The appearance of painful sensations in the body indicates some health problems associated with various reasons. At the same time, the localization of pain can already tell a lot. For example, if the lower back hurts on the right side at the bottom, this often indicates diseases of the kidneys, pancreas and other internal organs or problems with the musculoskeletal system. It is unreasonable to leave such pain unattended. A timely visit to a neurologist
will help you avoid more serious problems and serious, expensive treatment.
Reasons why the lower back hurts on the right
Back pain (in the lower back or higher) can have a wide variety of causes. If you try to list all the options, you will get a whole book with a huge table of contents - from abruptly getting up from a chair or sofa, from simple fatigue and overwork as a result of sports activities to serious problems with internal organs. Only a specialist can find out the cause and make an accurate diagnosis followed by well-chosen treatment. The main causes of lumbar pain syndrome include the factors listed below.
Muscle inflammation
Pain often occurs due to overexertion, after playing sports and excessive physical activity, as well as as a result of sudden movements or lifting unbearable weights. Typically, lower back pain goes away within a few days and does not require serious medical intervention. But you should consult a doctor about painkillers and ointments. If your back hurts in the lumbar region on the right, you need to see a doctor.
Osteochondrosis and sciatica
The most common cause is called osteochondrosis, which causes pain after sudden and intense movements, as well as when coughing, laughing or sneezing. Depending on your overall health, the pain may spread to your hips and buttocks. Sometimes the pain completely immobilizes a person for some time.
Spinal hernia
With a hernia, as a rule, a person feels a dull aching pain that appears due to pinching and which radiates to the legs and buttocks. Other problems with the spine also cause pain in the lumbar region: joint diseases, stenosis, ankylosing spondylitis, etc.
Age problems
The main cause of lower back pain in older people is problems with the spine and associated age-related changes (deterioration of bones, joints, ligaments, old injuries, etc.). Changes can be of a very different nature and be associated with any of the existing problems.
Kidney and liver diseases
Pain in the lower back on the right may indicate kidney infections and the presence of stones, which is usually accompanied by fever, nausea or vomiting, and difficulty urinating. If there is pain on the right because of the liver, then this can be caused by hepatitis, cirrhosis, or complete cessation of liver function.
Nature of pain
The pain reaction in the right side and back can differ in intensity, character and duration.
Depending on the intensity of the pain syndrome, there are 2 main types: acute and chronic pain. Epicritic (acute or primary) pain reaction can be burning, cutting, stabbing. It has a clear localization, but can change intensity when moving or changing the position of the body. With an exacerbation of the disease that caused this syndrome, the patient cannot fixate in one position. Acute pain is often caused by spinal injuries, radiculitis (pinched spinal roots), myositis (inflammation of skeletal muscles), and cancer.
Protopathic (secondary or chronic) pain reaction can be aching, pulling and dull. It spreads from the primary focus higher or lower, so its exact localization cannot be established. Despite the fact that the pain is moderate, it is impossible to get used to it. In most cases, it is caused by diseases of the heart and blood vessels, gastrointestinal tract, genitourinary system, and other abdominal organs. Another cause of chronic pain syndrome is pregnancy.
Lower right lower back pain
This localization of pain occurs due to the appearance of tumors or after injury. Discomfort can occur even as a result of intense physical activity (sports or physical labor). In women and men, pain in this area may indicate problems in gynecology (inflammation, ectopic pregnancy, oncology) and urology. If the lower back hurts on the right back and below, this is considered relatively normal only in late pregnancy, when the fetus is located close to the back wall of the uterus and puts pressure on the sacrum of the expectant mother.
Diagnostics
A gastroenterologist examines patients with complaints of pain in the right side; if necessary, other specialists are involved - a surgeon, a gynecologist, a nephrologist. During the physical examination, peritoneal symptoms, specific signs of appendicitis are checked, and deep palpation of the abdomen is performed. To establish a diagnosis, laboratory and instrumental methods are recommended:
- Sonography.
Ultrasound of the abdominal organs is a screening method. Using ultrasound, inflammatory processes, space-occupying formations, and enlarged mesenteric lymph nodes are detected. Doppler ultrasound visualizes blood flow in the large vessels of the abdominal cavity. - Radiography.
A survey radiograph is not very informative; detailed visualization of the intestine is provided by irrigoscopy with double contrast. The method is suitable for detecting tumors, ulcerative defects, local narrowing or expansion of the intestine. Abdominal CT is widely used. - Colonoscopy.
Using endoscopic instruments, the mucous membrane of the colon is examined, and a biopsy sample is taken for chronic inflammation or suspected cellular atypia. If symptoms indicate damage to the small intestine, a modern method is used - video capsule endoscopy. - Gynecological examination.
