One Sided Lower Back Pain
- Do you have lower right back pain when driving??
- Do you feel lower right back pain while lifting weights?
- Are you searching for answers to why you have one sided lower back pain?
In this article (updated in 2021), I will be covering right and left side lower back pain. At the end of the article, it also covers the baffling situation of when your lower back pain CHANGES SIDES.
I’ll also be covering possible diagnoses, causes, and treatment options for single-sided lower back pain. This article will not cover sciatica in-depth (pain past the knee), but you can read all about that in one of my other articles here.
I’ve had lower right back pain and have been able to recover from it entirely. When I was 15, I was told I would need back surgery to reduce my pain so I could play baseball again.
Long story short, I did not require surgery, injections, or medication to return to baseball. I am 38 now and play baseball two days a week, lift weights, sprint, and have no issues with my lower back holding me back from doing what I want.
I’m telling you my story of recovery to let you know that you can recover as well (if you find the right person to help you as I did).
Hopefully, this article gives you better information to discuss with your sports chiropractor, physiotherapist, physical therapist, personal training, orthopedic or medical doctor.
Not everyone will get back to feeling 100%. As a general rule, the longer you’ve had it, the more challenging it can be. But this does not mean it’s impossible to feel physically capable again.
Let’s get on to the article.
Cause #1: Driving With Lower Right Back Pain
Driving your car is the #1 cause of single-sided lower back pain in people over 25.
If you are living in the US, you may experience more right-side low back pain when driving.
If you are in Europe, you may experience more pain in the lower left back while driving.
It has to do with the gas pedal.
As we discuss single-sided low back pain in this article, it may be helpful first to understand that not all low back pain is created equally.
Different causes for back pain have other mechanics, positions, and postures that will increase or decrease your pain.
I say this because if you’re in the US and you experience left low back pain while driving, that’s common as well. Keep reading this article.
As we venture into other causes of 1 sided low back pain, you’ll start to realize that positions and postures of your whole spine, arms, and legs matter. What you are doing with your body daily matters.
Now that you understand that postures and positions matter, you should realize that you also have some control over your condition. As I describe these mechanics, consider reversing them and seeing if it helps tomorrow. Not all ergonomic corrections yield immediate relief.
Back to driving…
Suppose you are in the US, lower right back pain while driving occurs as you tension the sciatic nerve with every up and down on the gas pedal. This tends to happen more in stop-and-go traffic. You may think it is the stress of the traffic, but that may not be so!
Multiple spinal nerve roots create your sciatic nerve that exits from tiny holes in your spine called intervertebral foramen. Your low back nerves could be subjected to pressure around this location, creating nerve swelling, making lower back stiffness and pain.
When you pressure a lumbar spinal nerve (L4, L5, or S1), typically stretching of the sciatic nerve will induce your lower back pain.
When you pressure a lumbar spinal nerve (L4, L5, or S1), typically stretching of the sciatic nerve will induce your lower back pain.
If this is you, simply move your seat closer to your steering wheel and increase the lumbar support on your chair (if you have one).
If you don’t have built-in lumbar support, roll up a towel and place it behind your lower back to let your lower back relax.
Moving your car seat forward allows for more knee bend (sciatic nerve slackening) and less pain.
Pressure on a spinal nerve root (not the sciatic nerve itself) creates the situation where your lower back pain is only on one side.
The following symptoms also may describe your situation:
- Lower back pain right side above buttocks
- Pain on right side under ribs towards back
- Lower back and hip pain on one side
- Sharp stabbing pain in lower back right side
- Worse while sitting in traffic
- Pain into upper glute muscle
- Chronically tight hip flexors
- Occasional changes of sensation in the thigh, calf, or foot (buzzing, tingle, numbness, or pain)
- Pain with sex (some positions but not others)
- Pain with overstriding while running
- Chronic hamstring tightness
- Achy QL muscle
- Tightness in your neck or shoulder blades
We can do specific tests (in the office or virtually) to see if you have been placing pressure on a spinal nerve.
These are called neural tensioning tests.
When they duplicate 1 sided low back pain, this tells us there is a high probability that you have a pinched nerve. Remember, pinched nerves don’t like it when you stretch them.
