There are several potential troubling symptoms that accompany lower right back pain and these symptoms, while rare, may indicate a serious medical condition and must be treated on an urgent basis.

See A Guide to Lower Right Back Pain

A CT or MRI scan may be recommended to confirm the suspected cause of your back pain.
Read:
Getting an Accurate Back Pain Diagnosis

Specific red-flag symptoms related to lower right back pain include:

1. Retention of urine or complete loss of bowel and/or bladder control

If you experience any changes in your bowel and/or bladder control, it can indicate damage to your spinal cord or cauda equina (nerves that descend from the spinal cord).1,2 The possible changes may include:

  • Incontinence: Loss of control over bowel and/or bladder movements.1
  • Retention or incomplete voiding: The inability to pass urine, a reduced urinary sensation, a loss of desire to pass urine, or a poor stream.1,2
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The symptoms may start slowly or abruptly and typically indicate a compression of the spinal cord or cauda equina (conus medullaris syndrome or cauda equina syndrome). Conus medullaris syndrome typically causes retention of urine; urinary incontinence is more common in cauda equina syndrome. These syndromes may progress to lower body paralysis if left untreated.

Read more about Cauda Equina Syndrome Symptoms

2. Saddle anesthesia

Spinal cord or cauda equina compression may cause a specific type of numbness, called saddle anesthesia. The numbness may occur in one or more of the following parts2,3:

  • Groin
  • Buttocks
  • Genital region
  • Inner thighs

Saddle anesthesia is typically accompanied by sexual dysfunction (often causing lack of pleasure or numbness during intercourse) and pain and/or weakness in both legs.

See Causes of Cauda Equina Syndrome

3. Abdominal and side pain

If your lower right back pain is accompanied by severe pain in your abdomen and/or on the side of your abdomen, it may indicate a serious and possibly life-threatening condition called abdominal aortic aneurysm. Pain may also occur in your hip, groin, and/or buttock.4

See Abdominal Aortic Aneurysm Symptoms

Your abdominal aorta is a large artery and this condition is caused when a part of the artery bulges out. While the pain may be vague initially, it can progress to sharp and/or stabbing when the bulge on the aorta presses against a spinal structure.4

See Abdominal Aortic Aneurysm Causes

In addition, there are anatomic irregularities in some people that can lead to lower right back pain. For example, depending on where the appendix is located, in some people, an inflamed or ruptured appendix may present primarily as lower back pain.

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As a general rule, back pain accompanied by fever, nausea, vomiting, progressive or unexplained weight loss, mental health changes, such as confusion or anxiety may indicate a tumor, cancer, or infection and requires urgent medical evaluation. must be evaluated by a medical professional.

Consult your doctor immediately if you experience any of these listed symptoms or other troublesome signs. If the symptoms occur at night, it is advisable to visit the emergency room and not wait until the next morning to check with a doctor. Timely treatment in these conditions is crucial and may also be lifesaving.

See When Back Pain May Be a Medical Emergency

Learn more:

Lower Right Back Pain from Internal Organs

Abdominal Aortic Aneurysm Treatment

References

  • 1.Kim K-H, Kim DH. Diagnosis and Treatment of Spinal Pain. In: Minimally Invasive Percutaneous Spinal Techniques. Elsevier; 2010:1-28. doi:10.1016/b978-0-7020-2913-4.00001-x
  • 2.Fairbank J, Mallen C. Cauda equina syndrome: implications for primary care. Br J Gen Pract. 2014;64(619):67–68. doi:10.3399/bjgp14X676988
  • 3.Verdugo RJ, Campero M, Castillo JL, Cea G. Pain and Temperature. In: Textbook of Clinical Neurology. Elsevier; 2007:363-381. doi:10.1016/b978-141603618-0.10020-7
  • 4.de Boer NJ, Knaap SF, de Zoete A. Clinical detection of abdominal aortic aneurysm in a 74-year-old man in chiropractic practice. J Chiropr Med. 2010;9(1):38–41. doi:10.1016/j.jcm.2009.12.002
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