Women undergo a standard bimanual examination and vaginal speculum examination. To exclude pathology of the appendages, an ultrasound of the pelvic organs is performed. For a more detailed examination, hysteroscopy, transvaginal sonography, and hysterography are prescribed. - Laboratory methods.
The list of mandatory studies includes clinical blood and urine tests, coprogram, and checking stool for helminth eggs. The expanded diagnostic complex includes biochemical blood tests with assessment of the content of acute-phase proteins, and stool culture.
Upper right lower back pain
If you have back pain above the lower back on the right, then most likely they arise due to a disruption in the normal functioning of the internal organs - both the gastrointestinal tract and the genitourinary system. With such localization of pain, it is customary to first assume gallbladder disease, kidney stones
or radiculitis. However, pain is not the only indicator. Each specific case has its own accompanying symptoms.
Determining the cause of pain by symptoms
The table was compiled by Victoria Druzhikina, a practicing therapist on the AskVracha website, and serves as the most reliable source of information when determining the cause of pain.
| Disease | Symptom | Drugs used |
| Acute cholecystitis | Acute, severe pain radiating downwards, nausea, vomiting, fever, loose stools. | Antispasmodics (Duspatalin, No-shpa, Papaverine); Antibiotics (Ciprofloxacin, Amikacin, Meropenem); Analgesics (Diclofenac, Ketorol); Antacids (Famotidine, Omeprazole, Rabeprazole). |
| Chronic cholecystitis | Most often dull, aching, paroxysmal pain, intensifying after fatty foods, rarely - pronounced, loose stools. | Antispasmodics (“Duspatalin”, “No-shpa”, “Papaverine”); Antibiotics (“Ciprofloxacin”, “Amikacin”, “Meropenem”); Analgesics (“Diclofenac”, “Ketorol”); Antacids (Famotidine, Omeprazole, Rabeprazole). |
| ZhKB | Sharp, cutting pain, nausea, vomiting, yellowing of the skin, loose stools" | Antispasmodics (“Duspatalin”, “No-shpa”, “Papaverine”); Antibiotics (“Ciprofloxacin”, “Amikacin”, “Meropenem”); Analgesics (“Diclofenac”, “Ketorol”); Antacids (Famotidine, Omeprazole, Rabeprazole), surgery |
| Hepatitis | The pain is strong, but dull, and may be nagging. Nausea, vomiting, fever, loose stools, weakness, sweating. | Specific antiviral therapy. |
| Cirrhosis of the liver | Dull, in the final stage severe pain, ascites (fluid in the abdominal cavity, looks like a bulging belly), yellow-brown tongue, weakness, nausea, vomiting, loose stools, heaviness in the right side. The protruding edge of the liver is often visible from under the ribs. In the final stage, the organ shrinks and stops protruding. | Hepatoprotectors (“Heptral”, “Ursosan”, “Ornithi”n, milk thistle extract); Proton pump inhibitors (Omeprazole, Rabeprazole, Esomeprazole); Anticholinergic drugs (Mebeverine, Trimebutine). |
| Appendicitis | Many faces - pains are sharp, dull, strong, weak, from the navel to the level of the sternum. Nausea, single vomiting. Fever. Loose stools. Mixing of pain from the epigastrium to the right iliac region after 3–4 hours from the onset (Kocher’s symptom). | Surgery |
| Enteritis, colitis | Pain along the intestines, rumbling in the abdomen, bloating, blood and mucus in the stool. The stool is irregular, liquid. | Antispasmodics (“No-shpa”, “Papaverine”); Antidiarrheal ("Smecta") |
| Bowel cancer | The pain is aching at first, then severe. Constipation, obstruction, weight loss. | Surgical treatment, chemotherapy, radiation |
| Nephroptosis | The pain is often associated with sudden movements, especially high jumps. Varying intensity, usually medium. | Kinesiology. Osteopathy. Surgical correction – kidney suturing |
| Osteochondrosis | The pain comes from the spine and intensifies with movement, inhalation, and coughing. At rest I subside or decrease. | NSAIDs (“Meloxicam”, “Xefocam”, “Diclofenac”, “Aertal”); Muscle relaxants (“Sirdalud”, “Mydocalm”); Chondroprotectors (“Teraflex”, “Dona”, “Arthra”); B vitamins (“Neurobion”, “Combilipen”, “Milgamma”). |
| Endometriosis | The pain is quite intense and is accompanied by cycle disruption and bleeding. | Surgery; Hormonal drugs. |
| Bruise, injury | Pain is associated with a fall, blow, etc., and is limited by this impact. Intensifies with pressure. Accompanied by the formation of a hematoma and bruise. | NSAIDs (Meloxicam, Xefocam, Diclofenac). |
| Myositis | Pain in the muscle, intensifies with pressure and movement. Quite noticeable, subsides when resting. | NSAIDs (“Meloxicam”, “Xefocam”, “Diclofenac”, “Aertal”); Muscle relaxants (“Sirdalud”, “Mydocalm”); |
Classification of pain syndrome
Right lower back pain can be classified according to different parameters. One of them is the nature of pain:
- aching pain may indicate osteomyelitis;
- nagging pain – due to gynecological diseases (in women) or prostate problems (in men);
- dull, aching, constant nagging pain that appears at night or after prolonged sitting is often a chronic pathology;
- sharp, cutting, severe pain is a sign of lumbago (the discomfort intensifies after bending over, during hypothermia, or even after taking a shower).
