Lower Back Pain in Females: Types, Causes & Treatments

Key takeaways:

• Lower back pain in women is influenced by unique factors like hormonal changes, reproductive health, and the female anatomy.
• Identifying specific symptoms and the underlying cause can lead to more effective treatments.
• Practicing preventive measures, making lifestyle adjustments, and getting timely medical care can significantly reduce pain and improve your quality of life.

Lower back pain is a common issue among women and individuals assigned female at birth (AFAB), often felt as a persistent ache or sharp discomfort that can interfere with your daily activities. Women and individuals AFAB may experience this pain differently than men or individuals assigned male at birth (AMAB) due to factors such as hormonal fluctuations, reproductive health issues, and the physical demands associated with pregnancy or caregiving.

Let’s explore the types, causes, and symptoms of lower back pain in females, including effective treatments and prevention strategies. Whether your pain stems from a muscle strain, a hormonal condition, or an underlying medical issue, understanding its root cause is key to finding relief.

Why females may experience lower back pain differently than males

Women’s and individuals AFAB’s bodies are uniquely structured, with hormonal and bodily differences that influence their experience of lower back pain. These differences often require different approaches to diagnosis and treatment.

• Hormonal fluctuations: Hormones like estrogen and progesterone affect the elasticity of ligaments and the stability of joints. For example, during pregnancy, increased hormone levels prepare your pelvis for childbirth but can also lead to lower back discomfort. Hormone-related conditions such as premenstrual syndrome (PMS) or menopause can cause back pain or make it worse.
• Reproductive health: Disorders such as endometriosis or uterine fibroids can cause pain that radiates to your lower back. Women and individuals AFAB may also experience discomfort from pelvic inflammatory disease (PID) or ovarian cysts, which can mimic musculoskeletal back pain.
• Bone density: Women and individuals AFAB are at greater risk for osteoporosis, a condition that weakens bones and increases the likelihood of fractures, including the vertebrae. Vertebral (spinal) fractures are a common cause of chronic lower back pain in postmenopausal women.
• Postural challenges: Activities such as carrying children, breastfeeding, or prolonged standing often lead to postural changes, straining your lower back. These demands can create stress on the muscles and ligaments of your lumbar region.

Types of lower back pain experienced by females

Females and individuals AFAB may experience various types of lower back pain influenced by hormonal, musculoskeletal, nerve-related, or internal organ factors.

Hormonal back pain

Hormonal shifts during your menstrual cycle, pregnancy, or menopause often cause lower back pain. During menstruation, uterine contractions can radiate pain to your lower back. Menopause-related changes in bone density and joint health can also contribute to chronic discomfort.

Musculoskeletal pain

Muscle strain and ligament sprains are common among women and individuals AFAB, often resulting from physical activities, heavy lifting, or maintaining awkward postures for extended periods. This pain is usually felt as a dull ache or localized tenderness.

Nerve-related pain

Conditions like sciatica, in which the sciatic nerve is compressed, can cause sharp, shooting pain that radiates from the lower back down one or both legs. Nerve-related pain may also result from a herniated disc or spinal stenosis, both of which require careful medical evaluation.

Referred pain

Pain from your internal organs, such as your kidneys, uterus, or ovaries, can be felt as if it is coming from your lower back. This type of pain is often accompanied by other symptoms, such as pelvic discomfort or changes in urination.

Symptoms associated with lower back pain in females

Lower back pain in females and individuals AFAB is often accompanied by specific symptoms that can help identify its underlying causes.

Persistent aching

A dull, constant ache in your lower back is often associated with musculoskeletal strain, arthritis, or degenerative disc disease. Women and individuals AFAB who engage in repetitive tasks or have sedentary jobs may notice this symptom more frequently.

Shooting or radiating pain

Sharp pain that travels from your lower back to your buttocks or legs often indicates nerve compression. This type of pain can make standing or walking difficult and may worsen with prolonged sitting.

Pain associated with menstruation

For many women and individuals AFABs, lower back pain coincides with their menstrual cycle. This is usually due to uterine contractions or conditions like endometriosis, which can cause inflammation and referred pain to your back.

Stiffness and reduced mobility

Difficulty bending, twisting, or performing routine tasks can indicate muscle strain, ligament damage, or joint issues. Stiffness can often worsen after a period of inactivity, such as sitting or lying down for an extended time.

