Pain in Right Side of the Back: 11 Common Causes

Updated in December 2023

What is it:

Pain on the right side of the back is usually caused by muscle, ligament or tendon injuries that may arise from everyday situations, like  poor posture or carrying heavy objects. Mild pain can usually be relieved with conservative measures like rest and warm compresses.

However, right back pain can be associated with specific health conditions that affect the organs on the right side of the body, such as the kidney, gallbladder, lung, or appendicitis, especially when the pain is very intense or persists for many days. These conditions typically require immediate medical attention.

It is important to consult a general practitioner, orthopedist or pulmonologist whenever pain appears on the right side of the back, especially when it is frequent or accompanied by other symptoms, such as fever, nausea, cough, difficulty urinating or breathing and, therefore, , be diagnosed and begin the most appropriate treatment.

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What causes pain on the right side of the back?

The main causes of right back pain are:

1. Muscle injuries

Muscle, ligament or tendon injuries in the back are the most common cause of back pain on the right or left side. These usually occur due to physical activities, lifting or carrying heavy objects, poor posture, repetitive movements or direct blows to the back.

These conditions can cause inflammation and muscle spasms, which generally worsen with movement. Pain is described as  heaviness or tightness in the back, which can interfere with daily activities.

What to do: Some ways to relieve muscle pain are to apply a warm compress to the area for 15 minutes, twice a day. Many patients may also find anti-inflammatory ointments beneficial. It is also important to avoid exertion during this time and to maintain correct posture on a daily basis, as well as stretch to reduce muscle tension and alleviate discomfort.

2. Sciatic nerve inflammation

Sciatic nerve inflammation can occur due to compression of this nerve from spinal problems like a herniated disc. It causes pain in the lower back on the right or left side.

Sciatica usually appears suddenly and disappears in less than 1 week and can also affect the buttocks, and radiate to the back of the thigh and foot, causing a tingling, stabbing, shock or burning sensation.

What to do: Sciatica stretches and cold-heat therapy can be beneficial for relieving discomfort. There are also medications for sciatica that you can take to help manage pain. However, if the pain does not improve or if symptoms such as difficulty walking, sitting or carrying out daily activities appear, you should consult a doctor who can prescribe the most appropriate treatment approach.

3. Herniated disc

A herniated disc can cause pain in the spine on the right or left side, and can affect different regions of the spine, such as the lumbar, thoracic or cervical region. This pain can radiate to other locations such as the legs and arms, and is often described as a a burning sensation, tingling or weakness.

A herniated disc occurs when a vertebral disc, located between the vertebrae of the spine, bulges out of its correct position, or ruptures, which ends up causing compression of the nerves in the region.

What to do: Treatment for a herniated disc should be carried out by an orthopedic surgeon who may recommend the use of analgesic and anti-inflammatory medications, such as acetaminophen or ibuprofen. Physiotherapy can also help relieve pain and reduce inflammation. In more serious cases, the doctor may recommend surgery. 

4. Osteoarthritis

Osteoarthritis of the spine is a disease that occurs due to wear and tear on the cartilage of the vertebrae. It can affect different regions of the spine, such as the cervical or lumbar region, and cause pain on the right or left side of the back.

This spinal condition can cause severe back pain that worsens with movement, and lead to difficulty moving the affected region. This pain can radiate and cause tingling or numbness in the legs, arms or neck.

Despite being more common in the elderly, osteoarthritis can also affect young people. The cause of osteoarthritis in younger patients is usually associated with accidents, excessive physical activity or lifting too much weight.

What to do: Treatment of osteoarthritis in the spine should be guided by an orthopedic surgeon. Given there is no cure, it is aimed at relieving symptoms and preventing worsening. The doctor may prescribe analgesics, anti-inflammatories, corticosteroids or opioids, for example, as well as physiotherapy and, in severe cases, surgery.

5. Rib fracture

Rib fractures on the right side can produce right back pain that starts suddenly, or they can present with mild pain that lasts for weeks and ends up weakening the entire region, causing difficulty breathing.

This type of fracture is more common in the elderly due to the weakening of the bones from natural aging or from direct trauma. Athletes are also susceptible to this injury due to blows, especially in high-impact sports, such as wrestling or football.

What to do: If a rib fracture is suspected, you should seek urgent medical attention and complete imaging tests, such as a chest X-ray, to confirm the condition. Treatment usually involves painkillers to relieve pain while recovering from the fracture. 

6. Osteoporosis

Osteoporosis is a condition that can affect the spine, causing back pain on the right or left side. It occurs when the bones of the spine are weaker and more fragile due to a decrease in bone mass. This lower bone density is usually related to the body's reduced ability to metabolize and absorb dietary calcium, which is a mineral that is essential for bone health.

