Sudden Severe Lower Back Pain in Females

Experiencing sudden severe lower back pain as a woman can be concerning, to say the least. You may be worried that the pain is a sign of a serious underlying health condition or may require emergency medical care. 

Understanding the possible causes of lower back pain in females can help assuage these concerns and help you get the care you need. Read on to learn more!

What Can Cause Lower Back Pain in Women?

Lower back pain in women can be caused by premenstrual syndrome, premenstrual dysmorphic disorder, dysmenorrhea (painful menstruation), endometriosis, and spinal conditions. 

Premenstrual Syndrome and Premenstrual Dysmorphic Disorder

Premenstrual syndrome (more commonly referred to as PMS) is a common cause of lower back pain in women. Uterine contractions are thought to trigger this PMS symptom, as these muscular contractions can radiate from the uterus to the lower back. Increased inflammation may also contribute to back pain from PMS. 

Also known as PMDD, premenstrual dysmorphic disorder is a severe type of PMS. For many women with PMDD, the effects of this condition disrupt their day-to-day life. These symptoms tend to be similar to PMS symptoms, including lower back pain, but more debilitating.

Risk Factors

Risk factors for PMS and PMDD include:

  • A family history of PMDD
  • Depression
  • Anxiety
  • Mood disorders
  • Consuming caffeine more than three times weekly

Treatment Options and Long-Term Management

PMS and PMDD are often treated with a combination of methods, including:

  • Medications, including NSAIDs, birth control pills, or antidepressants
  • Dietary changes, often including more protein, less caffeine, and less sugar
  • Supplements, including calcium, magnesium, and vitamin B6
  • Exercise

Prevention

The following strategies may help prevent PMS and PMDD, or reduce the severity of your symptoms:

  • Upping your protein and complex carbohydrate intake while lowering your caffeine, alcohol, sugar, and salt intake
  • Sticking to a consistent sleep schedule
  • Exercising regularly, particularly with aerobic exercise
  • Managing stress through healthy lifestyle habits, mindfulness, and deep breathing

Dysmenorrhea

Dysmenorrhea is the medical term for painful menstruation. While many women experience pain during menstruation, dysmenorrhea involves pain that’s severe enough to disrupt their normal activities. With this condition, women tend to feel severe uterine cramps that may radiate into the lower back. 

Risk Factors

Dysmenorrhea risk factors include:

  • Smoking
  • Drinking alcohol during menstruation
  • Starting menstruation before age 11
  • Being overweight or obese

Treatment Options and Long-Term Management

The first line of defense against dysmenorrhea is heat therapy and exercise. If pain persists, your doctor may recommend medications including NSAIDs, acetaminophen, or hormonal contraceptives, like birth control pills. They may also suggest these lifestyle adjustments for long-term symptom management:

  • Limiting caffeine and alcohol consumption
  • Quitting smoking
  • Regular exercise

Women who have secondary dysmenorrhea, which is caused by an underlying reproductive condition, will need to treat the condition causing their symptoms. This may involve different medications or procedures, depending on the root cause. 

Prevention

The most effective way to prevent dysmenorrhea is to lead a healthy lifestyle by:

  • Exercising regularly, ideally with a combination of aerobic and strengthening workouts
  • Eating a balanced diet and limiting caffeine, alcohol, and sugar 
  • Managing stress levels through self-care
  • Considering hormonal birth control, as recommended by your doctor

Endometriosis

Endometriosis occurs when endometrial cells develop outside the uterus. This condition impacts an estimated 10% of women in the world, and it involves a variety of symptoms, including pelvic and back pain. Endometriosis tends to trigger chronic lower back pain if the endometrial tissue develops in or close to the back. 

Risk Factors

Risk factors for endometriosis include:

  • Family history of endometriosis
  • Low body fat
  • Starting menstruation before age 11
  • Having heavy periods that last longer than a week and short monthly cycles

Treatment Options and Long-Term Management

Although there’s currently no cure for endometriosis, it can be managed with NSAIDs, analgesics, and/or hormonal therapy. Surgery may be required in some cases if conservative treatments don’t resolve endometriosis symptoms.

Surgery for endometriosis often involves removing endometriosis tissue without compromising the uterus and ovaries. This is often done through a procedure called laparoscopy, a minimally-invasive procedure. 

Prevention

Endometriosis is considered idiopathic, meaning it has no clear cause. This makes it difficult to prevent. However, if you have a family history of endometriosis, consider talking to your doctor about ways to proactively manage your reproductive health.  

Additionally, while not proven to reduce the risk of endometriosis, these lifestyle habits may help with symptom management if you develop the condition:

  • Maintaining a healthy weight through aerobic exercise and a balanced diet
  • Limiting alcohol and caffeine consumption

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Spinal Conditions

Spinal conditions are a possible cause of persistent lower back pain in women. Aside from back strains and sprains, which affect the soft tissues of the back, spinal conditions that may trigger lower back pain include:

  • Spinal stenosis
  • Spondylolisthesis
  • Herniated disc
  • Degenerative disc disease
  • Vertebral fractures
  • Spinal tumors 
  • Osteoarthritis 
  • Sciatica

Risk Factors

Risk factors for spine disorders include:

  • Older age (over 90% of people have some disc degeneration by age 60)
  • Being overweight or obese
  • A sedentary lifestyle
  • Poor posture
  • Smoking
  • Poor diet
  • Careers involving heavy lifting
  • Exercise-related overuse
  • Underlying medical conditions, like rheumatoid arthritis or thyroid disease

Treatment Options and Long-Term Management

For most spine conditions, treatment options include physical therapy, medications, lifestyle adjustments, alternative remedies, and surgery. 

