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9 Surprising Causes of Lower Back Pain in Women

The Clearing Team
The Clearing Team

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Lower back pain is defined as pain, tension, or muscle stiffness that you feel in the part of your back beneath your ribs and above your buttocks. This type of pain may extend to your legs, but it doesn’t always. 

Lower back pain is extremely common, with somewhere between 60 and 80 percent of people experiencing it during their lifetime and some demographics being more likely to develop it than others. For a multitude of reasons, women between the ages of 45 and 60 are at a higher risk of developing this type of pain.

When your back hurts day after day, it takes away from activities that you enjoy. It’s understandable that you would want to find a treatment plan to get relief. But the causes of lower back pain aren’t always as straightforward as identifying and treating a back injury. It can take some detective work, and the help of health professionals who are willing to advocate for you and be on your team, to figure out the root cause.   

Why do women experience lower back pain differently? 

Experts agree that more research is needed to better understand why women experience lower back pain differently than men. But from what we know now, there appear to be two main reasons why women experience lower back pain differently.

First, women have a different musculoskeletal structure. On a day-to-day level, that probably isn’t something that most of us think about too much, but when it comes to pain, it makes a difference. 

Women carry their weight differently, especially after menopause, with weight from other places shifting to be distributed across the hips and stomach area. Life events like pregnancy can put stress on the skeletal system that may be felt for the rest of a woman’s life. 

Secondly, your hormones can be a trigger for lower back pain. Some conditions that cause lower back pain, such as endometriosis and PMS, are linked closely to your varying hormone levels. When you go through menopause, your body’s levels of estrogen begin to decrease, and your body responds in lots of different ways as it gets adjusted. 

But estrogen doesn’t just play a role in your reproductive system — a lack of estrogen contributes to declines in bone density. That’s part of what makes women more prone to osteoporosis, compression fractures and other bone injuries. As your estrogen levels decrease, your risk for these conditions increases. 

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What are some surprising causes of lower back pain in women? 

Endometriosis

Endometriosis is a chronic condition that causes uterine tissue to grow outside of your uterus. In the United States, it’s estimated that as many as ten percent of women of childbearing age have this condition. 

Lower back pain is one of the most common symptoms of endometriosis. You may feel pain that is sharp and stabbing in your lower back or pelvis, especially prior to or during your period. It can take some time to get properly diagnosed with endometriosis, which can delay the start of treatment. 

Ankylosing Spondylitis

Ankylosing spondylitis (AS) is a type of arthritis that affects your spine. It’s an inflammatory condition that can cause some of the bones in your spine to fuse together. If you have this condition, the pain and stiffness in your lower back may be especially uncomfortable early in the morning or after sitting down for long periods. 

Men are at higher risk for developing AS, but that means the condition can be overlooked in women. Physical therapy and non-steroid anti-inflammatory drugs (NSAIDs) such as naproxen are typically prescribed to treat AS. In serious cases of AS, treatment by a rheumatologist should be considered.  

Sacroiliac Joint Dysfunction

The sacroiliac joints are two joints on either side of your spine. These joints keep you stable while you walk. If these joints become dysfunctional or inflamed, it can cause pain in your lower back. This is known as sacroiliac joint dysfunction, or SJD. It’s estimated that between 15 and 30 percent of adults who have lower back pain are experiencing SJD. 

Because of differences in the musculoskeletal structure, women’s sacroiliac joints are less stabilized than men’s. Hormonal changes, including those during pregnancy, can stretch out these joints, making them more likely to become injured or inflamed. 

Pain from SJD may be sharp and stabbing, or it may be something mild that only flares up occasionally. Pain symptoms can often become chronic. NSAIDs, physical therapy and stability braces may be prescribed for treating SJD. 

Urinary Tract Infection

Urinary tract infections, or UTIs, are known for causing burning and pain in the pelvic area. For some women, this pain is felt in the lower back as well (especially if the infection is affecting your kidneys). 

UTIs are the third most common type of infection found in the human body, so experiencing one (or a few) in your lifetime isn’t unusual. Women get more UTIs because the urethra (the tube that brings urine out of your bladder) is shorter in women than it is in men. 

