What Causes Left Lower Back Pain in Females?

Mar 6, 2026

Left lower back pain in females is often rooted in either a musculoskeletal injury (like a back muscle strain), reproductive health issue (like endometriosis, PMDD, or ovarian cysts), or kidney conditions (like kidney stones or infections). Women are generally more prone to back pain than men due to hormonal fluctuations (especially those related to pregnancy and menopause), unique anatomical features (wider pelvis, smaller sacroiliac joints), and pregnancy. These factors can contribute to pain in the left side that stems from the pelvis or organs (also known as “referred pain”). 

While left-sided lower back pain often stems from minor injuries or PMS, persistent cases can indicate an underlying spinal condition, like spondylolisthesis or spinal stenosis, which requires specialized care. 

Read on for a detailed overview of each possible cause of left lower back pain in females and when to seek professional treatment. 

Quick Summary

Cause	Type of Pain	Key Secondary Symptoms
Strains & sprains	Localized, worsens with movement	Stiffness, muscle spasms
SI joint dysfunction	One-sided, radiating, occurs in the lower back & buttock	Hip & lower back stiffness
Kidney infection	Unaffected by movement, occurs in the flank, and worsens in waves	Fever, chills, nausea, vomiting, and bloody or cloudy urine
PMS/PMDD	Sore, achy, throbbing	Bloating, headache, fatigue
Pregnancy	Deep, dull, occurs below the waist	Pregnancy
Spinal degeneration	Dull & achy or sharp & stabbing, worsens with movement	Stiffness, radiculopathy, muscle weakness

When to Go to the ER

Seek emergency medical care if you experience these symptoms with left-sided lower back pain, as they may indicate a serious condition:

• Pain that worsens rapidly and doesn’t get better with rest
• Loss of bowel or bladder control
• Saddle anesthesia (numbness in the inner thighs, buttocks, and perineum)
• Fever and chills
• Nausea or vomiting
• Fainting or extreme weakness
• Severe abdominal pain or pain that radiates from the lower back to the abdomen

Key Causes of Lower Back Pain in Women

Lower back pain in women may be caused by musculoskeletal, reproductive, spinal, or organ conditions, or pregnancy. 

Musculoskeletal Causes

Simple strains and sprains are among the most common causes of lower back pain in women. SI joint dysfunction, pelvic floor dysfunction, lifestyle factors, and even stress can also play a role. 

Strains and Sprains

A back strain occurs when a muscle stretches too far, causing the fibers to pull or tear. A back sprain results from an overstretched ligament. 

Along with left-side back pain, you may experience the following symptoms with a back strain or sprain:

• Back stiffness
• Back muscle spasms
• Worsened pain with movement

Typically, back sprains and strains heal within two to four weeks. However, more severe cases can take longer to treat – up to a few months. 

SI Joint Dysfunction

SI (sacroiliac joint dysfunction) results from abnormal movement in one or both of the small joints at the bottom of the spine. SI joint dysfunction is more common in women than men, in part because women have smaller SI joints. It’s also particularly prevalent in pregnancy due to posture changes, increased weight, increased pressure on the abdomen and uterus, and spinal and pelvic laxity. 

Symptoms of SI joint dysfunction include:

• Pain in the lower back, buttock(s), pelvis, hip(s), and/or groin
• Sensation of leg instability
• Inability to sit for extended periods, or sitting only on one side
• Pain while transitioning from sitting to standing

Pain from SI joint dysfunction can differ depending on whether it’s caused by excessive SI joint mobility (hypermobility) or poor SI joint mobility (hypomobility):

• Hypermobile SI joint pain may be felt in the lower back or hip, potentially radiating into the groin. 
• Hypomobile SI joint pain is often felt on one side of the lower back and buttocks, potentially radiating into the affected leg. 

Pelvic Floor Dysfunction

The pelvic floor muscles stabilize the core and support the pelvic organs, including the bladder, bowels, and uterus. This makes them crucial for continence and sexual function. Pregnancy and childbirth often weaken the pelvic floor, making women susceptible to pelvic floor dysfunction; an estimated 32% of women have a pelvic floor disorder, according to a study of 25,000 women from Scientific Reports.

While not a primary symptom of pelvic floor dysfunction, lower back pain often occurs with this condition. According to Harvard Health, this may be due to:

• The close link between the pelvic floor and posture
• Referred pain from pelvic floor muscle tension 

Key symptoms of pelvic floor dysfunction include:

• Sensation of aching, fullness, or pulling in the vagina
• Difficulty urinating or fully emptying the bladder
• Seeing or feeling a “bulge” protruding from the vagina
• Frequent or urgent need to urinate
• Painful urination
• Urine leakage while laughing, coughing, or exercising
• Constipation 
• Difficulty controlling gas
• Difficulty reaching the bathroom in time

Female-Specific Lifestyle Triggers: High Heels and Heavy Handbags

Some women are more prone to back pain due to lifestyle factors like wearing high heels, carrying heavy handbags, and even poorly-fitted bras. 

