Can Fibroids Cause Back Pain?

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The Short Answer –

Lower back pain in particular, is a very common side effect of oversized fibroids. In this article we look at how fibroids cause back pain and what you should if you develop them.

Understanding Fibroids

Fibroids can be defined (by The NHS in England) as

“…non-cancerous growths that develop in or around the womb (uterus). The growths are made up of muscle and fibrous tissue, and vary in size. They’re sometimes known as uterine myomas or leiomyomas.”

It is quite possible that as a woman you may have fibroids and not even be aware of them.

Typically they do not exert any symptoms, although on certain occasions they may present as side symptoms with any of the following –

  • heavy periods or painful periods
  • tummy (abdominal) pain
  • lower back pain
  • a frequent need to urinate
  • constipation
  • pain or discomfort during sex

As a general rule, patients typically describe back pain caused by fibroids as being a dull pain. Sometimes it can start with abdominal pain and then move towards the back.

That is unless the fibroids are pushing against sciatic nerves – in which case the pain is much more intense and shooting.

Causes of Fibroids

The exact cause of fibroids remains unknown. One theory is they are linked to the female reproductive hormone, oestrogen.

They typically develop between the ages of 16-55, principally because this is the age range when oestrogen levels are at their highest.

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Can Fibroids Cause Back Pain?

Fibroids typically start causing back pain when they grow large. They can press against the nerves of your lower back causing painful pressure.

Typically, it is when large fibroids form on the back of the uterus that back pain results.

Back pain can be the result of numerous different things, so there is no guarantee that your back pain is caused by fibroids.

One potential clue that the source of back pain is your fibroids, rests on whether you are experiencing leg pain as well. A large fibroid pushing on nerves in your pelvis can easily start to affect nerves that reach into your leg.

Fibroids can also cause back/ leg pain if they start pressing on blood vessels, since this compression can cause swelling – restricting blood flow and causing further pain.

Finally, in a worst case scenario, an enlarged fibroid can actually push against a sciatic nerve, resulting in intense pain in your lower back and right down your leg.

Is It Definitely Fibroids Causing Your Back Pain?

Even then however, there are a whole host of other conditions that create similar pressure and an equivilent level of subsequent pain.

The likelihood of fibroids being the source of your back pain depends, to some extent, on the size of the fibroids.

How Likely Are Fibroids To Cause Back Pain?

A study in the International Journal of Women’s Health (2017) found that 60% of women with fibroids had lower back pain. This was against just 22% that reported general abdominal pain and 25.8% that suffered with bloating/ diorrheoa/ constipation.

Diagnosis of Fibroids

If your doctor feels you have symptoms (including back pain) that are very likely to be linked to your fibroids, then they will probably carry out a pelvic examination and then refer you to diagnostics.

Among the options for diagnosing fibroids are the following –

  • An abdominal ultrasound scan (a scan from the outside of your tummy)
  • A transvaginal ultrasound scan (a small ultrasound is inserted into your vagina)
  • A Histeroscopy
  • A Laparoscopy

Any one of these tests can potentially determine the existence and size of your fibroids.

From there, you can consider if the pain is significant enough that you want to treat the fibroids.

Treatment Of Fibroids

Sometimes fibroids will shrink naturally as a result of going through the menopause, but in other circumstances, your treatment options will include –

Medication for the symptoms…

  • NSAIDs
  • Tranexamic Acid.
  • Levonorgestrel intrauterine system (LNG-IUS). This is a small plastic device in the shape of a ‘T’ that is placed in your womb and slowly releases progesterone.
  • The Contraceptive Pill
  • Oral Progesterone
  • Injected Progesterone

Then there are medications to shrink fibroids –

Medication To Shrink Fibroids…

  • Gonadotropin releasing hormone analogues (GnRHas)
  • Ulipristal acetate

Another option for reducing the size of your fibroids is to undergo surgery. If you opt for surgery, you have the following options –

Surgical Options…

  • Hysterectomy
  • Myomectomy
  • Hysteroscopic resection of fibroids
  • Hysteroscopic morcellation of fibroids

There are also a number of non-surgical/ non-medicinal options for reducing your fibroids. These include –

Non-Surgical Options…

  • Uterine artery embolisation (UAE)
  • Endometrial ablation
  • MRI-guided percutaneous laser ablation
  • MRI-guided transcutaneous focused ultrasound

The Final Word –

Can fibroids cause back pain?

Absolutely. Large fibroids push against nerves/ muscles in your spine causing what is generally a dull pain.

Sometimes however, a large fibroid can compress a sciatic nerve, resulting in a much sharper pain.

Fibroids are not generally considered a problem unless they start presenting troublesome or painful symptoms and a very common one of these is lower back pain.

However, there is no guarantee that your lower back pain is fibroid-related, but if it is (and the pain is worth seeking treatment), then there are a range of options available to you.

Ultimately, fibroids are generally innocent in themselves, but if they grow to a size that causes you back pain, then it may be time to get rid….

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References Used –

1. Various. NHS Website. Fibrroids.
2. Mahesh J Fuldeore and Ahmed M Soliman (2017). Patient-reported prevalence and symptomatic burden of uterine fibroids among women in the United States: findings from a cross-sectional survey analysis. International Journal of Women’s Health

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