But UTIs can become dangerous if left untreated, and recurring UTIs can become a source of chronic pain. Antibiotics, increasing your fluid intake and resting to let your body heal are typically prescribed to treat UTIs. 

PMS

Right before you have your period, your body experiences inflammation as it prepares to release the lining of your uterus. This inflammation can actually cause discomfort in your back and legs that goes beyond period cramps.

That’s right, menstrual pain can affect your skeletal system and cause lower back pain that radiates through the whole lower half of your body. 

Treatment options for lower back pain that shows up with your period typically include heat therapy and a pain reliever. In some cases, changes to your diet and daily activities can relieve pain and other symptoms of PMS. 

Sloped posture

Your posture may be causing what’s known as “non-specific” lower back pain. If you’re feeling back pain after you sit for long periods of time, or if doctors can’t find an alternative explanation for your back pain, it might have to do with your posture. Poor posture isn’t necessarily a health diagnosis, per se, unless you have an underlying spine condition such as scoliosis or spondylosis

This type of pain may be more prevalent if you sit for long periods of time due to your job, if you have a sedentary lifestyle, or if you have a job that puts a lot of pressure on your spine and lower back due to lifting, carrying things and bending down repeatedly.

Physical therapy, chiropractic adjustments, back braces and posture-correcting exercises that you do at home can help to relieve back pain caused by your posture. You should also consider ergonomic seating and a standing desk at your workplace.

Lumbar compression fracture

Compression fractures happen when the bones in your spine become weak and can’t hold their firm, upright shape. These fractures aren’t the same as broken vertebrae but they are quite painful.

Compression fractures affect 25 percent (or more) of post-menopausal women. Having osteoporosis puts you at a much higher risk of developing these types of fractures, which is why they occur more often in women. 

These fractures can limit your movements and cause sudden, sharp pain. You may also feel pain or weakness in your arms and legs. Lumbar compression fractures specifically impact your lower back.

Treatments for these types of fractures can range from simply letting your body rest, to wearing a brace and getting physical therapy, all the way to corrective surgery in the most severe cases. 

Spine infections and malignancy

Your discs, joints and vertebrae can become infected, causing severe lower back pain. Osteomyelitis (an infection of your bone) is extremely rare, but more common if you have pre-existing conditions such as diabetes or a previous surgery on your spine. 

If you have an auto-immune condition or take immunosuppressant drugs, you may also have a higher risk of these types of infections. Some studies even suggest that these types of infections are on the rise, after declining for years amongst the general population. Experts speculate this is connected to increased use and abuse of recreational drugs that require intravenous delivery. 

A spinal infection is a serious health condition, and typically needs to be treated in the hospital where you can receive antibiotics via an IV and rest while your body gets better. If the infection persists, you may need surgery to remove the infected tissue. 

Spinal metastasis is another very rare cause of lower back pain in women, especially those who have a history of breast cancer. Spinal metastases are lesions on your spine that develop from cancer that originally appears in your breasts or another part of your body. These lesions swell, causing pain as well as neurological symptoms such as weakness and a loss of some sensations.

Spinal metastasis is difficult to treat, but aggressive chemotherapy and surgical options can help stop the lesions from developing further. 

Fibromyalgia 

Fibromyalgia is a chronic pain condition that is far more common in women than in men. The causes of fibromyalgia are not completely understood, but the condition is often linked to a traumatic pain incident or accident from which pain lingers for months or years. 

Fibromyalgia pain can be felt anywhere in your body, including your lower back. Treatment for fibromyalgia may include physical therapy (especially aerobics), over-the-counter pain relievers and treatment from a mental health professional for depression or anxiety.

How can Clearing help to treat lower back pain?

Most people will experience lower back pain sometime in their life. Women are especially likely to suffer from lower back pain, so it’s important to be aware of the potential causes. At Clearing, we believe in empowering our patients to live their lives to the fullest. That’s why we offer a comprehensive program that, depending on your situation, can include a personalized exercise program, custom compounded pain cream, CBD cream, nutraceuticals, health coaching and access to leading pain specialists.

This article is for informational purposes only and does not constitute professional medical advice. Always seek the advice of your healthcare professional with any questions or concerns you may have regarding your individual needs and medical conditions.