29 yr husband, sudden onset of lower back pain. radiates to lower right abdomen, can't move at all without extreme pain. smokes, drinks, high bp, help?

Pancreatitis: Combination of symptoms worrisome for acute pancreatitis - have him checked immediately.

? kidney stone: What you have described sounds more like a kidney stone than anything else . On the rt lower side appendicitis is also a concern. But many other possibilities such as bulging disc. Etc. It depends if he has other symptoms such as nausea, vomiting, numbness, weakness, urinary symptoms etc. More info would help but with extreme pain it is best you take him to er for testing.