What Can Cause Lower Back Pain in Women?

Common Causes of Lower Back Pain in Women

1. Menstrual-Cycle Related Pain

For many women, lower back pain is linked to their menstrual cycle. Hormonal changes through the month can also cause changes in the body that will lead to a variety of discomforts, including in the lower back. Some conditions that cause lower back pain for women include:

• Premenstrual Syndrome (PMS): PMS is a condition that affects many women before their period, and its symptoms can vary widely from person to person. The symptoms may include physical issues such as lower back pain, headaches, fatigue, and bloating, as well as emotional and behavioral changes like mood swings, food cravings, anxiety, and difficulty concentrating. These symptoms are primarily caused by hormonal fluctuations that occur throughout the menstrual cycle, with common discomforts including breast tenderness. PMS typically begins a few days before your period and subsides within a day or two after menstruation starts. In some cases, PMS can be severe enough to cause cramping in the lower back due to these hormonal shifts.
• Premenstrual Dysphoric Disorder (PMDD): PMDD is a severe type of PMS that creates intense back pain and exhaustion together with large mood swings including depressive or irritable behavior. The symptoms of PMDD affect people more seriously than those of PMS yet remain less prevalent. While the emotional, behavioral, and physical symptoms of PMDD are similar to PMS, they are typically more intense. Primary symptoms of PMDD start one week before the start of menstruation and lessen few days few days after the onset of the period, according to study. The various symptoms of PMDD create difficulties in maintaining work performance and cause problems in relationships and daily activities. Because of its impact, it's important for those experiencing PMDD to explore treatment options, including lifestyle changes, therapy, or medical support.
• Dysmenorrhea: Dysmenorrhea is painful menstruation, often with cramping in the lower back, abdomen, hips, and legs. The pain usually starts just before or at the beginning of a period and lasts 1 to 3 days. It can range from a dull ache to sharp pain and may disrupt daily activities. While many women have mild symptoms, some experience more severe pain. It's more common if you're under 20, smoke, have heavy periods, or have a family history of painful periods. Underlying conditions can also intensify dysmenorrhea, including:
  • Endometriosis: Tissue similar to the uterine lining grows outside the uterus.
  • Fibroids: Noncancerous growths in the uterus that can cause heavy bleeding and pain.
  • Pelvic Inflammatory Disease (PID): A reproductive tract infection that may worsen menstrual pain

2. Endometriosis

Endometriosis occurs when tissue similar to the lining inside of the uterus starts to grow outside of the uterus. It often does this around the pelvic lining, fallopian tubes, or ovaries. This condition can cause quite a bit of pain, including during menstruation. Many women with this experience chronic lower back pain.

Pain is the most common symptom of endometriosis, and it can manifest in several forms. Along with very painful menstrual cramps, many women also experience sharp pain during or after sex, persistent pelvic and lower back pain, and discomfort during bowel movements or urination during their periods. These symptoms can interfere with daily activities and overall quality of life.

According to Dr. Gregory P. Gasic Neuroscientist | Co-Founder | VMeDx

Problems with the back muscles, bad posture or sedentary habits are common causes of lower back pain in women; endometriosis and osteoporosis are more specific to them, as are hormonal shifts and pregnancy.

This condition is more common for women in their 20s and 40s, especially if they have a family history of the condition. Those who have not had children or who have heavier menstrual periods may be at higher risk too.

3. Pelvic Inflammatory Disease (PID)

PID is an infection inside the reproductive organs. It is often caused by STIs like gonorrhea and chlamydia. This condition can cause a lot of pain in the lower stomach and back. Having multiple sexual partners, a history of STIs or unprotected sex can lead to a higher risk of this condition.

4. Fibroids and Adenomyosis

Fibroids are non-cancerous growths on the uterus that may cause lower back pain. It is most common in women over 30. Adenomyosis is a condition that occurs when the tissue that normally lines the uterus starts to grow on the muscular wall of the uterus and it can also cause lower back pain. This is common for women in their 40s and 50s without children.

5. Ovarian Cysts

Ovarian cysts are fluid-filled sacs that start to develop on the ovaries. Most are harmless and will not cause symptoms. But if they get big, they can lead to pelvic and lower back pain. Women with irregular menstrual cycles are at higher risk. Fertility treatments can also increase the risk.

6. Pregnancy and Postpartum Changes

During pregnancy, the body goes through big changes to help support fetal development. This can lead to lower back pain. The growing uterus, changes in posture as the baby grows, and hormonal shifts will add to this discomfort. Postpartum changes can also lead to back pain as the body tries to get back to its pre-pregnancy state.

According to Dr. David Shapiro, Clinic Director at Complete Spine Solutions,

Pregnancy brings unique challenges through relaxin-induced ligamentous laxity and progressive postural changes. The growing uterus increases lumbar lordosis while compromising core stability through diastasis recti and pelvic floor dysfunction.

Those carrying multiples, those who have had previous pregnancies, or those who are overweight may experience more back pain during this time.