  • Physical therapy

As a drug-free, non-surgical treatment for pain and lost mobility, physical therapy is widely used for spine conditions. Physical therapy for conditions like spinal stenosis and herniated disc involve strengthening the core and back muscles, which support the spine. Your PT will also work with you to improve your range of motion, providing stretches and home remedies (like heat therapy) to boost your mobility. 

  • Medications

Medications can help you manage pain from spinal conditions. Doctors often recommend them alongside physical therapy to preserve your quality of life while your body heals. Sometimes, for those with chronic spine conditions, medications may be suggested for long-term pain management. 

  • NSAIDs and analgesics are available at over-the-counter and prescription strengths for back pain.
  • Doctors may also prescribe muscle relaxants to calm muscle spasms—a common spinal stenosis symptom. 
  • Corticosteroid injections can provide a dramatic improvement in pain and inflammation, but should be used sparingly to prevent complications.  
  • Lifestyle adjustments

Lifestyle adjustments can help lower your pain levels and deter spine conditions from progressing. Key components of a healthy lifestyle for spine health include:

  • Nutritious diet
  • Low-impact exercise regimen
  • No smoking and limited alcohol intake
  • Consistent sleep schedule
  • Proper posture
  • Alternative remedies

When Western medicine isn’t sufficient for symptom relief, many people turn to alternative remedies. Thankfully, methods like massage therapy, acupuncture, and chiropractic care offer proven benefits for back pain (as long as you see a trained, qualified provider). Alternative medicine can help with spine conditions by reducing inflammation, supporting the body’s healing process, and encouraging natural pain relief.

  • Surgery

In severe cases, surgery may be necessary to resolve lower back pain from spinal conditions. For conditions like spinal stenosis, spondylolisthesis, and herniated disc, spinal decompression surgery removes tissue that’s impinging on spinal nerves. This type of surgery is often followed by spinal fusion to restabilize the spine, although this involves permanently fusing two (or more) vertebrae.

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Prevention

Prevention strategies for spine conditions that can cause lower back pain in females include:

  • Maintaining a healthy weight
  • Quitting smoking
  • Eating a balanced diet
  • Exercising regularly with low-impact workouts
  • Strengthening the core and back muscles
  • Improving your posture
  • Avoiding a sedentary lifestyle and taking frequent breaks from sitting

What Can Cause Extreme Back Pain in Women Out of Nowhere?

Extreme back pain in women out of nowhere can be caused by:

  • Acute injury, such as a back muscle tear
  • Muscle spasm
  • Compression spinal fracture
  • Ruptured disc
  • Endometriosis
  • Labor

Extreme Back Pain from Muscle Spasms

Back muscle spasms are a prevalent health concern that range in severity. While some spasms are mild and go away quickly, others can lead to extreme back pain. 

Spasms are more likely to affect athletes (namely weightlifters) and individuals with other forms of back pain. This is because spasms most often result from overusing the back muscles. This type of spasm can usually be treated successfully with heat/ice therapy, rest, and/or over-the-counter pain medications.

However, back spasms are a possible symptom of serious medical conditions, including ankylosing spondylitis or gallstones. So, if you experience an extreme back spasm, contact your medical provider for an evaluation. 

Extreme Back Pain from Endometriosis

Some women with endometriosis develop cysts on the ovaries. These cysts can rupture and trigger sudden, severe lower back or abdominal pain. Sometimes, ruptured cysts require emergency medical care and even surgery. So, if you experience sudden, severe lower back pain and have endometriosis, seek immediate medical care. 

Lower Back Pain in Labor

When a woman is in labor, she may experience sudden lower back pain. This is thought to be the result of the fetus’s head pushing against the tailbone and spine. Your medical provider will recommend positions to alleviate back pain during labor. 

Why Did My Lower Back Start Hurting All of a Sudden?

Your lower back may start hurting all of a sudden from a fall, lifting a heavy object, a spinal condition, or endometriosis. 

Sudden Lower Back Pain from Falls or Lifting Heavy Objects

The most common cause of sudden lower back pain is an acute injury from falling or lifting a heavy object. Taking a hard fall can cause a herniated or ruptured disc, vertebral fracture, or back strain. Lifting a heavy object, particularly with poor posture, can cause back muscle strains, tears, or spasms. These injuries affect the soft tissues of the back and are usually resolved with conservative treatments. 

Sudden Lower Back Pain from Spinal Conditions

While some spinal conditions develop slowly with gradual symptoms, they can trigger sudden lower back pain in certain cases. One spinal condition that may cause sudden lower back pain is osteoarthritis, which can trigger compression fractures in the spine. Compression fractures are small fractures in the vertebrae caused by weakened bones.

If you experience a compression fracture, you may experience sudden lower back pain or back pain that gradually worsens, along with reduced spinal movement, a stooped posture, and symptoms of nerve damage. 

When Should I Go to the ER for Sudden Back Pain?

You should go to the ER for sudden back pain if you experience:

  • Fever
  • Bladder or bowel incontinence (inability to control bladder or bowel function)
  • Difficulty walking or standing
  • Loss of consciousness
  • Sudden numbness and/or weakness in the pelvic area or leg(s)
  • Radiating pain from the lower back to the abdomen

Is It Better to Rest or Move With Lower Back Pain as a Woman? 

It’s usually better to move with lower back pain as a woman.

Physicians recommend low-impact exercise for many cases of lower back pain in women. Lower back pain from PMS, for example, greatly benefits from gentle movement, like yoga or walking. 

However, if you experience lower back pain from an acute injury as a woman, you may need to rest to prevent further damage. If you’re unsure or your pain doesn’t go away within two weeks, contact a spinal specialist in your area.