The majority of adults will experience lower back pain at some point in their lives, whether it is the result of an acute injury that resolves or a more chronic pattern of back pain. Some of these causes of lower back pain can happen to anybody, but there are certain conditions found in women that can be contributing factors. During the course of back pain treatment, women experiencing these issues will need to consider additional possibilities as the root cause of any lower back pain.
Common Causes of Lower Back Pain
Certain conditions and circumstances can lead to back pain in both women and men as a result of spinal issues. There is no significant difference in the construction of the lower back between the sexes, meaning that these causes are the same across the board.
Muscle Strain
One of the most likely causes of lower back pain is a strain in the muscles or ligaments that support the lumbar spine. These can be caused by one-time strains, like bending or twisting, sudden movements, or overstretching the tissue; they can also be a result of repetitive overuse through heavy lifting or other activities.
Sciatica
Though it is commonly used as a diagnosis, sciatica is a symptom that arises when the sciatic nerve is compressed or damaged. The sciatic nerve is the longest nerve in the body, traveling from the lower spine through the buttocks and down the backs of the legs. When the nerve is compromised, it can cause a burning pain or a shocking sensation in the lower back, which will typically extend down one leg. Severe cases may also cause numbness and weakness in the legs, especially when sitting.
Herniated Disc
Between the vertebrae that make up the spine sit small, gel-like discs that cushion these bones, absorbing shock and preventing them from rubbing against one another. If the disc becomes compressed or dislodged, it can bulge into the surrounding area or even rupture. When this happens, the disc’s matter compresses the nerves in the spine, leading to pain.
Herniated discs may result from injuries, especially those brought on by a sudden impact, like car accidents and falls. They can also result from wear and tear on the discs as you age. The lower back usually bears the brunt of this and is the most common area for discs to herniate, though they also appear in the neck.
Disc Degeneration
As you age, the discs in the spine can begin wearing down through natural processes. This can also be sped up by injuries, repetitive motion, or issues like chronic dehydration. Typically, by the age of 40, most people will have at least some degeneration of the discs, though whether this causes pain varies.
Because of the additional movement, the neck and the lower back are the most common areas for disc degeneration to cause pain.
Causes of Lower Back Pain in Women
Along with the other potential causes, some conditions in women are likely to cause lower back pain.
Premenstrual Syndrome (PMS)
While you often hear PMS referenced as a joke or a casual mention of mood swings, premenstrual syndrome is a real condition that many women experience in the time leading up to their period. Most people will not have all the symptoms of PMS, and the timing can vary. PMS can start a few days before your period and end within a couple of days of your period starting.
Symptoms of PMS can be emotional and behavioral, including mood swings, food cravings, anxiety, and trouble with focus or concentration. It can also include physical symptoms like headache, fatigue, bloating, and lower back pain.
Premenstrual dysmorphic disorder (PDD)
PMDD is a more severe form of PMS in which symptoms begin to interfere with daily life. Someone with PMDD can have trouble functioning, working, and performing normal tasks when symptoms are present. This is less common than PMS but still occurs in many women, especially those with a family history of depression and other mood disorders.
Emotional, behavioral, and physical symptoms of PMDD are similar to those of PMS; however, they are generally more severe and last longer. PMDD symptoms can begin a week before your period and last for up to a week past your period starting.
Endometriosis
In women with endometriosis, the tissue that lines the uterus grows outside of the uterus, onto surrounding organs like the ovaries and fallopian tubes. In some cases, the endometrial lining can even grow around the urinary tract and the bowels. The most common symptom of endometriosis is abdominal pain, but it can also lead to:
- Very painful menstrual cramps
- Pain during or after sex
- Pain during bowel movements and urination, especially during your period
- Pelvic and lower back pain
- Bleeding or spotting between periods
- Digestive issues like bloating or diarrhea
Endometriosis can also make it difficult to get pregnant or cause related health conditions.
Dysmenorrhea
Unusually painful menstruation is known as dysmenorrhea. The condition can be manageable in many cases, while others experience symptoms to the point of debilitation during their period. The pain is usually felt throughout the lower abdomen, lower back, hips, and legs and can be described as dull and achy or shooting pains. The pain typically lasts for 1 to 3 days.
Certain factors put someone at a higher risk of dysmenorrhea, such as:
- Being under the age of 20
- Smoking
- Heavy bleeding during periods
- A family history of painful periods
- Underlying conditions, including endometriosis, fibroids in the uterus, and pelvic inflammatory disease
Pregnancy
During pregnancy, it is common for a woman’s center of gravity to shift as their abdomen grows. Hormones also relax the ligaments in preparation for birth. Along with this, weight gain is common, causing more stress on those ligaments. This combination of factors means that lower back pain is extremely common in pregnancy, especially in the later months.
While some women experience lower back pain in very early pregnancy, it more commonly sets in between the fifth and seventh months. The pain usually appears right below the waist and across the tailbone, though it can also appear in the center of the back and around the waistline and even radiate down the legs.