You may not have formally had these tests performed on you, but you may have already experienced a life situation. Many people perform a sloppy version of the test on themselves with daily tasks.
- Lower back pain with a long seated hamstring stretch
- Bending over to touch toes (yoga forward fold)
- Standing chair hamstring stretch
- Stiff-legged deadlifting
Suppose you’ve experienced right or left-sided lower back pain in any of these activities. In that case, I’d gamble to say it would drastically reduce if you just bent your knee a bit more.
A simple way of slacking the sciatic nerve is to bend the knee more. Easy right?
Right, but it does not solve the problem completely. It just removes the trigger. Addressing non-painful/ dysfunctional areas of the body with mobility and stability exercises is the next step. With one-sided back pain, normally, the midback and hips are the highest payoff point.
After restoring mobility and stability to areas that did not hurt (but also were not functioning well), the next step to “save” your progress by strengthening the area.
Strength building helps the computer of the body (your central nervous system) retain movements and get rid of painful movement compensations.
Without some challenging rehabilitation, you may regress backward to having the same low back pain within a matter of months. The rehabilitation process was not completed, regardless of pain-reducing.
At Performance Place, we help people weekly with years of left and lower right back pain, and yes left sided as well.. The treatment is simple. Chill the nerve down before reintroducing the provoking movements. We offer in-person (Costa Mesa, CA) or virtual sessions.
Cause #2: Sitting With A Twist
Do you sit in your car, constantly twisting your upper body to the right side?
If you’re outside the US, you may be twisting to your left more often.
Why would you be turning your body away from the road?
In the US, police or emergency personnel have laptops and radios to the right side of their body. Sitting at a traffic light or waiting for a call often defaults into twisting your upper body to your right side while your lower half is buckled in tight.
Note: This situation can also happen with a dual-screen workstation.
Over weeks, twisting can make the right side of your spine sensitive due to the pinching effect I mentioned previously. Still, not all police officers, firefighters, and paramedics have lower right back pain.
Pain in the lower left back can also occur via different spinal mechanics. Remember earlier I said that knowing the mechanics of your back pain helps in diagnosis and treatment.
Lumbar spine disc herniations, bulges, extrusions, and prolapse tend to present in the left lower back in this situation, as the nuclear disc material (jelly) moves away from the laptop.
The standard explanation is about “jelly donuts.”
The nuclear material/ jelly moves to the outer walls of the donut when under pressure.
The jelly will move away from the location of constant mechanical pressure from sitting and twisting.
So if you have pain in the lower left back and you often bend forward and twist to the right side, this may be your scenario.The following symptoms also may describe your situation:
- Worse in the morning hours
- Lower left side back pain above buttocks
- Pain with sitting
- Walking reduces pain after a few moments
- Pain moving from a sitting to a standing position
- Exiting a car is uncomfortable
- Putting on your shoes and pants in the morning is challenging
Spinal disc injuries do not happen with trauma.
They often happen over time with no single injury event.
They do not often require surgery, medication, or injection.
Using non-surgical treatment, you may experience a dramatic reduction of day-to-day pain within just weeks of starting a treatment plan.
The simplest thing you can do is walk more. Walk when you get home from work and before you even drive to work.
Ideally, 30 minutes in the morning, but if you are busy, even just a 5 – 10 minute brisk walk is better than nothing. Sprinkle it throughout the day!
As I said in the beginning, you have control to improve your situation. Nobody can do the work for you.
At Performance Place, we specialize in non-surgical treatment for spinal disc herniations and pinched spinal nerves. With the proper guidance, you can improve within a matter of weeks.
You are in control!
Cause #3: Asymmetrical Sports
This discussion can become very specific very quickly, so I’ll try to keep it broad.
Allow me to start by mentioning that playing a sport that requires lots of asymmetrical movements does not damage your back. “Wear and tear” situations are not as common as we think. I’ve played baseball for 30 years, and I don’t have back pain anymore.
Yet each sport can come with different risks. The most common single-sided athletes who suffer from 1 sided low back pain are:
- Field Hockey
- Ice Hockey
How can you solve this type of lower back pain?
