03 / Understand the area
One side of the lower back
Pain on one side of the back may come from how you move, but pain farther around the flank can need a medical assessment for a different cause.
An educational guide that covers the left and right sides alike. Where it hurts is a useful clue, but only a clue.
A useful starting point
What this area can tell you.
Where exactly it hurts matters: right next to the spine, over the top of the pelvis, or farther around your side. So does any change with everyday movement, and any fever, nausea or discomfort when you urinate. Those details come before anyone assumes it's a strained muscle or a sacroiliac joint problem, and fever or urinary symptoms with flank pain call for a medical assessment first. Our office cares for musculoskeletal causes of back pain; we don't diagnose or treat kidney stones or urinary tract infections. When a muscle-and-joint explanation fits, a plan can focus on the activities you care about, and on checking whether your response matches the original assessment.
Notice the pattern
Three questions to bring with you.
You don't need to know what it is before you come in. These are details that help when you tell us what you're feeling.
- Is the pain right beside the spine, near the top of the pelvis or around the flank?
- Does it change with everyday movement, or stay intense whatever position you're in?
- Are fever, nausea, painful urination or blood in the urine part of the same episode?
When to get help sooner
Back or flank pain with fever, vomiting or urinary symptoms needs urgent medical advice. Severe sudden pain with faintness needs emergency care, as do new bladder-control changes or numbness around the genitals.
Follow the connection
Possible explanations. Better questions.
These guides cover conditions and patterns that may overlap with this area. Think of them as a place to start our conversation: no body map can tell you which one, if any, you have.
What the studies found, and where they stop
How the research fits this area.
The low back guideline is about back pain care once a proper assessment has been done. Its exercise and manual therapy options don't apply to a kidney problem, and they can't tell anyone what's causing one-sided flank pain.
How we select and explain sources ↗Follow the evidence
Research, with context.
Selected published sources behind what we've written, each with what it found and what it can't tell us. We give you both halves because no paper can diagnose you or predict how your own care will go.
Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians
Adults with acute, subacute or chronic low-back pain considering noninvasive management.
What it foundThe guideline prioritizes non-drug options for chronic low-back pain, including exercise. Spinal manipulation is one of several options, supported by lower-quality evidence.
What it can't tell usA guideline pulls together existing evidence; it doesn't report a new experiment. It doesn't establish disc realignment, a cure for everyone, or superiority over all other care.
Publication details & citation
Qaseem et al. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Annals of Internal Medicine. 2017. DOI: 10.7326/M16-2367.
Read the publication record
Our editorial policy explains how to read these sources and what our clinical-review labels mean.
Your next step
Bring your questions.
We’ll start there.
Your answers to those three questions are where we start. We go over your history and symptoms, examine you, and explain what we found before we recommend anything. If it turns out to be something another doctor should look at, we'll tell you.
Anatomy: BodyParts3D, © DBCLS, CC BY 4.0. Model & rendering credits. Return to the full body explorer.