Lower Right Side Soreness / Abdominal Soreness

I am a 52 year old male. I have had a soreness in my lower right side (below ribs but above hip bone - on a pain scale of 1-10 maybe a 2) for a long time. I also have a fatty cyst above this area (under armpit) which has now grown to a larger size and is painful) which has also been around as longer than the above described pain. My old doctor always told me that the cyst likely was irrating side muscle causing the lower right side discomfort.

About a month ago I also began having lower abdominal pain (below belly button but above groin (also on a pain scale of 1-10 maybe a 2) which pretty much goes across the front (left to roght side). At the same time I started having lower back pain and slight soreness in the right hip area.

I have no other symptoms such as change in stool/urination habits, no fever, no real intense pain, no bllod in stools, etc., no nausea, no weight loss.

I had my physical recently and reviwed all of this with my doctor. He did all standard blood work and a through physical exam with all results being positive (no issues). I was told it is time to have the cyst removed (scheduled in a week or two) and that my back and hip pain was likely cyatic nerve related. He had no suggestion as to what the admoninal pain was and made no further suggestions.


I have since visited a chiroprator and they took xrays showing some hip and lower back nerve issues which they are working on.

I still remain concerned about the abdominal discomfort along with this long term right side soreness. I am schedule for a colonoscopy in early January (mainly cause I am over 50). Should I do any thing else and should I be concerned about something worse here?

[Enoch Choi, MD]

There are a number of concerns that I'll address separately:

1) a fatty cyst is often called a "lipoma" and can stay stable for a long time.  When a bump becomes tender and larger it's concerning that a previously sterile cyst has become infected, and requires incision and drainage. It's important to address enlarging tender bumps promptly since if they are from infection, the infection can expand beyond the cyst to surrounding tissues, a condition called cellulitis

2) Chronic lower right sided abdominal pain can be from overlying muscles or any number of organs in that part of the abdomen: intestines, appendix, ovaries & fallopian tubes, uterus, kidneys, ureters and bladder.  When pain moves to both sides and is in the back, it increases the chances of muscle pain or organs that are further back such as kidneys.  Pain from kidneys can be from stones, cysts, or masses.  A CT scan with IV contrast can help look at these possibilities. Although irritation of the sciatic nerve can cause pain that radiates down the buttocks and legs, it's not a common cause of low back pain without pain radiating down.  It's important to find a doctor that will address all of your concerns, including abdominal pain rather than just focusing on one area such as the back.

It's important to have all concerns addressed, so a second opinion is always helpful

Enoch Choi, MD