You may have experienced a sharp pain that comes on suddenly on the left side of your back, or a throbbing sensation on your right side that grows worse each day. According to the American Chiropractic Association, about 80 percent of Americans experience back problems and spend about $50 billion a year treating it.
“One-sided back pain is a fairly common issue,” said Bradley Tucker, MD, a Penn Medicine Physician and Assistant Professor of Clinical Physical Medicine and Rehabilitation.
Back pain can radiate from the bones, joints, ligaments, muscles or a combination of sources. Lifestyle, sports injuries, poor posture, obesity and psychological stress can also contribute to back pain.
When the pain seems to occur only to one side, it could either represent something minor from which your body will heal itself, or it may be a more serious condition. In this article, we lay out some possible symptoms to watch for and give you an idea of what back pain on one side may mean.
One-sided back pain from tissue injuries
Injuries to the spinal structures can happen in the muscles, discs or joints, and they make up the most common causes of back pain on just one side. They often occur after minor injuries or from an impact after an accident.
Tissue injuries typically cause pain that is central to the spine, but they can lead to pain entirely on either the right side or the left side of the back. Of tissue injuries overall, muscle strains are the most common cause of lower back pain on one side.
Poor posture is another possible culprit for this type of one-sided back pain, according to Dr. Tucker. “Typically, when you sit, everything should be at a 90 degree angle: knees, ankles, hips and elbows,” he explains.
Muscle strain symptoms include:
- Limited range in motion
- Tenderness or swelling
- Muscle spasms
- Pain the improves with rest, ice or NSAIDs
- Pain that worsens after sitting or getting out of bed
Bone issues may cause one-sided back pain
Arthritis, bone spurs or spinal stenosis (a narrowing of the spinal column) may cause pain on one side of the back. The pain may radiate down the leg or cause weakness.
For instance, Dr. Tucker says, “If someone has right hip pain from arthritis, they may walk in a way meant to prevent falling and minimize hip irritation. But then they might have left-side back pain as a result.”
He adds that this compensation might not be something your body does consciously. “It’s just the body protecting itself from worsening pain, which causes muscles and other joints to be overused or over-fatigued,” he says.
Your treatment options depend on the severity of the condition and whether it affects basic activities in your daily life just like walking and sitting. Your physician will discuss your optimal treatment options based on the severity of your symptoms. Treatments may include pain medication and hot and cold packs. They may also range from physical therapy to surgery.
Internal organ problems lead to back pain
It may be quite scary to think about, but pain on the right side or left side of your back may actually come from the organs in your middle back, abdominal or pelvic area. That pain may signify infection, inflammation or irritation of the organs. The potential affected organs include:
- Kidneys
- Pancreas
- Colon
- Uterus
“There are a lot of one-sided issues you could have from pelvic or abdominal structures, but it’s not the typical back pain people think of,” says Dr. Tucker. “For instance, kidney stone pain tends to radiate from the flank down to the groin.”
Your kidneys live toward your lower back and can cause pain if infected. However, if you’re experiencing kidney stones or a kidney infection, you’ll likely have other symptoms, too, including pain when urinating, nausea or fever.
Chronic inflammation of the large intestine, called ulcerative colitis, can also cause back pain — along with abdominal cramping, digestive issues, weight loss and fatigue as well.
In women, pelvic pain from endometriosis or fibroids can radiate into the lower right back. This pain often comes with other issues, too, including abnormal menstruation, frequent urination and pain during intercourse.
Emergency back pain symptoms
There are certain symptoms that require emergency treatment, especially if they’re happening in conjunction with other symptoms, such as spinal tenderness, swelling or bowel or bladder problems.
One such issue is a serious nerve condition called cauda equina syndrome, and it involves nerve compression at the end of the spinal cord. “Usually, symptoms include numbness around the groin, significant leg pain, loss of bowel/bladder control and paralysis,” explains Dr. Tucker.
Another condition is abdominal aortic aneurysm, which causes the abdominal aorta to balloon and, in some cases, rupture. If the aneurysm ruptures, there is often associated sudden and severe abdominal or chest pain radiating to one side of the back.
It would be better to be extra cautious when dealing with back pain on your right or left side, especially if the pain interrupts your daily life or comes on suddenly and doesn’t go away with rest or medication.
Should you experience these symptoms, call your doctor or go to an emergency room immediately to receive proper care for your back and other underlying conditions.
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