This disease is more common after the age of 50 and in women, especially after menopause. It can the risk of spinal fractures, which can cause sudden stabbing pain in the back that worsens when walking, standing, coughing or sneezing, and improves when lying on your back or sitting. 

What to do: Treatment of osteoporosis should be directed by a family doctor or orthopedic surgeon, who may prescribe medication that stimulates the production of bone mass, such as calcium and vitamin D supplements.

In addition, your doctor a registered dietitian may advise a diet with plenty of vitamin D foods and calcium. 

7. Ankylosing spondylitis

Ankylosing spondylitis can cause back pain on the right or left side due to an injury to the spine in the region where the vertebrae come together. It is associated with symptoms such as difficulty moving the spine and pain, which can worsen at rest and improves with movement.

What to do: Treatment should be guided by an orthopedic surgeon who may prescribe medications like analgesics, anti-inflammatories or muscle relaxants to relieve pain and improve joint mobility. Physiotherapy can also help to increase flexibility and mobility, improving quality of life. 

8. Kidney stones

Kidney stones in the right kidney usually cause intense pain in the right lower back or right side of the body on the right side. The stone can travel to any part of the urinary tract, from the ureters, bladder, to the urethra, causing intense pain along the entire route it passes through.

In addition, other symptoms may appear, such as pain that radiates to below the rib, legs or groin, spikes of intense cramps, nausea, vomiting, pain or burning when urinating, fever above 38ºC or the presence of blood in urine. Check out our online kidney stone symptoms quiz to determine your risk for this condition.

What to do: You should seek medical attention immediately if you suspect you may have kidney stones. The doctors will initiate IV analgesics to help relieve pain, however a surgical procedure may be necessary to remove or break the stone into smaller pieces, allowing for elimination in the urine. You can also use these home remedies for kidney stones to complement your medical treatment to help facilitate elimination or prevent further stones from forming.

9. Gallstones

Gallstones typically cause intense and sudden pain in the belly on the right side, just below the ribs, which can radiate to the back or right shoulder. Other common symptoms include nausea, vomiting, diarrhea, a feeling of fullness and loss of appetite.

Gallstones are generally caused by excess cholesterol in the bile and difficulty emptying the gallbladder, leading to the formation of small crystals that tend to increase in size, forming larger stones that impair the flow of bile into the intestine.

When the stone completely obstructs the passage of bile to the intestine, symptoms like fever, persistent abdominal pain, drowsiness or low blood pressure may also appear.

What to do: Gallstone treatment is typically directed by a gastroenterologist, and involves a gallbladder diet, medication help dissolve the stone (such as ursodeoxycholic acid) or even antibiotics in cases of infections. It is important to seek medical attention immediately if symptoms of bile outflow obstruction appear, as surgery may be necessary to remove the gallbladder and avoid complications, such as cholangitis or choledocholithiasis.

Check out home remedies for gallstones that you can take to complement your prescribed treatment and prevent gallstones in the future.

10. Appendicitis

Appendicitis is inflammation of the appendix, which is a part of the large intestine, located on the lower right side of the abdomen. Swelling is generally caused by the accumulation of feces and bacteria in this area.

This inflammation leads to strong, sharp pain on the right side of the belly, which may also be accompanied by lack of appetite, nausea, vomiting and fever, and may radiate to the back, causing pain on the right side of the spine. Check-out our online appencitis symptoms quiz to determine your risk for this condition.

What to do: Appendicitis pain is a medical emergency and must be treated as quickly as possible in the hospital. The appendix is usually surgically removed to avoid complications, such as infection in the peritoneum or abdominal abscess.

11. Pleuritis

Pleuritis is a condition in which the pleura, a membrane that covers the lungs, becomes inflamed. When this inflammation occurs in the right lung it can cause pain on the right side below the rib that worsens when breathing. This pain can radiate to the right back or shoulders, depending on the inflamed site of the pleura and the extent of the injury.

Other common symptoms of pleuritis are constant coughing, pain that worsens when taking a deep breath, coughing or sneezing, feeling short of breath, difficulty breathing or fever.

Pleuritis can be caused by bacterial, viral or fungal pneumonia, tuberculosis, lung cancer or lung failure.

What to do: Treatment for pleuritis is guided by a lung specialist, and usually involves anti-inflammatory or analgesic medications, such as Ibuprofen or naproxen, to reduce pain and alleviate discomfort. Bronchodilators can help to improve breathing. and reduce shortness of breath. Additionally, the doctor may recommend the use of antibiotics to treat pneumonia or tuberculosis, or anticoagulants in the case of pulmonary infarction.

In addition, respiratory physiotherapy may also be indicated to help improve breathing capacity.