Pain on the right side of the torso can be puzzling due to the number of organs and systems located there, including the abdomen, flank, and lower back. The source of discomfort ranges from a simple muscle strain to complex issues involving the digestive, urinary, or reproductive organs. Understanding the pain’s characteristics and accompanying symptoms provides helpful context. However, this information is not a substitute for professional medical advice. If the pain is sudden, severe, or concerning, immediate medical attention is necessary.
Causes in the Upper Right Abdomen
The upper right abdominal quadrant, beneath the rib cage, houses the gallbladder, liver, and a portion of the small intestine. Gallbladder problems are a frequent source of discomfort, commonly caused by gallstones. These hardened deposits can block the bile ducts, leading to biliary colic, which manifests as a severe, gripping or gnawing pain. This pain can last for several hours and sometimes radiates to the upper back or right shoulder blade.
If a gallstone causes a persistent blockage, it may lead to acute cholecystitis. This inflammation results in constant, worsening pain in the upper right abdomen, often accompanied by fever, chills, and nausea. The discomfort frequently intensifies after consuming fatty meals, as the gallbladder contracts to release bile.
An inflamed liver, known as hepatitis, can cause a dull ache or throbbing sensation in this quadrant. Liver pain is often linked to the stretching of the liver’s external capsule due to swelling. Conditions like viral hepatitis or fatty liver disease cause this inflammation, sometimes presenting with symptoms like jaundice.
Another potential cause is a duodenal ulcer, a sore in the lining of the first part of the small intestine. The pain is often described as burning or gnawing and typically appears a few hours after eating, or may wake a person when the stomach is empty. This pain can often be temporarily relieved by eating food or taking antacids.
Irritation of the diaphragm, the muscle separating the chest and abdominal cavities, can also refer pain to the upper right quadrant. For example, lower lobe pneumonia may irritate the diaphragm, causing sharp, localized pain that worsens with deep breathing or coughing.
Causes in the Lower Right Abdomen
Pain in the lower right abdomen, extending from the navel to the hip bone, often involves the appendix, large intestine, or reproductive organs in women. The most known cause is appendicitis, inflammation of the appendix. The pain classically begins as vague discomfort around the belly button before migrating to localize sharply in the lower right quadrant over several hours.
As inflammation worsens, the pain becomes severe and constant, often accompanied by loss of appetite, nausea, vomiting, and a mild fever. Blockage of the appendix lining causes the buildup of pressure and bacteria. Other digestive causes include Irritable Bowel Syndrome (IBS), which results in cramping and abdominal discomfort relieved after a bowel movement.
Diverticulitis, while usually left-sided, can occur on the right side, causing lower abdominal pain. This condition involves the inflammation or infection of small pouches in the colon wall, and the pain is usually more constant and severe than IBS.
For women, the lower right quadrant houses the right ovary and fallopian tube. Reproductive conditions like a ruptured ovarian cyst or pelvic inflammatory disease (PID) can cause significant lower abdominal pain. An ectopic pregnancy requires immediate medical evaluation for women of childbearing age.
An inguinal hernia can also cause pain in the lower abdomen and groin, often presenting as a noticeable bulge. The discomfort typically worsens with straining, coughing, or lifting heavy objects.
Pain Originating in the Right Flank and Back
When pain is felt primarily in the right flank or lower back, the kidneys are often the source. Kidney stone pain is severe, frequently described as intense, cramping pain that comes in waves (renal colic). This discomfort begins in the flank, just below the ribs, and often radiates toward the lower abdomen and groin as the stone moves down the urinary tract.
Kidney stone pain is often accompanied by nausea, vomiting, and blood in the urine. A kidney infection (pyelonephritis) presents differently, typically causing a persistent, dull ache in the flank or lower back. This bacterial infection is usually accompanied by systemic symptoms such as a high fever, chills, and painful or frequent urination.
Differentiating kidney pain from simple musculoskeletal strain is important. Muscle strain pain is usually more superficial and aggravated by specific movements, twisting, or touching the area. In contrast, kidney pain is felt deep within the body and generally does not change with movement.
Recognizing Urgent Symptoms
While many causes of right-sided pain are not life-threatening, certain signs require immediate medical attention. Sudden, severe, or rapidly worsening pain that prevents sitting still warrants an emergency room visit. Pain accompanied by a high fever or chills suggests a systemic infection, such as acute cholecystitis, pyelonephritis, or a ruptured appendix.
Serious symptoms requiring urgent evaluation include blood in the urine, persistent vomiting, or an inability to pass gas or have a bowel movement. For women, right-sided abdominal pain paired with a missed period or pregnancy possibility must be assessed immediately to rule out ectopic pregnancy. Any pain following a traumatic injury to the torso, such as a fall or accident, should also be seen by a healthcare provider without delay.