What Causes Lower Back Pain in Females?

Back pain is a universal health concern, and it doesn’t discriminate. The factors that trigger back pain are often the same in women and men. However, certain causes of back pain, such as menstruation, pregnancy, and osteoporosis, are either unique to or more prevalent among women.

The most common issues of lower back pain in females are menstruation, pregnancy, stress, osteoporosis, and spinal conditions like disc disease, herniated discs, spondylolisthesis, and spinal stenosis. Let’s research them deeper:

Table of Contents

Menstruation

Menstruation is a key cause of back pain that exclusively affects women. During menstruation, the uterus produces substances known as prostaglandins. Prostaglandins manage muscle contraction, and during menstruation, they send messages to the uterus instructing it to contract. 

These muscle contractions are the direct cause of cramps and back pain during menstruation. Additionally, the cramps associated with menstruation place added stress on the back muscles, potentially leading to back muscle pain.

Pregnancy

Pregnancy often causes back pain, particularly in its later stages. The added weight of carrying the fetus puts significant stress on the spine, as well as the supporting muscles and ligaments. 

Additionally, the ligaments stretch and soften during pregnancy. This is one of the body’s methods of childbirth preparation. Unfortunately, as the ligaments soften, the lower back and pelvis become less supported. This may trigger back pain. 

Also, while being overweight for any reason can cause back pain, the rapid weight gain that occurs during pregnancy compounds the problem.

Stress

Mental stress is known to cause or contribute to back pain, in part because it contributes to the involuntary tightening of muscles in the back. Stress can also cause or exacerbate back pain during pregnancy which, as a major life change, is a time of great psychological stress.

Osteoporosis

Later in life, our bodies’ bone-building process gradually weakens. As a result, calcium is depleted from our bones, and our overall bone mass drops. The bones become more brittle, making them more prone to breakage. This phenomenon, which is referred to as osteoporosis, is more common among women than men. 

If osteoporosis causes spinal fractures (known as compression fractures), it can lead to severe back pain. With a compression fracture from osteoporosis, patients typically struggle to sit, stand, and walk. 

Spinal Conditions

Common spinal conditions, such as degenerative disc disease, herniated disc, spondylolisthesis, and spinal stenosis, affect women, just as they do men. These conditions can lead to chronic lower back pain. 

Chronic Pain Conditions

Chronic pain conditions like fibromyalgia, piriformis syndrome, sacroiliac joint dysfunction, and arthritis can lead to back pain in females. Since these conditions are chronic, meaning they last for longer than six months, they require ongoing management.  

  • Fibromyalgia is a chronic condition causing musculoskeletal pain throughout the body, as well as increased pain sensitivity. It’s often accompanied by fatigue and difficulty sleeping. Lower back pain is very common with fibromyalgia, and an estimated 80 to 96% of people with fibromyalgia are women. 
  • Piriformis syndrome occurs when the piriformis muscle (located in the buttocks) spasms and presses on the sciatic nerve, causing pain in the buttocks and lower back. This pain may radiate into the legs and feet, especially after sitting down for a long time or climbing stairs. 
  • Sacroiliac joint dysfunction develops when the sacroiliac joints (the joints that connect the lumbar spine and pelvis) don’t function properly—often due to hypermobility or instability. It’s more likely in women than men, as women typically have greater mobility in the sacroiliac joint. Possible symptoms include lower back pain, numbness, tingling, weakness, and leg instability. 
  • Arthritis is a category of conditions involving joint pain, inflammation, and stiffness. When it affects the facet joints of the spine, it can cause lower back pain. Two of the most common types of arthritis, osteoarthritis and rheumatoid arthritis, affect a higher percentage of women than men. 

Lifestyle and Posture

Aside from medical conditions, lifestyle and posture can contribute to back pain in females. While these factors alone can trigger back pain, they may also worsen back pain caused by underlying conditions. 