• Wearing high heels creates a deeper curve in the lumbar spine, which contributes to back muscle tension and increases stress on the spine. 
• Carrying a heavy bag throws off your body’s weight distribution and posture, which may lead to back pain over time. 
• Wearing a bra that doesn’t fit properly may contribute to back pain by increasing muscle tension and forcing the shoulders out of their proper position. 

Psychological Factors: Stress and Muscle Tension

Psychological factors, including stress, anxiety, and depression, can exacerbate lower back pain in women. Here’s how:

• Stress and anxiety can worsen back muscle tension, possibly causing stiffness and pain. 
• Stress, anxiety, and depression are thought to increase pain sensitivity. 
• The body’s natural stress response can cause a hunched posture. 
• Stress, anxiety, and depression increase cytokine production, which may elevate inflammation throughout the body. 

Reproductive and Gynecological Causes

Reproductive causes of lower back pain in women range from the usual, like PMS and menstruation, to medical concerns that require professional treatment, like endometriosis and pelvic inflammatory disease. 

• Menstruation and PMS (premenstrual syndrome): During menstruation, the body releases prostaglandins to prompt uterine contractions and expel the uterine lining, which can cause lower back pain.  
• Dysmenorrhea is the term used for severe, painful menstrual cramps. It’s common, affecting between 50% and 90% of reproductive-age females, according to American Family Physician. Lower abdominal pain from dysmenorrhea can radiate into the lower back.  
• PMDD (premenstrual dysphoric disorder) is a severe form of PMS affecting around 5% to 8% of menstruating women, according to Harvard Health. Common symptoms include depression, mood swings, anxiety, fatigue, and difficulty sleeping, all of which can make it difficult to function and may lead to conflict with loved ones. Some people with PMDD experience severe cramps and menstrual pain, which may affect the lower back. 
• Endometriosis occurs when endometrial tissue develops outside of the uterus. The primary symptom of endometriosis is pain, which can affect the lower back, lower abdomen, or pelvis. Other symptoms include:
  • Cramps before or after a period
  • Pain during intercourse
  • Pain while urinating or passing bowel movements
  • Constipation or diarrhea during a period
  • Fatigue
  • Heavy or irregular periods
  • Bloating
  • Nausea 
  • Infertility
• Pelvic inflammatory disease (PID) occurs when the female reproductive organs (uterus, ovaries, or fallopian tubes) are infected. It’s usually caused by untreated STIs, including chlamydia and gonorrhea. While not one of the main PID symptoms (which include lower abdominal pain/tenderness, abnormal vaginal discharge, fever, chills, nausea, vomiting, painful intercourse, burning with urination, and abnormal periods), it can create a dull ache in the lower back. 
• Adenomyosis occurs when endometrium-like tissue grows into the myometrium, the uterus’s muscular wall. It affects an estimated 20% of women, according to Healthcare. While pain from this condition most often occurs in the pelvis, a dull, achy pain may radiate from the pelvis to the lower back. Other symptoms include:
  • Dysmenorrhea
  • Heavy menstrual bleeding or abnormal menstruation
  • Infertility
  • Painful intercourse
  • Bloating 

Post-Menopausal Factors: Osteoporosis and Compression Fractures

Women are more likely to experience spine and joint pain during and after menopause, according to Menopause Review. This is largely because estrogen production drops off, leading to reduced bone density and a heightened risk of osteoporosis. Osteoporosis is the primary cause of vertebral compression fractures (VTCs), which can trigger sudden and sharp or dull and achy back pain that typically worsens when walking or standing and improves while lying down. 

After menopause, women are also more susceptible to degenerative disc disease and facet joint osteoarthritis, which can cause back pain, stiffness, and neurological symptoms. 

Pregnancy and Post-Partum Back Pain

An estimated 70% of pregnant women experience back pain during pregnancy, according to BMC Pregnancy and Childbirth. It’s particularly common in the second and third trimesters, as the larger fetus places more stress on the lower back tissues, although some women experience lower back pain as early as two months into pregnancy. 

Lower left pain during pregnancy usually isn’t something to worry about. It’s often a sign that your body’s ligaments are softening to prepare for labor. The growing fetus also brings your center of gravity downward, which naturally triggers some discomfort. 

