle.

According to the National Institute of Neurological Disorders and Stroke, strains and sprains are the one of the leading causes of acute back pain.

A person may experience a sprain or strain as a result of:

  • lifting heavy objects or using improper lifting technique
  • twisting or jerking their body awkwardly
  • overstretching or not warming up properly before exercise
  • falling

Back pain that results from a strain or sprain can range from mild to severe and may radiate into the buttocks. It can cause symptoms such as:

  • aching, stiffness, or tenderness in the lower back
  • difficulty standing or sitting upright
  • muscle spasms in the lower back

The type of treatment will depend on the cause and severity of the symptoms.


A person can treat mild sprains and strains at home with rest, ice packs or heat packs, and over-the-counter (OTC) pain relievers such as acetaminophen and ibuprofen.

For people with more severe sprains and strains, a doctor may prescribe muscle relaxants and stronger pain relievers to help manage symptoms.

Other treatment options may include:

  • physical therapy
  • gentle massage
  • stretching exercises
  • electrical muscle stimulation
  • surgery

Spinal stenosis is a narrowing or compression of the spinal canal, which is the area inside the spine that contains the spinal cord. Although it can develop anywhere along the spine, it most commonly affects the lower back.

This narrowing places pressure on the spinal cord, which can cause numbness and pain that radiates to the lower back, buttocks, and legs.


Treatment options for spinal stenosis include:

  • anti-inflammatory medications
  • physical therapy
  • steroid injections

Doctors may recommend surgery for severe cases of spinal stenosis.

Certain minerals can build up in the kidneys and form hard deposits, or stones. Kidney stones vary in shape, size, and mineral content.

Small kidney stones can leave the body via the urine without causing symptoms. However, larger stones may cause blockages that can lead to sharp pain, typically on only one side. This pain may radiate to the groin and lower abdomen.

Kidney stones can also cause symptoms such as:

  • cloudy or bloody urine
  • foul-smelling urine
  • a frequent or urgent need to urinate
  • a painful burning sensation while urinating
  • fever and chills
  • nausea and vomiting

People who are experiencing symptoms of kidney stones should contact a doctor right away.


Treatment options for people with kidney stones include:

  • drinking plenty of fluids to help stones pass more quickly
  • taking prescription medications to ease pain and other symptoms
  • undergoing kidney stone removal, which may involve various procedures, such as shock wave lithotripsy, cystoscopy, and percutaneous nephrolithotomy

Doctors may also strain the urine to catch the kidney stone for analysis.

UC is a chronic condition that causes inflammation of the lining of the large intestine, or colon.

According to a 2020 study, UC and other forms of inflammatory bowel disease appear to have an association with sacroiliitis — inflammation in the pelvis that can cause low back pain.

Some other symptoms of UC are:

  • appetite loss due to nausea
  • a frequent need to have a bowel movement
  • unexplained weight loss
  • fatigue
  • fever
  • anemia

Learn more about UC and sacroiliitis.


There is currently no cure for UC. The aim of treatment is to achieve remission, which is a sustained period in which a person has few or no symptoms.

Treatment options depend on the severity of a person’s symptoms but can include medications such as:

  • aminosalicylates
  • corticosteroids
  • immunosuppressants
  • biologic therapies

If treatment does not improve the symptoms, a doctor may recommend surgical removal of the person’s colon.

The appendix is a small organ that connects to the first section of the large intestine. Appendicitis is an inflammation of the appendix that may occur as a result of a blockage or an infection.

Appendicitis typically causes pain that begins near the belly button and then moves lower and to the right. This pain can also radiate to the right side of the back.

Other symptoms of appendicitis include:


Appendicitis requires immediate medical care. People who think that they may have appendicitis should go to an emergency room immediately.

Treatment typically involves a procedure called an appendectomy, which is the surgical removal of the appendix.

Bacterial or viral infections that affect the urinary tract can move upstream into one or both kidneys. If a person does not receive treatment, a kidney infection can lead to serious complications such as chronic kidney disease, kidney failure, or sepsis.

Kidney infections can cause symptoms such as:

  • pain in the back, side, or groin
  • nausea and vomiting
  • cloudy, dark, or bloody urine
  • foul-smelling urine
  • frequent urination
  • a burning or painful sensation while urinating
  • chills and fever

People with symptoms of a kidney infection should contact a doctor as soon as possible.


Treatment for kidney infections usually involves a course of antibiotics. A doctor may also prescribe pain relievers to help ease a person’s symptoms.

Drinking plenty of water is important to prevent dehydration and fever.

Causes of pain in the lower right side of the back that are specific to females can include:

Period pain, or dysmenorrhea

“Dysmenorrhea” is the name for the pain a person can experience during their period. Although everyone experiences the symptoms of dysmenorrhea differently, the most common symptoms are:

  • lower back pain
  • pain and cramping in the lower abdomen
  • pain that radiates down the legs

A person may also experience:

  • nausea
  • fatigue
  • vomiting
  • diarrhea
  • headaches
  • fainting

To treat the pain, a person can:

  • take OTC pain relievers
  • use heating pads
  • massage the abdomen
  • take a hot bath or shower

Learn more about lower back pain during a period.

