In some cases, low back pain is felt entirely or primarily on the right side rather than spread evenly across the back. Understanding the possible causes of lower right back pain, as well as its typical characteristics, can help lead to an accurate diagnosis and more effective treatment.

General Causes of Lower Right Back Pain

Lower right back pain most commonly results from the following general sources:

  1. Injury to the muscles, ligaments, and/or tendons surrounding and supporting the spine (collectively called soft tissues)
  2. Problems with the spinal structures, such as the facet joints or intervertebral discs
  3. Issues or diseases affecting the internal organs in the mid-back, abdominal, or pelvic regions

Watch: Causes of Lower Back Pain Video

Seeing a doctor is recommended if lower right back pain continues or worsens after a few days, or if there is sudden onset of severe pain, or if it occurs with other concerning symptoms.

See When Back Pain May Be a Medical Emergency

Most cases of low back pain stem from minor injuries to the muscles and/or ligaments in the lower back, and the body is usually well-equipped to heal itself after these types of injuries. While the initial pain of a muscle strain may be significant, the pain tends to subside on its own over a few days or weeks.

See Pulled Back Muscle and Lower Back Strain


Lower Right Back Pain and Emergency Symptoms

In some cases, lower right back pain can be one sign of a serious condition needing attention from a health professional. For example, the following potentially serious conditions may include lower right back pain as one of the symptoms:


This condition occurs when the appendix, located in the lower right hand side of the abdomen, becomes inflammation and/or ruptures. It may cause sharp, intense lower right back pain and/or pain on the lower right side of the abdomen. Symptoms vary and may include nausea, vomiting, or fever. Symptoms may occur suddenly or develop gradually.

Cauda equina syndrome

This condition occurs when the nerve roots exiting the bottom of the spinal canal in the lower back region become compressed and inflamed. Symptoms vary with cauda equina syndrome, but typically will include some degree of bowel and/or bladder dysfunction, as well as sharp pain and significant weakness, numbness, or tingling in the lower body.

See Cauda Equina Syndrome Symptoms


Abdominal aortic aneurysm

An aneurysm in the abdominal area refers to the ballooning or rupture of the abdominal aorta. The range of symptoms will typically include severe, sudden-onset abdominal and/or low back pain, and symptoms of low blood pressure such as fainting and/or nausea.

See Abdominal Aortic Aneurysm Symptoms


This is an infection in the spine. It will typically present with significant back pain, along with a fever. Additional symptoms may include unexplained weight loss and possible swelling, redness, or tenderness around the spine.

Patients need to use their judgment in seeking medical attention; as a general rule, it is advisable to see a doctor if the back pain is severe to the point of interrupting daily functions, such as walking, standing, or sleeping, and/or if intense back pain comes on suddenly and does not seem to subside with rest or pain medications.

See Medications for Back Pain and Neck Pain

The above list is not intended to be an exhaustive list of all possible causes of lower right back pain. For example, chronic pain conditions, such as fibromyalgia or ankylosing spondylitis, which affect large portions of the musculoskeletal system.

See Ankylosing Spondylitis Video

Dr. Lawrence Alexander is an orthopedic surgeon with more than a decade of clinical experience treating back and neck conditions with surgical and non-surgical methods. He specializes in minimally invasive spine surgery.