Lifestyle factors that can contribute to back pain in women include:

  • A sedentary lifestyle: Sitting for prolonged periods can influence back pain by increasing impact on the lumbar spine and triggering muscle tension. Females who sit at a desk during the workday are at a higher risk, although taking frequent breaks or working with a standing desk can help. Regular exercise can also help with back pain by promoting mobility, muscle strength, and blood flow. 
  • Stress: Women who struggle with chronically heightened stress levels are more susceptible to back pain. Stress can increase muscle tension, inflammation, and pain sensitivity. 
  • Poor sleep quality: Women who struggle with sleep disorders or inconsistent sleep are more likely to experience back pain. This is because sleep allows your body to rest, recover, regenerate damaged tissue, and reduce inflammation. 
  • Smoking: Nicotine is a vasoconstrictor, meaning it causes blood vessels to constrict. This limits the flow of nutrients and oxygen throughout the body, increasing the risk of various conditions, including back pain.  
  • Diet: Women who don’t consume enough essential nutrients (like vitamin D, omega-3s, and calcium) may experience increased inflammation throughout the body, contributing to back pain. 

Lower Right Back Pain in Females

Lower right back pain in females can be caused by spinal conditions, soft tissue injuries, endometriosis, uterine fibroids, pregnancy, or various underlying conditions. 

The spinal conditions that can cause lower right back pain in females include spinal stenosis, degenerative spondylolisthesis, and disc degeneration. These conditions can trigger spinal nerve compression, which may lead to sharp or burning pain in the right side of the back. 

Endometriosis, uterine fibroids, and pregnancy are possible causes of lower right back pain that can only occur in women. 

  • Endometriosis is a condition that impacts the lining of the uterus and may lead to chronic pain in the lower back. 
  • Pregnancy can trigger pelvic pain that impacts the lower back. Women may experience this pain in one or both sides of the back. 
  • Uterine fibroids are a type of non-cancerous growth that develop in the uterus. Lower right back pain is a potential symptom of uterine fibroids. 

Organ-Related Causes of Lower Back Pain in Females

Organ-related causes of lower back pain in females include:

  • Reproductive organ conditions, like endometriosis, ovarian cysts, and uterine fibroids
  • Kidney stones and infections
  • Appendicitis
  • Ulcerative colitis
  • Pancreatitis

These organ conditions can cause pain and inflammation that travels from the organ to the lower back. This is often called “referred pain”, and it can make it challenging to pinpoint the source of your discomfort. 

What Female Organs Can Cause Lower Back Pain?

Certain internal organs can lead to lower right back pain in female patients. Specifically, organs located in the pelvis, abdomen, and mid-back area may be the root of lower back pain. 

  • Reproductive organs

In women, the reproductive organs in the pelvis can trigger pain in the lower right area of the back. For instance, endometriosis, which typically affects the ovaries and fallopian tubes, can lead to pain that extends to the lower back. 

  • The appendix

The appendix is an organ that’s linked to the large intestine. People who develop appendicitis, which occurs when the appendix becomes inflamed, can develop lower right back pain. 

Appendicitis requires immediate treatment to prevent rupture and complications. In addition to lower right back pain, symptoms may include sudden pain on the right side of the lower abdomen that worsens with abrupt motions, loss of appetite, nausea, and vomiting. 

  • Kidney

The kidneys are organs that remove waste from the blood. Kidney issues, such as kidney stones or a kidney infection, can lead to pain on one side of the lower back. Other symptoms of kidney problems often include pain while urinating, nausea, and vomiting. 

  • Colon

Ulcerative colitis is a condition that’s characterized by inflammation in the colon. It causes repeated cramping in the abdomen that may trigger lower back pain, as well as symptoms including diarrhea, weight loss, and fatigue. 

How Can a Woman Find Out That Their Lower Back Pain is Serious?

Extreme lower back pain can be a cause for concern. But, since back pain is a common ailment, it can be difficult to know whether or not your pain requires medical attention. 

As a general rule of thumb, visit your doctor for an evaluation if you experience back pain that persists for longer than two weeks and holds you back from regular activities. If you experience severe back pain, visit a doctor sooner than after two weeks. Additionally, seek out immediate medical care if you have:

  • Fever with back pain
  • Sudden weakness in the arms or legs
  • Unexplained weight loss with back pain
  • Lost bladder or bowel control
  • Back pain following trauma, such as a car accident

Lower Back Pain Treatment For Women

Whatever its origin, there’s no reason to live with back pain, as a variety of treatment options exist for all their causes. Women wondering how to help lower back pain may consider physical therapy, medication, or even lifestyle changes to alleviate back pain caused by spinal conditions.

