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Patient Questions  /  Low back pain on one side

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Why Does My Lower Back Hurt on One Side?

One-sided low back pain is common. It usually comes from a strained muscle, an irritated joint in the spine, or the sacroiliac (SI) joint, where the spine meets the pelvis. A disc pressing on a nerve can also cause pain on one side, often with pain down that leg. Less often, the pain comes from a kidney or another organ.

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Common causes from the back and pelvis

  • Muscle strain after lifting, twisting or a new activity. It often hurts to bend or turn toward one side.
  • Spine joints. The small joints at the back of the spine can cause a one-sided ache that is worse with arching back or twisting.
  • SI joint pain. Usually felt low, near the dimple at the back of the pelvis. It may hurt with stairs, rolling over in bed, getting out of a car or standing on one leg. It's common during and after pregnancy.
  • A disc and nerve. Pain that travels into the buttock and down one leg, sometimes with tingling, can be sciatica.

When it might not be your back

Kidney stones and kidney infections can cause pain in the side or back, just under the ribs. That pain usually doesn't change when you move and may come in waves. It often comes with fever, pain when you pee, cloudy or bloody urine, or nausea. These need a doctor, not exercise.

Back pain that changes with position, eases with rest and is tied to how you move is much more likely to come from muscles and joints.

What usually helps

Stay active, use heat, and avoid staying in one position for long. Most one-sided back pain improves over a few weeks. If it keeps coming back, it's worth finding out which structure is involved.

When to see a doctor

See a doctor promptly if you have:

  • Side or back pain with fever, chills, pain when you pee, or blood in your urine
  • Numbness in the groin or inner thighs, or new trouble controlling your bladder or bowels: get emergency care
  • Weakness in a leg or foot that is getting worse
  • Back pain with unexplained weight loss or a history of cancer

How physical therapy at ARI can help

A physical therapist can test the spine, hip and SI joint to narrow down where your pain is coming from. They then use hands-on care and specific exercises to calm it, and build strength around the back and pelvis so it's less likely to return.

At ARI Physical Therapy in Bakersfield, every visit is one-on-one and in person with a licensed physical therapist, and our clinic director, Deepa Konnur, PT, MPT, OCS, is a board-certified Orthopedic Certified Specialist. We accept most private insurance plans and Medicare, and we have staff who speak Spanish and Hindi.

Read our full guide: SI joint pain →

No referral needed to start. In California, you can see a physical therapist directly for up to 12 visits or 45 days, whichever comes first. Some insurance plans still require a referral for coverage; call us at (661) 282-8584 and we'll help you check.

Related questions

Ready to feel better?

Talk to a licensed physical therapist at ARI, one-on-one. Request an evaluation and we'll get back to you, usually within one business day.

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This page is general information, not a diagnosis. If you have symptoms, a licensed clinician should evaluate you.

Clinically reviewed by Deepa Konnur, PT, MPT, OCS, board-certified Orthopedic Certified Specialist · Reviewed October 2026