Where it hurts: upper, middle and lower right back
- Upper right back: muscle strain around the shoulder blade, poor posture at a desk, a stiff joint between the ribs and spine, or pain referred from the neck. Gallbladder pain can also be felt under the right shoulder blade.
- Middle right back: thoracic joint stiffness, muscle strain after twisting or lifting, rib joint irritation and, less often, kidney problems felt higher up. See middle back pain.
- Lower right back: muscle and ligament strain, facet joint irritation, a disc problem or sacroiliac joint pain. Kidney stones and kidney infection cause flank pain just above the waist.
Muscle, joint and disc causes
The most common cause is a strain of the muscles or ligaments after lifting, twisting, a sudden movement or long periods in one position. The pain is often one-sided because we tend to load one side more, for example carrying a child on one hip or twisting to the same side at work. See lower back strain and back spasm.
The small facet joints at the back of the spine can become stiff and painful on one side, typically worse when leaning back or twisting. A disc that bulges to one side can irritate a nerve root and cause pain that travels into the buttock and leg, which is sciatica; see pinched nerve in the lower back. Sacroiliac joint pain is felt low, over the dimple at the back of the pelvis.
When the pain comes from an organ
- Kidney stones: severe pain in waves in the flank that may spread to the groin, restlessness, nausea and sometimes blood in the urine.
- Kidney infection: flank pain with fever, chills, feeling unwell and pain or burning when passing urine.
- Gallbladder: pain under the right ribs that can spread to the right shoulder blade, often after fatty meals, with nausea.
- Appendicitis: usually starts around the navel and moves to the lower right abdomen, but can occasionally be felt in the back.
- Shingles: burning or tingling pain in a band on one side, followed a few days later by a rash.
- Women: endometriosis, ovarian cysts and pregnancy can also cause one-sided low back pain.
How to tell muscle pain from organ pain
- Muscle and joint pain changes with movement, posture and touch; organ pain usually does not.
- Mechanical pain often started after a specific activity or awkward movement.
- Fever, chills, urinary symptoms, blood in the urine, nausea or vomiting point to another cause.
- Constant pain that is worse at night and not eased by any position needs medical assessment.
- Pain with unexplained weight loss or a history of cancer should always be checked.
If you are not sure, a doctor can examine you and request a simple urine test or blood tests.
What you can do at home
- Keep moving as normally as you can; bed rest slows recovery.
- Use heat on the sore area for 15 to 20 minutes, or ice in the first days if you prefer.
- Take simple painkillers if you need them and can take them safely, following the leaflet.
- Change position often and take short walks during the day.
- Try gentle stretches such as knee-to-chest and gentle rotations, without forcing.
- Sleep on your side with a pillow between your knees, or on your back with a pillow under your knees.
How physiotherapy helps
A physiotherapist assesses how your back moves, which movements trigger the pain and whether a nerve is involved. Treatment usually combines advice, a graded exercise plan to restore movement and strength, manual therapy to ease stiff joints and muscles, and practical changes at work or during sport.
For pain that keeps returning, strengthening the trunk and hips and improving lifting technique reduce the risk of new episodes. Most people with mechanical back pain improve within a few weeks, and exercise is the most useful long-term treatment.
When to seek urgent help
- Numbness around the genitals or buttocks, or loss of bladder or bowel control: go to A&E.
- Weakness in a leg or foot, or numbness that is spreading.
- Fever with back pain, or pain when passing urine.
- Severe pain in waves that makes you unable to stay still.
- Back pain after a fall or accident.
- Pain that is getting worse after several weeks, or constant night pain.
Key points to remember
- Most right-sided back pain comes from muscles, joints or discs and improves in weeks.
- Pain that does not change with movement, or comes with fever or urinary symptoms, may come from an organ.
- Staying active, heat and gentle exercise help mechanical back pain.
- Red flag symptoms need urgent medical attention.
Questions about right side back pain
These answers are general information and do not replace an examination or individual medical advice.
What organ is on the right side of your back?
The right kidney sits under the lower ribs at the back. The liver and gallbladder are at the front and side but can refer pain to the back and right shoulder blade.
How do I know if my right side back pain is my kidney?
Kidney pain is usually in the flank, does not change much with movement and often comes with fever, urinary symptoms or blood in the urine.
Can a pulled muscle cause right side back pain?
Yes. It is the most common cause, and the pain is usually worse with certain movements and better with rest and heat.
Can gas cause right side back pain?
Trapped wind can cause discomfort that is felt in the back, but persistent pain should be assessed.
How long does right side back pain last?
Mechanical back pain usually improves within 2 to 6 weeks. Pain that persists longer needs assessment.
Should I see a doctor or a physiotherapist?
See a doctor first if you have fever, urinary symptoms or red flags. For mechanical pain, a physiotherapist is a good first contact.
Sources
This guide is for general information and does not replace medical advice. How a problem is diagnosed and treated depends on your examination and medical history. If you think you have an emergency, contact your local emergency services.