The nature of pain in the lumbar region on the right or left can be temporary or permanent. In any case, it is unpleasant and should not be tolerated. And if the right side or back right in the lumbar region hurts for a long time and with a certain frequency, then you certainly should not ignore the problem. It can be caused by any type and complexity of pathology.
Kinds
Each type of pain in the right side of the lower back has characteristic signs that may indicate the cause of the syndrome:
Why may lower back pain occur in women?
- Spicy. Accompanies shocks, falls, sudden body movements and increased stress. It can be caused by hypothermia. Even if this syndrome was short-lived, it is advisable to conduct an examination at a medical institution.
- Temporary. Characteristic of physical overexertion or prolonged stay of the body in one position. It subsides on its own or is relieved with painkillers.
- Long lasting. Indicates the presence of a serious pathology in the body and requires urgent medical attention.
- Aching. It is one of the accompanying symptoms of osteomelitis, which requires careful diagnosis. Pain often accompanies degenerative processes in the lumbar spine and informs about osteochondrosis and spondyloarthrosis.
- Pulling. Possible with hepatitis and hepatomegaly. Considering the danger of these diseases, immediate examination becomes extremely necessary.
Which doctor should I contact?
If you experience pain in the lower back, it is recommended to consult a doctor as soon as possible. You should not self-medicate, since the cause may be one or more diseases, and only a specialist can make the correct diagnosis, as well as offer a competent and effective treatment plan. If you do not have chronic diseases and do not know about the possible causes of pain, then first you should consult a therapist
, who will give recommendations and refer you to other doctors:
gynecologist
,
urologist
,
neurologist
, etc.
Neuralgia
If pain bothers a person between the ribs, then these are manifestations of neuralgia. This pathological condition is not only interconnected with vertebrogenic pathologies, but also with other underlying causes. Pain on the right side appears sharply and increases when the patient takes a deep breath. Also, the pain will spread not only from the front side, but also from the back.
If the pathological process is bilateral, then the pain will become encircling. A person feels “goosebumps” crawling longitudinally between the ribs, and the skin goes numb. During the examination, it is necessary to exclude cardiac pathology, in which pain syndrome may appear in the pericardial area.
Pain in acute appendicitis
The appendix is a lymphoid organ that takes part in the immune defense of the digestive system. It is located in the area of the right ilium, but its position is quite variable. This causes difficulties in diagnosing inflammation of the appendix. Appendicitis has its own distinct stages of development, which only a surgeon can diagnose.
Signs of appendicitis are:
- Diffuse pain in the navel and stomach;
- The pain is localized in the right half of the abdomen for three hours;
- Reducing pain when lying on the right side;
- Increased pain when walking and lying on the left side;
- Against the background of pain, general health worsens, body temperature rises, vomiting and diarrhea occur.
In such cases, emergency surgical treatment is performed in a surgical hospital.
Problems of the spinal cord, spine
Intervertebral hernia, osteochondrosis, spondylosis, pinched nerve roots - all these problems can cause sharp pain localized on the right side of the back. In order not to confuse spinal pathology with other diseases, it is worth studying other signs. A feeling of stiffness appears in the back, a pain attack increases with movement, radiating to the chest, limbs, and groin area. Numbness and “pins and needles” may also occur.
Severe pain is possible with a fracture of the scapula or ribs on the right. It is activated by coughing, deep breathing, and movements.
Prevention
Preventive measures to prevent pain in the right hypochondrium boil down to following the following recommendations:
- taking medications only as prescribed by a doctor;
- avoidance of stressful situations;
- compliance with personal hygiene rules;
- healthy and active lifestyle;
- rejection of bad habits;
- proper and nutritious nutrition;
- use of barrier contraceptives during sexual intercourse, refusal of casual relationships.
Regular medical examination (once a year) will allow you to prevent or promptly detect any health problems and receive the necessary treatment.
After load
Unpleasant sensations in the form of nagging or stabbing pain occur after physical exertion in people with hepatitis, cirrhosis, or congestive liver. After shaking or physical exertion, an attack of calculous cholecystitis may occur. Also, periodic pain during exercise appears in patients with myositis, intercostal neuralgia, osteochondrosis, rib fractures, and vena cava thrombosis.