Lower back pain on the right side – one of the most common lower back pain symptoms 

What are the different causes of lower back pain on the right side?


Several  different problems can cause lower back pain on the right side. Up to date guidelines advise that lower back problems are grouped into one of three categories 1.

  • The first – non-specific lower back pain - is the most common, up to 95% of people with back pain on the lower right side will have this problem.
  • The second category is nerve root irritation, this is much less common, less than 5% of us get this type of back problem. This tends not to cause left or right side back pain on its own but its more often felt with leg or buttock symptoms.
  • The third, much less common type of problem, less than 1% of us suffer from this , is serious or specific lower back pain.

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What are the most common causes of back pain on the lower right side?

In my experience non-specific lower back problems are usually the main culprit. This diagnosis describes many different back problems, none of which are serious but all of them can cause you to have quite nasty or severe lower back pain.

1. Facet joint strain is a common problem that causes lower right back pain


Check the human spine anatomy  section on this site and you will see that your spine is made up of large bones called vertebra that overlap each other to form a pair of joints at the back. These joints are called facet joints and they allow movement in the lower back. They are like finger joints in a way, they allow gliding and sliding and let us move in all directions. Each joint is surrounded by  ligaments and by supportive muscles. It’s very common for us to strain or stress one of these joints which can lead to lower back pain on the right or left side.

2.Lower Back Muscle spasm – including the erector spinae muscles - can cause lower back pain on the right side


If we subject our lower back to too much stress and strain eventually it becomes sore. The stress and strain can be caused by sudden, unexpected movements but most commonly it is a prolonged slower stresses that cause the problem, such as sitting in a poor posture for a long time for example.  If a joint becomes stressed or strained often the muscles surrounding it will tighten up to give it a bit more support, this can lead to back muscle spasm which in turn is painful.  There are many back muscles that can be affected by this, the erector spinae in particular.

3. Spinal disc degeneration causing ‘micro-instability’


The research base is developing rapidly and we are learning more and more about spinal disc degeneration. These changes can occur in quite young people and  are not limited just to older people. As the disc becomes degenerate it dehydrates and  can’t  offer the same degree of support and control that it used to. This in turn leads to increased stress on the facet joints, ligaments and protective back muscle spasm can then occur. New studies are also finding that the disc itself can be painful, a normal disc has little nerve supply but a degenerate disc develops extra sensory nerves which can contribute to symptoms. Facet joint problems can occur as a result of degenerative disc disease  and can cause lower back pain on the right or left side.

4. Sacroiliac Joint problems – if your lower back pain on the right side is a little lower down then this might be the problem


Although less common there are a significant number of people who struggle with this condition. It mostly affects women, especially those who have had children. It can be caused by trauma, childbirth or inflammation from diseases such as ankylosing spondylitis.  You can find more information in the causes of back pain section on this website.


5. More serious problems that can cause right side back pain


Less common causes of right side lower back pain  that need to be ruled out are serious problems such as cancer ,infections, fractures and inflammatory joint problems such as ankylosing spondylitis. Your doctor will be able to rule out any of these serious back problems.


What is the best treatment for back pain on the lower right side?


Obviously treatment for this lower back symptom is dependent on knowing what the actual diagnosis is. For this you will need to see a doctor or other health care professional. Assuming you are happy that your problem is the non-serious non-specific type then you will find helpful suggestions for managing it in the treatment sections of this web site.

 

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References

1.  National Institute for Health and Clinical Excellence Back pain - low (without radiculopathy) - Management. Clinical Knowledge Summary. Nov,  (2009).

 

01-Feb-2013

 

 

 

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