Someone with a history of back pain is more likely to have severe pain during pregnancy, but anyone can experience these symptoms.
Managing Lower Back Pain
If lower back pain is a result of other conditions, especially those associated with your period, it may be reasonable to manage symptoms at home. When the root cause, or your period, resolves, the pain typically will as well.
Some effective ways to manage lower back pain include:
- Heat. Doing heat therapy can help relieve pain. As you apply a heating pad to your lower back, the heat will boost circulation and increase blood flow to that area. This allows nutrients and oxygen to reach the muscles, reducing strain and possible spasms. The relaxing of these muscles can provide immediate relief. You can also use a warm bath instead of a direct heat source.
- Medication. Taken sparingly, over-the-counter medication can help ease back pain as well as menstrual cramps. The best options are usually options that include anti-inflammatory properties, such as NSAIDs, ibuprofen, or aspirin.
- Exercise. While your instinct may be to lie still, staying active can actually ease pain by improving circulation, easing tension, and avoiding stiffness.
- Gentle stretches. Regular stretches can both reduce back pain and prevent it from returning or worsening once it has resolved.
- Ice packs. If your back pain results from muscle strain or an injury, an ice pack in the first 48 hours can help reduce pain, inflammation, and bruising. Apply ice to the painful area for 20 minutes at a time, three to four times per day, and make sure to use a cloth to avoid direct contact with the skin.
- Lumbar support. Making sure the chairs you use offer good lumbar support can reduce the strain placed on your lower back.
- Pillows. When sleeping on your side, use a pillow between your knees. If you sleep on your back, place a pillow below your knees. This can ease back pain and help you get better rest.
When to Seek Treatment
While mild issues and menstrual-induced pain may resolve on their own, most back pain will require treatment of the underlying issue.
Seek medical treatment if you experience any of the following:
- An inability to stand or walk
- Back pain accompanied by a fever
- Loss of control over bowels or bladder
- Pain, numbness, or tingling in the legs
- Severe abdominal pain
- Back pain that is severe and interferes with your quality of life
- Symptoms of endometriosis
- Pain during pregnancy with vaginal bleeding, fever, or pain during urination
- Back pain following a fall or accident
- Pain that lasts more than a week
A doctor will help you to rule out any serious issues and determine what is causing your back pain before developing a treatment plan.
Treating Lower Back Pain in Women
The treatment for lower back pain will vary greatly depending on the cause of the pain. If issues related to the female reproductive system are the root cause, those will need to be treated independently of managing back pain. This may involve referral to a gynecologist who can explore treatments such as:
- Hormonal birth control to manage endometriosis, dysmenorrhea, PMS, and PMDD
- Antidepressants to relieve symptoms of PMS and PMDD
- Surgery to address severe endometriosis. This procedure involves removing endometrial tissue from areas where it has grown beyond the uterus.
When these issues are not the root cause of lower back pain, you are more likely to work with a chiropractor or orthopedist to address the pain. Most doctors will try to avoid invasive options such as surgery, instead focusing on pain management and therapy to improve the condition. Common treatment options include:
- Prescription muscle relaxants, which depress the central nervous system and increase the mobility of tense muscles. This relieves pain from tightness and spasms enough to begin physical therapy. Muscle relaxants should never be used on a long-term basis.
- Back braces can be used to offer comfort and reduce pain that occurs during movement.
- Epidural steroid injections in which a steroid is directly injected into the outer part of the spinal cord. The injection temporarily relieves pain by reducing inflammation around a compressed nerve root.
- Corticosteroids can be injected into the back to reduce inflammation and manage pain for short periods of time.
- Chiropractic care to improve mobility, reduce stiffness, and improve the alignment of the spine.
- Physical therapy to strengthen the lower back muscles and promote proper movement and posture that may prevent future injury.
In more severe cases, surgery may be necessary to relieve symptoms and improve quality of life. Depending upon the exact issue, different types of surgery may be performed. The most common procedures are:
- Decompression. This procedure removes whatever is pressing on a nerve root from the spinal column, such as a herniated disc or a bone spur.
- Spinal fusion. If a disc is damaged and needs to be removed, it can be replaced with bone or metal in a fusion surgery. This allows the bones to grow together and stabilize, eliminating motion at that part of the spine.
- Artificial discs. In some cases, rather than fusing the spine after removing a disc, an artificial disc can be placed. This allows them to retain spinal motion.
- Posterior motion devices. These devices are a replacement for fusion in certain scenarios, which offer the same stabilization with a less invasive procedure.
The majority of lower back pain can be addressed through non-invasive options. At AICA Tucker, our specialists will work with you to create a personalized plan for addressing your lower back pain. By combining chiropractors, physical therapists, surgeons, and other experts, AICA Tucker will be able to evaluate the root cause of your pain and ensure the care you receive is pinpointed to your needs. Contact us today to schedule your first evaluation and begin finding relief for lower back pain.