Other Low Back Pain Causes

In addition to the causes above, there are several non-reproductive conditions that will contribute to lower back pain in women, including:

• Muscle strain: Improper lifting, overexertion, or poor posture can strain the muscles and ligaments in the lower back. Common triggers include:
  • Repeated heavy lifting
  • Awkward bending or twisting
  • Sudden, jerky movements
  • Overstretching muscles or ligaments
  If these actions are repeated or ignored, they can lead to back spasms and more intense pain. Recognizing these habits and improving your posture or technique can help prevent future strain.

Learn the causes and relief options for lower back pain in women. Watch this video to understand why it happens and how to find relief! Why Women Experience Lower Back Pain | Causes & Relief Explained (WATCH NOW!)

Dr. Chad Walding, Co-Founder and Chief Culture Officer, NativePath Lower back pain in women can stem from various causes, often linked to hormonal changes, pregnancy, or poor posture.

• Sciatica: Sciatica happens when the sciatic nerve is compressed or irritated. This can cause shooting pain from the lower back to the legs.
• Herniated discs: A herniated disc happens when the soft inner part of a spinal disc pushes through a tear in its outer layer, often pressing on nearby nerves and causing pain. Age-related wear, injuries, and sudden movements increase the risk. It’s most common in the lower back due to strain, but it can also affect the neck. According to the study, Knowing the risks helps with early detection and treatment
• Disc Degeneration and Posture Impact on Spinal Health

  As you get older, the discs in your spine naturally wear down, a process called disc degeneration. This is common after 40, especially in the lower back and neck. It can cause back pain, stiffness, or pain that travels to your butt or thighs. This pain might come and go.

  Poor posture, like slouching or sitting for a long time, puts stress on your spine and can speed up this process. Weak core muscles also make it harder to sit or stand up straight, which can worsen back pain. Knowing that things like injuries, repeated movements, and bad posture can trigger pain helps you manage it and keep your spine healthy.

How to Identify Chronic vs. Acute Pain

There are different types of pain that women can experience in their lower backs. The one they deal with will determine which treatment you will choose. Acute pain is the sudden pain that will often last less than six weeks. It is often related to muscle strain, overuse, or an injury.

Chronic pain, on the other hand, lasts for more than three months. It can be due to ongoing conditions, like degenerative disc disease or fibroids. If the back pain lasts for more than a few days or it is difficult to move, then talk to your doctor about it.

If your back pain lasts more than a few days or makes it hard to move, it’s time to talk to your doctor. Some symptoms may point to a more serious issue. Seek medical attention if you experience:

• Inability to Stand or Walk: If standing or walking becomes extremely difficult.
• Additional Symptoms: Fever, loss of bladder or bowel control alongside back pain.
• Leg Pain or Numbness: Tingling, numbness, or pain that radiates down your legs.
• Daily Disruption: When pain interferes with sleep, work, or basic activities.
• Pregnancy Concerns: If pain is paired with bleeding, fever, or painful urination, seek immediate care.

Recognizing these signs early can help you catch more serious conditions before they worsen and lead to better treatment outcomes.

Paul Roscioli, Chiropractic Physician, Owner, Main Line Disc Lower back pain in women can be caused by various factors, including pregnancy, hormonal changes, and lifestyle habits. Pregnancy puts strain on the lower back, and after childbirth, weakened muscles can lead to ongoing discomfort. Hormonal fluctuations during menstruation or menopause can also impact spinal stability. Additionally, poor posture, lack of exercise, and stress can contribute to chronic pain.

Treatment for lower back pain

Lower back pain can severely impact your quality of life. If it doesn’t improve with non-surgical treatments, your doctor may recommend surgery. Conditions like herniated discs, spondylolisthesis, and spinal stenosis may require surgical correction.

Non-Surgical Treatments

• Rest: Resting can reduce strain on your back for mild pain.
• Heat Therapy: Use a heating pad or warm bath to improve circulation, relax muscles, and promote healing.
• Cold Therapy: Apply an ice pack for 15-20 minutes to numb pain and reduce inflammation, especially after an injury.
• Pain Relief: Medications like NSAIDs, paracetamol, topical pain relievers, and muscle relaxants can help.
• Physical Therapy: Strengthening and flexibility exercises can improve posture and alignment.
• Steroid Injections: If other methods don’t work, your doctor might suggest injections to reduce inflammation and pain.

Surgical Treatments

• Artificial Disc Replacement: Replace a damaged disc with an artificial one.
• Spinal Fusion: Remove damaged discs and fuse vertebrae together, often for conditions like herniated discs or degenerative diseases.
• Discectomy: Remove a herniated disc pressing on a nerve, often combined with laminectomy.
• Spinal Laminectomy: Remove part of the vertebrae (lamina) to relieve pressure on the spinal cord.

Medical Treatments (Long-Term Relief)

• Medications: Over the counter pain relievers can help manage back pain. Using dietary supplements like magnesium, vitamin, or calcium can support the joints too.
• Physical therapy: A physical therapist can guide you through exercises that will strengthen the back and core, which can limit pain.
• Surgical options: In severe cases, your doctor may discuss surgery as a necessary treatment option for debilitating pain

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• Supplement: Best joint supplements like glucosamine and chondroitin can support joint function and reduce inflammation, potentially easing lower back pain caused by conditions like sciatica and disc degeneration.