  • Physical therapy

Physical therapy can help with lower back pain by helping relieve tension in the back muscles. Additionally, physical therapy exercises can target and strengthen the muscles that support the back. 

  • Pain medication

Over-the-counter pain and anti-inflammatory medications may help women manage lower back pain in the short term. These medications can also help alleviate menstrual cramps and the associated back pain.

However, women experiencing back pain caused by more complex conditions, such as endometriosis, should speak with their doctors about the available prescription medications for the condition.  

  • Lifestyle changes

Lifestyle changes may help you naturally achieve relief from lower back pain. For example, in women experiencing back pain during pregnancy, gentle, low-impact exercise may offer relief. 

Women with back pain caused by cramps during menstruation can consider lifestyle changes including quitting smoking, cutting down on alcohol consumption and adding more high-fiber foods to their diet. Additionally, women with spinal conditions, such as spinal stenosis, may need to modify their activities to avoid straining the spine. 

Home Remedies and Medical Interventions

Home remedies and medical interventions alike can help women manage lower back pain. Home remedies are gentler and more natural, often with a lower risk of side effects. However, medical interventions are more potent and may be necessary to experience lasting relief, especially for chronic conditions and advanced cases. 

Home remedies for lower back pain in women include:

  • Heat and cold therapy
  • Over-the-counter pain medications, like NSAIDs
  • Gentle stretches
  • Relaxation techniques, like deep breathing, meditation, and journaling
  • Self-massage, like using a foam roller

Medical interventions include:

  • Physical therapy
  • Prescription medications
  • Steroid injections
  • Minimally-invasive procedures
  • Surgery

Spine Surgery For Back Pain in Women

Surgery is rarely required for women with back pain. However, if the back pain doesn’t resolve within six months of conservative treatment, your doctor may recommend spine surgery for lasting pain relief. 

Among women for whom spine surgery is recommended, there are multiple surgical approaches to consider. Thankfully, advanced microsurgical techniques and stabilization systems provide effective treatments for potentially disabling spinal conditions.

Decompression Surgery For Back Pain in Women

Decompression spinal surgery is a commonly performed spinal procedure for conditions including spinal stenosis, spondylolisthesis, and herniated disc. In this procedure, a portion of the vertebra that’s impinging on a spinal nerve is removed. Decompression surgery can have a dramatic and immediate impact on back pain associated with prevalent spinal conditions.

Spinal Fusion

Spinal fusion surgery has traditionally been performed in conjunction with spinal decompression. This process involves fusing adjacent vertebrae at the affected segment to stabilize the spine.

Unfortunately, while spinal fusion may offer pain relief for patients suffering from chronic back pain, it has numerous drawbacks. For one, spinal fusion eliminates the patient’s motion at the affected segment. As a result, the patient loses the ability to bend, twist, and flex that area of the spine. 

Additionally, spinal fusion can lead to adjacent segment disease. This fusion complication occurs when the vertebrae surrounding the fused bone degenerate faster than usual. As a result, the patient may experience back pain, stiffness, and/or neurological symptoms.  

Spinal Fusion Alternatives For Women With Back Pain

Alternatives to spinal fusion are available and can help patients avoid the drawbacks of spinal fusion. The TOPS™ System from Premia Spine, in particular, provides a superior, clinically-proven outcome when compared to spinal fusion back surgery.

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Unlike spinal fusion, the TOPS™ System preserves the vertebrae’s range of motion. Having been used since 2005, the system has enabled patients around the world to maintain their full range of activities following decompression surgery. TOPS™ has further advanced the treatment of common but potentially debilitating spinal conditions.

The TOPS™ System has been FDA-approved for individuals between 35 and 80 years old with degenerative spondylolisthesis at a level from L3 to L5 and lumbar spinal stenosis. The FDA also granted TOPS™ a superiority-to-fusion claim. 

Women experiencing back pain from spinal conditions should consult their doctors to learn about the complete range of spinal treatments available today.