Back Pain After Hysterectomy: Causes & Finding Relief

Key takeaways:

• Back pain after a hysterectomy is common and may be acute or chronic.
• The uterus is firmly anchored in the pelvis. This means that removing it during a hysterectomy can cause back pain.
• Other potential causes of pain include infection, inflammation, and long-term complications like adhesions.

Any surgery disrupts your normal anatomy. A hysterectomy is no exception to this rule. Pain can be a natural response to bodily trauma, so it’s not uncommon to experience pain in the area where you receive surgical treatment. Surgically removing a pelvic organ such as your uterus is a complex procedure, entailing much more than simply removing it from where it sits. This reproductive organ has attachments on all sides that connect it to other tissues and organs. All these attachments separated by surgery are left in place and isolated. Getting relief from pain, then, means understanding what’s causing it and addressing the underlying issue.

Is it normal to experience back pain after a hysterectomy?

Back pain after a hysterectomy is common and can, in some cases, be considered a normal part of the healing process. While back pain of this kind may be common, it’s not necessarily normal in the sense that it’s to be expected. Acute or short-term back pain may result from inflammation or infection. Chronic or long-term back pain after a hysterectomy can be caused by how other organs stick to the ligaments and other connections left behind–called adhesions.

How long does back pain after this type of surgery typically last?

Acute back pain after a hysterectomy typically lasts for about four to six weeks, dissipating as the tissue left behind resorbs back into place. This pain can be aching, throbbing, and burning in nature. It can be localized to just the back, but it can also be more widespread and generalized. If adhesions form and disrupt the normal anatomy of nearby organs, like the colon or bladder, back pain may become chronic and last for months or years.

Causes of back pain after a hysterectomy

Since back pain following a hysterectomy can be acute or chronic, it has a range of potential causes.

Inflammation

Cutting into the body’s tissue, as is done during a hysterectomy, causes an injury. In response, the body releases signals into the bloodstream that lure inflammatory biochemicals to the injury site to start the healing process. However, this immune response also causes inflammation, which is meant to stop bleeding and wall off the injury from the rest of the body. Inflammation is natural, but it can still cause swelling, redness, tenderness, and pain.

Infection

The ends of tissues left behind after surgery are a great food supply for bacteria. Infection is a different level of inflammation, causing a different type of response–one that is more urgent and combative. Thus, infection is painful beyond mere inflammation. We humans are designed to combat infection, though, which typically means the body can fight off mild cases on its own.

Still, when an infection doesn’t resolve due to the volume of infectious organisms or an immune deficiency, the immune system becomes overwhelmed. As a result, the infection becomes more severe, potentially leading to worse pain symptoms. Until the infection is contained, that pain will continue.

Chronic pain from adhesions

Inflamed tissue will mobilize other tissues toward it to seal it away, protecting the rest of the body. However, this change can result in permanent adhesions, with tissues remaining stuck to each other once the inflammation is gone. Tissues meant to be flexible can become fixed together, limiting their function and potentially causing pain.

How to get short-term relief from back pain after a hysterectomy

Acute pain from inflammation is best treated with anti-inflammatories, such as ibuprofen. Also, moist heat increases circulation to an area, which helps decrease not only the inflammation but also remove swelling that inflammation causes. If an infection is present, taking antibiotics is usually a necessary part of the recovery process. Even in this case, anti-inflammatories, moist heat, and plenty of rest are usually the best short-term options for pain relief, as antibiotics may take a few days to begin to truly make a difference.

Treatment options for back pain after a hysterectomy for long-term relief

While back pain may be common after a hysterectomy, it can also become a chronic concern. Seeking treatment for back pain is important, as it can help you lessen the risk of complications and find long-term relief.

For general back pain after a hysterectomy

Exercise is a great way to help treat chronic pain. Being sedentary to avoid temporary postoperative pain will end up doing the opposite–setting you up for pain as you attempt to use muscles that have lost normal tone.

The pelvis is your center of gravity, so surgery there tempts you to alter your posture, from your waist all the way up to your shoulders. This can provoke pain in the lower, mid-, and upper back over time. Staying active can help you promote healthy posture and keep the muscles you use to walk and carry yourself strong.

For lower back pain after a hysterectomy

Anti-inflammatories are excellent at treating pain caused by ligaments cut during a hysterectomy. Limiting inflammation, in general, is good practice as you heal, as it can help you reduce the risk of developing chronic pain. Cold compresses can also help target localized inflammation by reducing blood flow to the area.

For middle back pain after a hysterectomy

Middle back pain can occur with a kidney infection, which is a risk some patients face due to the use of a urinary catheter during surgery. Antibiotics are used to treat this kind of back pain. Any middle back pain not related to kidney infection is likely due to straining mid-back muscle, which can be avoided with treatment like physical therapy.

For upper back pain after a hysterectomy

Avoiding normal back muscle use in an attempt to avoid temporary postoperative pain will strain everything else, even up through the upper back and shoulder joints. Treat upper back pain with:

• Anti-inflammatories
• Moist heat
• Mindfulness of how you alter your normal posture and poise
• Physical therapy and exercise

When you should see a doctor about your back pain after a hysterectomy

It’s not unusual to experience back pain after a hysterectomy, but that doesn’t mean you should ignore it. When pain worsens or comes with other symptoms, it might indicate that it’s time to speak to your doctor.

You should see a doctor if:

• Your back pain does not decrease on a daily basis as you heal. Post-op pain should not worsen over time.
• You have a fever alongside your back pain.
• Your back pain does not respond to home remedies like over-the-counter anti-inflammatories.

You should go to the emergency room if:

• You have a fever with worsening back pain.
• You develop nausea and vomiting.
• You notice a decrease in how much or often you urinate.
• You experience abdominal distention with severe cramps.

Questions to ask your doctor about back pain after a hysterectomy

• How fast should my back pain take to get better?
• Is there anything I should consider an emergency related to my back pain?
• What are the things for which you want me to immediately notify you?
• What’s the best way to avoid chronic pain after surgery?

Frequently asked questions: back pain after a hysterectomy

These answers to commonly asked questions about post-hysterectomy back pain may help you better understand your own symptoms.

What if you’re experiencing back pain 1 year after a hysterectomy?

This is usually due to adhesions forming and remaining after healing. Adhesional pain can be treated with surgery, but this typically isn’t recommended since such surgery can cause even more adhesions. The good news is that adhesional pain usually goes away by itself after a few years.

Can endometriosis cause back pain after a hysterectomy?

Endometriosis can cause back pain after a hysterectomy, but it’s not likely. In fact, a hysterectomy is the definitive treatment for endometriosis.

What if you’re experiencing severe back pain after the surgery?

While “severe” pain is subjective, it is always taken seriously until its causes are addressed and eliminated. Speak to your doctor if you experience what feels like severe pain after a hysterectomy, especially if the pain is accompanied by a fever.

Final thoughts on back post-hysterectomy back pain

Any surgery, especially abdominal or pelvic surgery, is a major disruption of your body’s integrity and well-being. Experiencing pain caused by inflammation or infection isn’t unusual, but it’s still worth bringing up to your doctor. Severe pain or pain that comes with other symptoms, like a fever, should be reported to your doctor immediately.

General Medicine follows a strict editorial process, including using real experts to write our articles, vetted primary sources, fact-checking, a secondary medical review, and updates as necessary. This article was medically reviewed and fact checked by Dr. Lane Thaut, DO.

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