Causes of lower back pain in females

Lower back pain in females and individuals AFAB can arise from various conditions, lifestyle factors, and physiological changes that affect the spine and surrounding tissues.

Endometriosis

Endometriosis is a condition where tissue similar to the uterine lining grows outside your uterus, causing inflammation, pain, and scar tissue. Lower back pain associated with endometriosis often worsens during menstruation and may require specialized treatment, such as hormone therapy or surgery.

Osteoporosis

Osteoporosis affects bone density and strength, making women and AFABs more susceptible to vertebral (spinal) fractures. These fractures can result in chronic pain and spinal deformities, affecting your mobility and quality of life.

Pregnancy

Pregnancy places unique demands on the female body and AFABs, including weight gain, postural changes, and hormonal shifts that loosen ligaments. All of these factors can cause lower back pain, especially in your second and third trimesters. Prenatal yoga, physical therapy, and supportive devices like maternity belts can help alleviate discomfort.

Urinary tract infections (UTIs)

UTIs can cause referred pain in your lower back, especially if the infection has spread to your kidneys. Symptoms such as fever, pain during urination, and changes in how often you have to urinate are often seen with a UTI.

Poor posture

Slouching, sitting in non-ergonomically designed chairs, or standing with poor spinal alignment can strain your lower back muscles and ligaments over time. This is a common but preventable cause of lower back pain in women and individuals AFAB.

How to get short-term relief from lower back pain as a female

Lower back pain in females and individuals AFAB can stem from a variety of causes, including medical conditions, lifestyle factors, and physiological changes.

Rest and active recovery

While brief periods of rest can help reduce acute pain, gentle movement is necessary to prevent stiffness. Activities like walking or light stretching will help to increase blood flow and muscle recovery.

Heat and cold therapy

A heating pad will help relax tense muscles and improve circulation, while cold packs can reduce swelling and numb sharp pain. Alternating between the two usually provides better relief than using just one or the other. Be careful not to burn your skin with a hot heating pad left on the area too long. You should not apply a cold pack directly to your bare skin, but wrap it in a towel or other covering before applying.

Over-the-counter medications

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (brand names Motrin and Advil), can reduce pain and inflammation. For menstrual-related back pain, medications like acetaminophen (brand name Tylenol) or prescription muscle relaxants may also provide relief.

Supportive tools

Using lumbar cushions, ergonomically designed chairs, or supportive footwear can help relieve strain on your lower back and improve your posture.

How to prevent lower back pain as a female

Strengthen core and back muscles

Exercises like Pilates, yoga, or strength training can improve your muscle tone and spinal stability, reducing the risk of back pain. Focus on low-impact activities that minimize strain on your joints.

Maintain a healthy weight

Excess weight increases pressure on your lower back and can contribute to chronic discomfort. A balanced diet combined with regular exercise can help you reach and maintain a healthy weight.

Practice ergonomic habits

Invest in ergonomic furniture and accessories, such as an adjustable chair or a standing desk, to reduce stress on your lumbar spine. Ensure that your workstation promotes good posture and doesn’t require you to sit or stand in an uncomfortable or awkward position.

Avoid prolonged inactivity

Break up long periods of sitting or standing by doing short stretches or taking walking breaks. Movement helps prevent stiffness and improves circulation to your back muscles.

Use proper lifting techniques

Bend at your knees and lift with your legs rather than your back to reduce the risk of muscle strain or injury.

When you should see a doctor about lower back pain as a female

Preventing lower back pain as a female or individual AFAB involves adopting healthy habits and ergonomic practices to support your spine and overall well-being.

You should see a doctor if:

• Your pain lasts for more than two weeks.
• You have symptoms like fever, weight loss, or changes in your urination.
• The pain is significantly affecting your ability to go about your daily activities or is getting worse over time.

You should go to the emergency room if:

• You experience sudden, severe pain that occurs after a fall or other trauma.
• You experience loss of control of your bladder or bowels, which may mean a medical emergency such as cauda equina syndrome.

Questions to ask your doctor about lower back pain in females

Asking your doctor the right questions about lower back pain can help you understand potential causes, treatment options, and prevention strategies tailored to your needs.