But if you experience severe, sharp, or intense lower left back pain during pregnancy, contact your doctor for further guidance, or visit the ER if it’s accompanied by:

• Vaginal bleeding
• Painful urination
• Fever or chills
• Neurological issues, like weakness, numbness, or tingling

25% of women continue to experience lower back pain three years after giving birth, according to the Journal of the Tunisian Society of Medical Sciences. This pain often results from weakened ligaments and core muscles, joint instability, and the physical trauma associated with childbirth.

Spinal Conditions and Age-Related Degeneration

Spinal conditions are a common cause of persistent lower back pain, especially in the older population. 

Arthritis

Various forms of arthritis, including osteoarthritis and psoriatic arthritis, can cause back pain. Sometimes this pain only affects one side of the back. 

• Osteoarthritis is also often called “wear and tear” arthritis. It can affect the joints of the spine, causing the cartilage to gradually break down. This creates inflammation within the joints, causing pain, stiffness, and diminished function. 
• Psoriatic arthritis is an autoimmune condition associated with psoriasis. It causes inflammation in the joints and entheses, the point at which ligaments and tendons attach to bone. Along with pain, psoriatic arthritis can cause:
  • Reduced mobility
  • Fatigue
  • Stiffness, especially in the morning
  • Changes in your nails
  • Eye redness and pain

Sciatica 

Sciatica refers to compression of the sciatic nerve, which extends through the lower back and down the backs of each leg. It typically causes pain, tingling, and numbness along the path of the nerve. The pain is often described as sharp, burning, and like an electric shock. 

Usually, sciatica affects just one side of the body (this is known as “unilateral”). This is why you may only feel its symptoms on the left side. 

Herniated Disc

A herniated, ruptured, or slipped spinal disc has developed a crack in its exterior, usually from age-related wear and tear, and the jelly-like interior is pressing out into the spinal canal. The injured disc may press on nearby nerves, including the sciatic nerve, potentially causing sciatica-like symptoms. 

Spinal Stenosis

Spinal stenosis occurs when the spinal canal narrows abnormally, usually due to age-related degeneration. Women have been shown to experience more lower back and leg pain from degenerative lumbar spinal stenosis than men, according to Pain Physician. This may be due in part to menopause-related hormonal changes. 

Pain from spinal stenosis may feel dull and achy or like a burning, electric sensation. It often radiates from the lower back into the lower extremities. A telltale sign of spinal stenosis is that pain improves with flexion (bending forward) and worsens while standing upright or walking. 

Spondylolisthesis

Spondylolisthesis develops when a vertebra slips downward, out of its normal position in the spine. This can cause nerve impingement and pain. While spondylolisthesis can be caused by genetic abnormalities or a pars interarticularis stress fracture from overuse, it’s usually degenerative, caused by wear and tear on the spinal discs and joints. 

Pain from spondylolisthesis often feels similar to a back muscle strain. But unlike a simple strain, it may be accompanied by sciatica symptoms, muscle stiffness, and leg or foot weakness (“foot drop”). 

Organ Conditions and Referred Pain

Pain in the lower left back in women can be what’s called referred pain, meaning the pain stems from a different area of the body in which it’s felt. The root of the pain may be in one of the internal organs, like the kidneys, pancreas, or colon. 

Kidney Stones and Infections (Pyelonephritis)

• Left kidney infections, also known as pyelonephritis, are a possible cause of lower back pain. These infections commonly start in the bladder and urinary tract. But, if the infection worsens, it may spread to the kidney.  

The most common symptom of a kidney infection is pain in the lower back, side, and around the genitals. This may be accompanied by:

• Fever
• Chills
• Shivering
• Weakness
• Fatigue
• Lost appetite
• Painful, frequent urination
• Burning sensation while urinating 
• Dark, cloudy, bloody, or odorous urine
• Kidney stones are deposits of salts and minerals that develop in the kidneys. They can be caused by a range of factors, including not drinking enough water, excessive or insufficient exercise, being overweight or obese, and consuming excessive salt or sugar. With kidney stones, you may experience severe, persistent back or side pain, as well as:
  • Bloody urine
  • Fever
  • Chills
  • Vomiting
  • Cloudy or odorous urine
  • Burning sensation while urinating 

Other organs, including the pancreas, colon, and uterus, are positioned near the lower left side of the back and can lead to lower left back pain.

Pancreatitis

Lower left back pain can be a symptom of pancreatitis, a condition characterized by inflammation of the pancreas. It can be acute (sudden) or chronic (prolonged). Most often, pancreatitis is caused by alcohol abuse or gallstones, which can obstruct the pancreatic duct, keeping enzymes from leaving the pancreas. 