Core endurance and reactive stability is a good starting point.
Here are some exercises we like at Performance Place.
Also, you may need to improve the function of your hips. Pinchy hips can rob your lower back’s ability to stabilize as you twist in sport.
Here is a Youtube video where I discuss how hip mobility and core stability work with 1 sided low back pain.
Full recovery is possible by following a customized, low back program. Most of the work is done at home or in a gym. You simply need to know what to do and how to do it.
Other athletes can develop one-sided low back pain yet are not performing asymmetrical motion repeatedly.
- Ice skating
These are unique situations that may require x-rays (and other images) to investigate the possibility of a spinal stress fracture. The area of interest is the pars interarticularis.
I won’t spend a lot of time on this topic since I have covered it in podcasts at length. Here is the most recent one we did on Dancers with lower back pain.
Compensated Movement From Old Aches/ Pains
- Do you squat with a shift to one side?
- Do you have a slight limp?
- Have you had a repeated knee injury (or ankle) on the left side and experience chronic lower right side back pain?
Your body can and will compensate for accomplishing a task. A limp is a perfect example.
If the task were to cross a busy street, you would run with a limp if you had a sprained ankle, yet you would still accomplish the task of avoiding a car.
The body will find a way to achieve the mission. Yet, sometimes it retains these movement compensations as a default even after your ankle pain is long gone.
Limping in the absence of any pain happens. Allow me to explain.
Generally, we have three situations of compensated movement, which can create one-sided lower back pain.
- You have a current ache/ pain in another part of your body that you’re compensating for (i.e., sprained ankle)
- You had a past ache/ pain that you UNKNOWINGLY compensate for (Past left ankle sprain that shifts you AWAY from using the left leg).
- You had a past ache/ pain that you KNOWINGLY compensate for (Past left ankle sprain that shifts you AWAY because you are afraid of hurting it again).
In Situation 1, you have a current injury in another part of the body. You may notice your 1 sided low back pain may reduce on its own in the same timeline as the active injury. The injured area is called a “painful/ dysfunctional” region, which creates short-term compensation.
Your body will reduce the need to compensate. You will gradually apply weight to the injured part of the body, which deloads the opposite side of your lower back.
In Situation 2, your past injury is categorized as a “non-painful/ dysfunctional” region that tends to create LONG-TERM compensation if not made functional again. I.e., Limping in the absence of pain or swelling of the said ankle.
Your knee connects to your hip, your hip connects to your low back, and so on… we all know the song. It turns out it is all true!
In this situation, a customized program should be implemented to address all NON-painful/ dysfunctional regions to deload the one side of your low back that hurts.
To do this, you may need a skilled eye to identify non-painful/ dysfunctional regions of your body that are forcing the low back to work too hard.
Using the Mobility, Stability, and Strength Model of program design typically works well. Yet, it’s always best to have someone narrow down what exercises will give you the most bang for your buck (and time).
Some of these programs can take 1-2 hours a day if they are not narrowed down. That’s way too long for most people to do daily!
The truth is you only need 30-60 minutes of activity to reverse the compensation process and reduce right or left-sided lower back stiffness quickly.
In Situation 3, where you know you are avoiding using certain joints, you should get 1-on-1 coaching to implement a similar program design as I mentioned above. Do not try to do this on your own.
We call this a “fear avoidance” case that needs reassurance that they are doing everything correctly.
If you are in Situation 3, don’t get paralysis by analysis.
Simply have a skilled coach, physical therapist, physiotherapist, sports chiropractor, or personal trainer tell you precisely what to do and how to do it.
You will be surprised about how much of your anxiety about movement will decrease by simply doing the exercises with the safety of a coach.
In Situations 2 and 3, no amount of massage, adjustments, electrical stimulation, heat, cupping, acupuncture, chiropractic adjustments, ice packs, medications, or surgery will change your movement patterns.
Correcting compensated movement patterns requires coaching. Just like a professional pitcher in baseball, we need a coach to optimize our movements sometimes.
How do you know if you’re compensating movement?
Usually, a simple mobility assessment gives enough information to move forward. A skilled trainer or medical professional can do this within 30 minutes or less.
Want to do it on your own first?
