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Lower Back Pain during Period: Causes, Diagnosis, and Treatment

For most women symptoms of bloating, headaches and abdominal pain may accompany menstruation. Some women may also have lower back pain during period, which is quite a common symptom. This pain often forms a part of the premenstrual syndrome (PMS) symptoms. Less commonly, it may occur as a result of other diseases such as endometriosis.
woman rubbing the muscles of her lower back

The back pain with period may range from mild discomfort to more debilitating pain that may interfere with your daily activities. Back pain during period may start a few days before the beginning of your menses and get better after the menses are over. It is typically muscular in nature and caused by hormonal changes. Let’s discuss how to manage severe lower back pain during period, as well as before and after it.

Causes of lower back pain during period

Lower back pain during period is usually muscular and caused by hormonal changes. Prostaglandins are chemicals a woman's body produces that cause many of the symptoms associated with menstrual discomfort. The tissue that lines the uterus makes these chemicals.  They stimulate contraction of the uterine muscles so that the uterine lining is shed during menstruation. Prostaglandins also cause the symptoms of menstrual cramps and discomfort. Heavy contractions can lead to low back pain, as the pain can radiate from the lower abdomen into the low back. Women with high prostaglandin levels may experience severe menstrual cramps and also severe back pain during period. Prostaglandins may also cause symptoms of vomiting, headaches, and diarrhea that accompany dysmenorrhea or painful menstruation. 

Lower back pain: period or pregnant?

Though period and back pain go hand in hand, lower back pain may be a symptom of early pregnancy. It may be present in some women even before they miss their period or before a positive pregnancy test. The cause of back pain during pregnancy may be that the ligaments in your body naturally become softer and stretch to prepare you for labor. This can put a strain on the joints of your lower back and pelvis, which can cause back pain. Hence, when considering lower back pain — period or pregnancy, period pain may start a few days before your periods and subsides after your periods are over. You may get low back pain due to early pregnancy around the fourth week of your pregnancy. You may continue having the pain for weeks or months while you are pregnant. The symptom of back pain during pregnancy may be associated with other symptoms of early pregnancy such as light vaginal spotting or bleeding, nausea, and breast tenderness. If you know about your pregnancy and you have symptoms of heavy vaginal bleeding or watery discharge, visit your doctor immediately. It becomes especially important to not ignore these signs and symptoms if you have a history of early miscarriage.

Eat a healthy and nutritious diet. Keep a good posture to relieve back pain. Stay active to strengthen your back muscles. Apply heat pads to the painful areas and massage these areas lightly to soothe the pain. 

You may also get cramps and back pain due to ectopic pregnancy. During this condition, a fertilized egg attaches itself in a place other than inside the uterus, for instance, the fallopian tubes. The symptoms are abdominal cramps, lower back pain, abnormal bleeding, nausea and shoulder pain. Some women may have typical early pregnancy signs of sore breasts and nausea. 

woman practicing yoga, standing in upward facing dog exercise

Lower back pain a week before period: should you be worried?

Lower back pain a week before period may be a part of premenstrual syndrome (PMS). PMS is a combination of emotional, behavioral and physical symptoms that occur in a woman before her menses. Premenstrual symptoms may start around the 14th day of your menstrual cycle and last till 7 days after your menses have started. 

Cramping and back pain after period: what does it mean?

Cramping and lower back pain after period may occur due to the following causes:
Ovulation: You may feel lower back pain after period along with cramping during ovulation — when your ovary releases an egg. It happens around the middle of your menstrual cycle. The pain due to ovulation may occur suddenly. It may last for a short duration or for up to two days. It may get better on its own.
Endometriosis: In this condition, the tissue lining the uterine cavity gets implanted outside the uterus, usually on the ovaries, fallopian tubes or on the tissue lining the pelvis. Endometriosis may cause lower back pain before period, and even during and after the period. Apart from cramping and lower back pain after period; the other symptoms of endometriosis are:

  • pain after and during sex
  • pain during urination
  • pain during bowel movements 
  • infertility
  • fatigue 
  • bloating 
  • nausea
  • excessive bleeding between or during periods 

Your doctor may treat endometriosis with medicines, surgery or hormone therapy. 

Uterine fibroids: These are noncancerous growths, which form in the uterine wall. They may cause lower back pain after period and other symptoms such as:

  • nausea
  • headaches
  • diarrhea 
  • constipation 
  • infertility 
  • leg pain 
  • prolonged or heavy menses 
  • difficult or frequent urination
  • irregular bleeding
  • cramping in abdomen
  • back pain during period 

Your doctor may treat uterine fibroids with medicine, surgery or certain medical procedures. 

 woman warming up outdoors

Adenomyosis: In this condition, the tissue lining the uterus starts growing into the muscular uterine wall. It may cause back pain during and after period along with a prolonged or heavy period, pain during sex, and passage of blood clots during the period. Your doctor may treat adenomyosis with medicines. In severe cases, they may perform a hysterectomy. 
Cervical stenosis: In this condition, which is present in some women, the cervical opening is very small and impedes the flow of menstrual blood. This leads to an increase in pressure in the uterus resulting in menstrual cramps and back pain during period. Your doctor may treat cervical stenosis using medicine or surgery.  
Pelvic inflammatory disease (PID): It is an infection of the female reproductive organs and is usually caused by bacteria. Apart from lower back pain after period other symptoms are: 

  • abnormal or heavy vaginal discharge
  • bleeding or pain during sex
  • fever with chills
  • difficult or painful urination
  • abnormal vaginal bleeding
  • bowel discomfort

You may treat PID with antibiotics and abstaining from sex temporarily. 

How to manage severe lower back pain during period?

You may try the following to manage severe lower back pain during period:

  • Painkillers: You may take over-the-counter ones, such as acetaminophen, or anti-inflammatories, such as naproxen sodium, and ibuprofen. a couple days prior to menstruation. If your pain doesn’t get better by OTC painkillers, your doctor may prescribe stronger pain relievers. 
  • Maintain a healthy diet and take nutritional supplements with vitamin B and magnesium.
  • Avoid smoking.
  • Exercise: Though due to the pain you may like to avoid exercising during a period, physical activity may help in reducing lower back pain on period. Try gentle exercises such as walking, cycling or swimming.
  • Heat: Applying a hot water bottle or heating pad on the lower back area may help in reducing back pain during period. 
  • Warm shower or bath: Taking a warm shower or bath may help you relax and relieve back pain during period. 
  • Massage: Gently massaging your abdomen and lower back may also relieve the back pain. 
  • Relaxation techniques: Doing relaxation activities such as Pilates and yoga may help in distracting you from feelings of discomfort and pain.  
  • Hormonal birth control: Your doctor may prescribe you the combined oral contraceptive pill to relieve cramping and severe back pain during period. 
  • Drink lots of water. 
  • Avoid foods containing salt and caffeine. 
  • Avoid alcohol. 
https://www.healthline.com/health/cramps-after-period#causes
https://www.healthline.com/health/womens-health/pms-symptoms-vs-pregnancy-symptoms#cramping
https://www.webmd.com/women/guide/menstrual-pain#1
https://www.nhs.uk/conditions/period-pain/
https://www.mayoclinic.org/diseases-conditions/menstrual-cramps/symptoms-causes/syc-20374938

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