Along with lower back pain, pancreatitis can cause fever, nausea, vomiting, rapid heartbeat, and swelling or tenderness in the abdomen. Chronic pancreatitis can cause pain that’s constant, severe, and worsens after meals. 

Colon and Digestive Issues (IBS, UC)

Lower back pain stemming from the colon can point to fecal impaction, constipation, ulcerative colitis (UC), or irritable bowel syndrome (IBS). It may feel like a dull, deep, achy pressure, typically accompanied by abdominal pain and other symptoms like abdominal cramps, bloating, constipation, or diarrhea.  

Rarely, lower back pain is a symptom of late-stage colon cancer. However, note that back pain rarely results from cancer. 

Pain-Tracking and Diagnostic Techniques

If you experience back pain that sticks around longer than a few days, it’s wise to start tracking your symptoms. Recording your pain severity, when it occurs, and any other symptoms will help your doctor make an accurate diagnosis. Consider adding these notes to your daily pain journal entry: 

• Your pain severity, on a scale of one to 10
• The location of your pain and any adjectives to describe your pain (sharp, dull, burning, achy)
• Other symptoms, like numbness, tingling, or muscle spasms
• How does your pain respond to home remedies like cold therapy, heat therapy, rest, and over-the-counter medication

Diagnostic methods for lower left back pain in females include a thorough family and medical history, symptom assessment, and physical examination. After these steps, your doctor may recommend further diagnostic tests, such as:

• Imaging tests, like X-rays or MRIs
• Blood testing
• Urine testing
• Other specialized tests or procedures, like a laparoscopy for endometriosis

Treatment and Prevention

Treatments for left-sided lower back pain in women vary widely based on the root cause. Common options include heat/cold therapy, physical therapy, medication, lifestyle adjustments, and, if all else fails, surgery. 

• Heat and cold therapy help manage inflammation and stiffness. While cold therapy is recommended to bring down inflammation in the first 72 hours after an injury, heat therapy boosts circulation and calms muscle cramps. 
• Physical therapy is implemented for acute injuries, spinal conditions, and other musculoskeletal issues to strengthen and stabilize the back while improving range of motion. PTs provide targeted exercises, stretches, and complementary therapies (massage, biofeedback, acupuncture, etc.) to help with symptom management. 
• Medication may be used to treat a vast range of conditions. Medication types include:
  • Painkillers and anti-inflammatory medications (like NSAIDs) for musculoskeletal injuries, arthritis, spinal conditions, and menstrual cramps
  • Steroid injections for chronic back pain from spinal conditions
  • Antibiotics for infections
  • Hormone treatments for endometriosis and post-menopausal bone health
• Lifestyle adjustments like low-impact exercise, quitting smoking, reaching a healthy weight, and eating an anti-inflammatory diet support overall health and may help prevent ongoing back pain in women. 

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When conservative methods fail to significantly improve lower back pain or other symptoms, surgery may be considered. Surgical methods vary for different conditions – for endometriosis, surgeons typically perform laparoscopy to remove the endometriosis tissue; for spinal conditions like spinal stenosis and spondylolisthesis, surgeons often implement spinal decompression surgery with spinal fusion. 

Opting for minimally invasive, modern alternatives to conventional surgical methods can help reduce possible risks and complications. One such option for lumbar spondylolisthesis and spinal stenosis is the TOPS System, a dynamic implant system that replaces the tissues removed during decompression surgery and restores a controlled range of motion in the spine. It’s been awarded approval and a superior-to-fusion claim from the FDA, underlining its benefits for patients seeking new, better alternatives to traditional spine surgery. 

FAQs

• Can a UTI cause left-sided back pain?
  • Yes, especially if it has spread to the bladder or kidneys.
• Why does my back hurt on the left side during my period?
  • This is likely due to normal uterine contractions. More severe pain may indicate an underlying condition, like PMDD, endometriosis, or uterine fibroids. 
• Is left-sided back pain a sign of menopause?
  • Not necessarily, although many women experience back pain after menopause due to reduced bone density and muscle mass. 
• How can I tell if my back pain is kidney-related?
  • If it occurs in the flank (the side of the back, between the ribs and hips) or under the ribs, if it’s unaffected by changing your position, or if it occurs with other telltale kidney symptoms like fever, chills, nausea, vomiting, and bloody or cloudy urine
• Why does my lower back hurt on the left side only?
  • It could be a sprain or strain, sciatica, a kidney stone or infection, a spinal condition, pancreatitis, or endometriosis.