Have a friend take a video of you squatting, lunging, bending over, and backward. These movements will provide lots of information to start with a program. You will see and feel things that you have never noticed before. Consider this as your “discovery phase” of recovery.
You may notice your lower back rounding or extreme flatness as you move. You may notice your hips feel tight. You may see you dominantly shift towards one side or another.
You won’t know unless you look.
Chances are you are in Situation #2, where the movement compensation occurs without you knowing it. Don’t try to correct it. Typically the proper mobility, stability, and strength exercises will do it all for you, so you don’t have to overthink.
Just move, don’t think. The right program and coaching are all you need.
Cause #4: Internal Causes
Organs, impact, accidents, tumors, infections, kidney infection, pancreatitis, ulcerative colitis, uterine fibroids, endometriosis, kidney stones, testicular torsion, and much more are in this category.
Many of these are accompanied by odd symptoms of nausea, vomiting, fever, gas, bloating, pain with urination, pain with sex, sweating while your sleeping, constant pain, intense abdominal pain, and much more.
I would love to say you will diagnose this on your own but do you want to take that chance? I wouldn’t.
I am in the medical profession, and I know how hard it is to dissect the information on your own. See a medical professional for a complete medical history and physical examination.
From that point, allow the medical professional to decide if you need blood work, X-rays, MRIs, CTs, nerve conduction tests, or any other advanced testing.
Cause #5: Back Pain That Changes Sides
Have you noticed that your lower back pain switches from side to side based upon the day or the activity?
When this happens, many rehab professionals consider this as an “instability case.” I’m not talking about a clinically unstable spine, such as what you could experience with high grades of spondylolisthesis or fractures. I’m talking about “deconditioned or poor stability.”
If you had a trigger point within the lower back muscles, your pain would NOT change sides.
If you had an active disc injury, you would NOT have your back pain be on the left side one day and then move to the other side the next.
If you had an SI joint sprain, your pain would NOT change sides.
If you had a pinched nerve in your lower back, the tension would NOT change sides.
It would change sides when we are NOT looking at a true structural reason for lower back pain. Lower back pain that changes sides is a biomechanical loading problem, a mobility problem, or a stability problem.
Above, we discussed Situations 2 and 3, where switches sides are often seen.
If you are suffering from lower back stiffness that switches sides every week, contact us. We would love to help.
Diagnosis of One Sided Lower Back Pain
I have written articles about these diagnoses already. If you want to investigate any of them further, just click on the links and use our sidebar on the following page to find what you are looking for.
- Low back disc injury (Youtube Video)
- Bone spurs
- Spinal stenosis
- Muscle Strain or Sprain
- Facet Syndrome (Youtube Video)
- Low Back Pinched Nerve (Youtube Video)
- SI Joint Dysfunction (SJD) (Youtube Video “What does it feel like”)
- Hip Flexor Syndrome (Youtube Video)
- Hip Impingement
- Pars Fracture
- Piriformis Syndrome (Youtube Video)
Non-Surgical Treatments For Lower Right Side Back Pain
- Trigger Point
- Releasing scar tissue
- Active Release Technique
- Chiropractic Adjustments
- Ice, Heat, and NSAIDs
Any of the treatments can use all of the above to decrease pain. Yet, none of them help restore function or reverse movement compensations.
While some of these non-surgical treatments can be used, they are best when coupled with a few of the following:
- Active care
- Corrective exercise
- Mobility exercise
- Stability exercise
- Strength training
- Dynamic Neuromuscular Stabilization (DNS)
- Functional Range Conditioning (FRC)
Effortful exercise with good coaching can help return you to a pain-free and fully functional life. The use of passive care is not required in many situations. Effortful treatment can also reduce pain quickly.
If you read the whole article, you can probably tell resolving lower back pain requires more than a simple, quick fix. Quick fixes do not improve mobility, stability, strength, or movement compensations (conscious or unconscious).
If you want to get rid of 1 sided lower back pain for good, contact us at Performance Place. We specialize in creating custom programs for left and right-side lower back pain. We will tell you (and show you) exactly what to do and how to do it.
Think less, do more and feel better quickly!
Hope to work with you soon!