• What could be causing my lower back pain?
• Do I need imaging tests like X-rays, MRIs, or an ultrasound to diagnose my condition?
• What are the best treatment options for my symptoms?
• How can I adjust my lifestyle to prevent future episodes of back pain?

How a doctor may help treat lower back pain in females

Doctors offer various treatments for lower back pain, ranging from physical therapy to advanced medical interventions, depending on the underlying cause.

Physical therapy

A doctor may recommend a customized physical therapy program tailored to your specific needs. These programs typically include targeted exercises and stretches designed to strengthen your core and back muscles, improve spinal alignment, and enhance your posture. Physical therapy can also address muscle imbalances and provide guidance on body mechanics to prevent future injuries.

Medications

Depending on the cause and severity of your lower back pain, your doctor may prescribe various medications to help with your symptoms. Muscle relaxants can reduce spasms, while nonsteroidal anti-inflammatory drugs (NSAIDs) target inflammation and swelling.

In cases where lower back pain is related to reproductive health conditions, such as endometriosis or fibroids, hormone-based treatments may be prescribed. Pain-relief options may also include topical analgesics or low-dose antidepressants for nerve pain.

Hormonal therapies

For women and individuals AFAB experiencing lower back pain linked to hormonal fluctuations or conditions like endometriosis, hormonal therapies can play a major role. Birth control pills, progesterone-only treatments, or hormone-releasing intrauterine devices (IUDs) may help regulate hormonal imbalances, reducing inflammation and pain.

These treatments aim to manage the underlying condition rather than just the symptoms, providing longer-term relief. It’s essential to consult your healthcare provider to weigh these therapies’ benefits and potential side effects.

Injections

When lower back pain is severe or caused by nerve-related issues such as sciatica, corticosteroid injections may be administered directly into the affected area. These injections reduce inflammation, decrease nerve irritation, and provide longer-lasting relief than oral medications. Epidural steroid injections are often used to manage pain from herniated discs or spinal stenosis.

Surgical intervention

In cases where conservative treatments fail or your pain is caused by an issue such as a spinal deformity, a herniated disc, or endometriosis, surgery may be necessary. Procedures such as spinal decompression or disc replacement aim to relieve pressure on your nerves and restore mobility.

For endometriosis-related pain, minimally invasive laparoscopic surgery may be performed to remove endometrial tissue. Surgery is typically reserved for cases where pain significantly impacts the quality of life or where there is a risk of permanent damage.

Frequently asked questions: lower back pain in females

Here are answers to frequently asked questions about lower back pain, covering causes, treatment, and when to seek medical advice.

What should you do if you feel sudden lower back pain?

If you experience sudden lower back pain, it’s essential to rest and avoid activities that might worsen the pain. Applying ice packs during the first 48 hours can reduce inflammation, while heat therapy, such as a heating pad or warm compress, may help relax tense muscles.

Over-the-counter pain relievers like ibuprofen (brand name Motrin or Advil) can provide temporary relief. If your pain continues for more than a few days, radiates to other areas, or you have other symptoms like numbness, tingling, or fever, you should see your physician to rule out a more serious condition.

How long can lower back pain last?

The duration of lower back pain depends on its cause and severity. Acute lower back pain, often caused by a strain or a minor injury, typically calms down and goes away within a few days to a few weeks with rest, physical therapy, and proper care. Chronic lower back pain, which persists for more than 12 weeks, may require long-term management, including lifestyle modifications, physical therapy, or ongoing medical care.

What specialists treat lower back pain in females?

Various healthcare professionals specialize in diagnosing and treating lower back pain in women and individuals AFAB. While your family physician can evaluate and treat you for a relatively minor acute episode of lower back pain, a referral to a specialist may be necessary. Orthopedic doctors often see such cases, or even neurologists or neurosurgeons, if there is nerve involvement. Your physician may enlist physical therapists and chiropractors to help with your treatment plan.

Managing lower back pain

Lower back pain in women and individuals AFAB is influenced by a variety of biological, hormonal, and lifestyle factors. Understanding its causes and symptoms is the first step toward effective treatment. While self-care measures and preventive strategies can often help to relieve pain, continuing or severe symptoms will require a medical evaluation to rule out an underlying condition.

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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