Uterine fibroids

Uterine fibroids are noncancerous growths that can develop in the wall of the uterus. Having them does not increase a person’s risk of developing uterine cancer.

Uterine fibroids can vary in size, and some people may not realize that they have any until a doctor detects them during a pelvic exam or an ultrasound.

Not everyone with uterine fibroids will have symptoms. Those who do may experience:

People without symptoms may not require treatment.

Treatment options can include:

  • OTC pain relievers
  • hormonal birth control
  • gonadotropin-releasing hormone (GnRH) agonists or antagonists
  • surgical procedures to remove fibroid growths, the lining of the uterus, or the entire uterus


Endometriosis is a condition in which tissue similar to the endometrium — the lining of the uterus — grows in other parts of the body, such as the ovaries, fallopian tubes, vagina, and cervix.

Endometriosis can cause chronic pain in the lower back or pelvis.

A person who has endometriosis may also experience:

There is currently no cure for endometriosis, so treatments focus on reducing symptoms and preventing further complications.

Treatment options for endometriosis include:

  • OTC pain relievers
  • hormonal birth control
  • GnRH agonists
  • surgical procedures to remove endometriosis tissue

Pelvic inflammatory disease (PID)

PID is an infection that typically occurs when a sexually transmitted disease, such as gonorrhea or chlamydia, spreads to the uterus, ovaries, or fallopian tubes.

Symptoms of PID can vary in severity and may include:

  • pain in the lower abdomen or back
  • unusual or unpleasant-smelling vaginal discharge
  • pain during or after vaginal intercourse
  • pain when urinating
  • fever and chills
  • nausea and vomiting

People with symptoms of PID should contact a doctor as soon as possible. Prompt treatment can help prevent or minimize scarring that can increase the risk of fertility problems and ectopic pregnancies.

Antibiotics can usually cure the bacterial infection that causes PID.

Pelvic pain during pregnancy

Some people experience pelvic pain during pregnancy. Pelvic pain can affect one or both sides of the lower back.

This pain may also affect the perineum or radiate to the thighs. It may become worse while a person is walking, standing up, or rolling onto their side.

A person may be able to reduce pelvic pain during pregnancy by:

  • doing exercises that strengthen the pelvic floor
  • stretching
  • taking warm baths
  • wearing flat, comfortable shoes
  • avoiding standing for too long
  • getting plenty of rest

People can also try applying ice or heat packs to help ease the pain.

OTC acetaminophen is generally safe to take during pregnancy. However, it is advisable to consult a doctor before taking any medications while pregnant.

Testicular torsion can cause back pain on the lower right side in males.

It occurs when the testicle rotates inside the scrotum, causing the spermatic cord to twist. A twisted spermatic cord can reduce or completely block blood flow to the testicle. This can cause irreversible damage.

Testicular torsion can cause the following symptoms:

  • severe and unexpected pain in the testicle or groin
  • pain that radiates to the right or left side of the back
  • swelling of the scrotum
  • nausea
  • vomiting
  • blood in the semen
  • pain in the low abdomen

Testicular torsion is a medical emergency, and anyone who experiences these symptoms should seek immediate medical attention.

Treatment involves a surgical procedure to either untwist the spermatic cord or remove the testicle.

People with severe, persistent, or worsening lower back pain should consult a doctor right away.

A person should also seek medical attention if they have lower back pain along with any of the following symptoms:

  • painful urination
  • cloudy, bloody, or foul-smelling urine
  • stools containing blood or pus
  • fever
  • nausea
  • vomiting
  • pain during or after sex
  • severe groin pain
  • irregular periods

The following are answers to commonly asked questions about lower back pain.

When should I worry about lower right back pain?

While lower right back pain is typically not anything serious, people should contact a doctor if their pain is severe or worsening. They should also get attention if they have painful urination, fever, nausea, or vomiting.

What causes lower back pain in females?

Beyond simple muscle strain or a pinched nerve in the lower back, female-specific causes include period pain, endometriosis, uterine fibroids, pelvic inflammatory disease, and pelvic pain during pregnancy.

How can you tell if back pain is muscular or something else?

Muscular back pain can be an aching or stiffness in the muscle of the lower back. However, a pinched nerve in the lower back or problems in the abdomen can be felt in the lower back.

Some causes include falls, twisting, or lifting heavy objects.

See a doctor if symptoms persist for more than a few days or fever develops.

Lower back pain is very common. Possible causes of lower back pain on the right side include sprains and strains, kidney stones, infections, and conditions that affect the intestines or reproductive organs.

People should consult a doctor if they experience lower back pain that does not improve with rest or affects their daily life.