Pain on the right side of the body, particularly in the abdomen, is common and can stem from various underlying structures. This region houses organs from the digestive, urinary, and reproductive tracts, meaning the source of discomfort can range from minor to serious. The specific location, character, and accompanying symptoms of the pain are important clues that help determine the cause. Understanding the potential origins of this pain is the first step toward seeking appropriate care.
Common Causes of Upper Right Abdominal Pain
Pain localized to the upper right quadrant (URQ), beneath the rib cage, often involves the liver or gallbladder. Gallstones blocking the bile ducts cause biliary colic, a sharp, cramp-like pain often occurring after a fatty meal. This discomfort may radiate to the right shoulder blade or back. Persistent blockage can lead to cholecystitis (gallbladder inflammation), presenting as persistent pain accompanied by fever.
The liver, which occupies a large portion of the URQ, can also cause a dull, aching sensation. Conditions like hepatitis may cause this discomfort along with fatigue, nausea, and jaundice (yellowing of the skin and eyes). The right kidney can also cause pain, particularly if stones or an infection are present. Kidney stone pain is severe and spasmodic, typically felt in the flank or back but sometimes radiating to the front of the abdomen.
Other digestive issues can mimic URQ pain, such as gas buildup or a peptic ulcer in the duodenum. Gas pain is transient and cramping, while an ulcer may cause a burning sensation that is relieved or worsened by eating. Pancreatitis also presents with upper abdominal pain that can affect the right side and frequently radiates straight through to the back.
Interpreting Lower Right Abdominal Pain
Pain in the lower right quadrant (LRQ) is concerning due to the presence of the appendix. Appendicitis, the inflammation of this organ, is a common surgical emergency that typically begins with a dull pain near the navel. This pain localizes and intensifies in the LRQ over several hours. The severe, localized pain often worsens with movement, coughing, or sneezing, and may be accompanied by fever, nausea, and vomiting.
The LRQ also contains the ascending colon, which can be affected by conditions like inflammatory bowel disease (IBD) or diverticulitis. Unlike the sudden pain of appendicitis, discomfort from colon issues is often more diffuse and chronic. This pain is frequently associated with changes in bowel habits like diarrhea or constipation. Inflammatory conditions of the colon can cause cramping pain that is relieved by a bowel movement.
For biological females, the LRQ contains the right ovary and fallopian tube, making reproductive issues a potential cause of pain. Conditions like a ruptured ovarian cyst, ovarian torsion, or an ectopic pregnancy can cause sudden, sharp, or severe pain requiring immediate medical attention. Ectopic pregnancy, where a fertilized egg implants outside the uterus, is a medical emergency often marked by cramp-like pain and sometimes vaginal bleeding.
Right Side Pain Originating Outside the Abdomen
Not all pain felt on the right side originates from internal abdominal organs. Musculoskeletal causes, involving muscles, bones, and joints, can produce highly localized pain often confused with visceral discomfort. A common example is costochondritis, the inflammation of the cartilage connecting a rib to the breastbone, which causes sharp pain that increases with deep breaths or chest wall movement.
Muscle strain in the abdominal wall or intercostal muscles can also cause pain that is tender to the touch and worsens when twisting or bending. This superficial pain is easier to pinpoint than the deep ache of an internal organ problem. Pain can also arise from nerve issues, such as Shingles, which presents as a painful rash or burning sensation on one side of the body, often wrapping around the chest or abdomen.
Referred pain from the back or spine, such as from a herniated disc or kidney issues, can be perceived as originating in the side or front of the abdomen. Kidney stone pain is frequently felt in the flank or side, sometimes moving down toward the groin. These non-visceral causes are differentiated by their relationship to physical movement, touch, or the appearance of a dermatological sign like a rash.
Warning Signs Requiring Immediate Medical Attention
While many causes of right-sided pain are minor, certain accompanying symptoms signal a potentially life-threatening condition requiring emergency medical evaluation. The sudden onset of excruciating pain demands immediate attention, as this can indicate a ruptured organ, such as a burst appendix or a twisted ovary. Pain that is rapidly worsening or accompanied by abdominal rigidity and tenderness are severe warning signs.
A high fever paired with abdominal pain suggests a significant infection or inflammation, such as appendicitis, cholecystitis, or a kidney infection. Persistent vomiting, especially if fluids cannot be kept down, may signal a digestive tract blockage and increases dehydration risk. Other urgent signs include blood in the stool or urine, or the inability to pass gas or have a bowel movement.
Jaundice (yellowing of the skin or eyes) combined with upper right pain suggests a serious liver or bile duct issue. If the pain is accompanied by signs of shock, such as confusion, fainting, cold sweats, or a rapid heart rate, emergency care should be sought without delay. Severe or persistent pain should not be ignored, as attempting self-diagnosis risks dangerous delays in treatment.