Is It Normal to Have One-sided Back Pain?

Back pain is common: 80% of adults will experience it in their lifetime. Usually, people think of all-over back pain, but one-sided back pain is also a thing. And it can be an annoying thing.

When to worry about back pain that’s only on the left or right side

“Unless you experienced an obvious cause, like a fall, you probably aren’t dealing with a fracture that requires special care,” says spine specialist Russell DeMicco, DO. “Rarely do you need to worry just because your pain is only on the left side or right side of the back.”

The exceptions are:

• Age: An older adult may experience a minor injury that results in a more serious condition — either because they have low bone density, or they developed arthritis that causes pain.
• Athleticism: Athletes may experience greater musculoskeletal wear and tear than the general population. They’re often more vulnerable to fractures, herniated disks or arthritis.

Tissue-related back pain is most common

Spontaneous one-sided back pain can occur for a variety of reasons, but it’s usually related to the soft-tissue (muscle, ligament, joint). The back muscles run up and down the left side and the right side — they don’t cross the midline (spine). So if you irritate a muscle on the left side of your back, you would likely only have pain in that region.

“Someone who is experiencing tissue-related pain will feel an aching soreness and stiffness,” says Dr. DeMicco. “Often, the area will be tender to the touch and have restricted range of motion because of the discomfort they feel.”

Causes of tissue-related discomfort include:

• Sound sleeping: If you have a night with limited movement, you might find that the muscles on just one side of the back tense up, causing pain.
• Sitting at the computer: If you’re in the zone at work and forget to move around, you could end up feeling it on just one side of your back.
• Travel: Being stuck in a seated position for an extended period can cause muscle tightness. Dr. DeMicco recommends taking frequent breaks if you travel by car or walking around the airplane cabin whenever possible.

Usually, muscle-related pain will subside if you use a nonsteroidal anti-inflammatory drug (NSAID), rest the area and use an ice pack.

Left- or right-sided organ-related back pain

If the pain you experience is a little deeper in the back, and you’re having other symptoms as well, it could be related to an internal organ. See your doctor, because these are signs of an infection or irritation:

• Intestines: Inflammation of the colon may affect just one side of the lower back, but you’d probably also experience abdominal cramping, digestive problems and weight change.
• Kidneys: An infection or kidney stones may also cause one-sided back pain that occurs between the bottom of the rib cage and your hips. Again, you could expect to have other symptoms like blood in the urine, pain when urinating or fever.
• Uterus: Pain on the right side of the lower back may be due to fibroids or endometriosis. Along with the pain, you’d likely also experience menstrual irregularities, a frequent need to urinate and painful intercourse.

When to see a provider about one-sided back pain

“If you have pain in the left or right side of your back that started for no particular reason, it will most often resolve on its own or with minimal treatment,” says Dr. DeMicco. “Typically, we see 50% of cases resolving within two weeks and 75% resolving by six to eight weeks.”

Have you been dealing with intense pain for 10 days and over-the-counter pain relievers aren’t cutting it? Time to call your doctor, who may recommend:

• Stronger medicines: Prescription-strength muscle relaxants and anti-inflammatory medications could take the edge off as your body heals.
• Manipulation: A physical therapist, chiropractor or osteopath could perform hands-on treatment that deliver relief.

“If your pain extends beyond six weeks, your doctor will likely recommend imaging,” says Dr. DeMicco. “An X-ray is usually the first step to ensure there isn’t a broken bone or some other obvious reason for the pain.”