Causes of Lower Back Pain In Women

Sometimes Your Lower Back Pain Is Not Quite What It Seems....

In This Article –

  • Biological Causes Of Lower Back Pain In Women
  • Other Dangerous Diseases That Cause Lower Back Pain In Women

By Definition –

There are different causes of lower back pain in women as opposed to men principally because the female body undergoes different transitions through life. These include such major events as childbirth, but even the female form itself can give rise to different forms of back pain.

This is not to mention the much more serious cases of back pain that are actually a symptom of something else.

There are numerous unique causes of lower back pain in women. Some causes have no cure, but are not too serious. Other causes are not down to your back and can KILL if not diagnosed and treated – this is why you need to know the causes of lower back pain in women.

A list of biological reasons why women suffer more lower back pain than men.

Causes Of Lower Back Pain In Woman (How Being A Women Makes You More At Risk).

In 2016, a review of 98 clinical trials concluded what has been considered for years – that more women do actually suffer with lower back pain than men at all age levels, particularly after menopause.

This may have been no great surprise, but given the wide range of potential alternative diseases that present lower back pain as a symptom, but not the cause – it is important to understand what might be happening next time you feel lower back pain.

When considering potential causes of lower back pain in women, it is important to look at it from two angles – on the one hand, the very biological nature of being a woman leaves you more likely to suffer certain back strains/ pulled muscles etc.

Meanwhile on the other hand there are also a host of other problems such as fibromyalgia or endometriosis that are not actually directly a result of damage to your spine, but can cause serious back pain none the less.

Mechanical back pain

By far the most common type of lower back pain is what is termed as ‘mechanical’ back pain. That literally means any form of strain/ pull that is likely to heal with simple rest.

Your spine is full of very joint, ligaments, and tendons, so there is plenty that can cause pain with half a chance. However, given that, as noted in this BMJ study in 2014, lower back pain is the single biggest reason for registered disability, mechanical back pain is no insignificant matter. 

So we’ll start off by looking at the biological reasons why you might suffer more with mechanical back pain….

1. Physical Shape.

Or more specifically, one of the downsides of having breasts. While it may be seen traditionally as desirable to have large breasts, a larger than normal chest will pull the skeleton forward over a prolonged period of time, effectively forcing the spine to bend and creating a permanently bad posture.

This can affect ladies of all ages and, unlike being overweight which can be changed with a better diet, the genetics of a significant chest can only really be resolved with breast reduction surgery.

It can however cause intense pain throughout the spine and is one of the less talked about causes of lower back pain in women.

Indeed, it is only fairly recently, that Bra manufacturers have looked in to this common problem and started producing special bras, aimed at spreading the weight burden and helping to relieve back pain in women.

Being generally overweight is of course another factor that is a significant contributor to back pain, and while this is certainly not considered more likely to affect women, there are a number of therapists who now advocate a change of diet as one way of reducing back pain.

Unfortunately, if you do have large breasts, your options are fairly limited – special bras, methods of managing the pain or surgery being the main options, none of which are perfect.

An image of a middle aged women suffering with lower back pain when trying to get out of bed

2. Pregnancy.

One of the most obvious physical problems with being heavily pregnant is that you suddenly have a large weight being carried by a frame that is not built for such stress.

The weight of the baby will temporarily alter your natural centre of gravity, pulling your frame forward, and distorting the natural position of your spine. This is made far more extreme by the relatively short time frame for which you carry your child.

If back pain was caused by weight gain through eating for example (or by having a large chest), then your body has at least had several years of warning to reinforce the muscles around your spine to try and cope as the extra burden grows.

When you are pregnant however, everything moves at such a pace that your body is in a constant battle to keep up – while at the same time sharing vital nutrients with your offspring to ensure their health. Indeed, in ‘Pelvic Disorders Related To Pregnancy’, there are a whole host of back and hip pains unfortunately related to childbirth.

As the baby grows, he/ she can also put physical pressure on the base of the spine. This can compress nerves and lead to feelings equivalent to sciatica.

The effect of pregnancy is then further intensified because, during pregnancy, levels of the hormone ‘relaxin’ are increased and this loosens the ligaments and structure around the spine.

Such an increase is designed to allow stretch for the baby, but does nothing for the strength of the spine and is a major reason why back pain is a common side effect of pregnancy.

In many cases after the birth, assuming some exercise and activity in the months following, you can return to a normal pain-free life – but not every time as sometimes the damage has already been done.

One such diagnosed form of back pain is Coccydynia (tailbone pain), which is characterized by sharp pain when sitting down.

This is often caused during childbirth because the head of the baby can push hard against your Coccyx causing injury.

However, frequently hormonal changes can also cause fragility in the Coccyx and for this reason, it is actually even more common in women over 40 that have previously had children.

An image of the curved spine of a heavily pregnant lady

3. Menstrual Cycle.

The normal menstrual cycle can also lead to considerable back pain. Menstrual cramps can often lead to back ache in both the days prior to and immediately following a period.

Prostaglandins released to shed the lining of the uterus can actively cause dysmenorrheal (painful) menstruations. Too many prostaglandins leads to heavier contractions and this pain travels from the lower abdomen to the lower back.

It is also common for the back pain to change from month to month depending on hormonal balance.

4. The Menopause.

Having survived potential childbirth and a monthly menstrual cycle you might think that would be it for your ‘enforced’ back pain.

Sadly not. The lower estrogen levels associated with the menopause are believed to cause ‘collagen wasting’ which in turn can lead to a variety of back problems as bone density is reduced and the cartilage in your back is damaged, of which approx 60% is made up of collagen (The Basic Science Of Articular Cartilage).

5. Less Bone And Muscle Mass.

This is constrained by a combination of social expectations and general physique. 

It would not be correct to claim that it is true of all women, simply that the average female body will contain a lower bone and muscle mass than the average male body. 

This can help to explain the higher rates of lower back pain in women because there is less supporting muscle around the spine.

About Us

Non-Mechanical Causes Of Lower Back Pain In Women

Injury

Naturally, if you are involved in an accident or physically beaten, then a spinal injury is a potential option.

In this case, an orthopaedic surgeon will need to know exactly what happened so that, together with the relevant scans, they can make an assessment on the likely injury. 

From this a treatment plan or surgical options can be decided upon.

Degenerative Spondylolisthesis

Spondylolisthesis literally means ‘slipped vertebral body’ in latin and refers to the situation when a vertebrae in your spine slips forward over the one below it.

This will frequently cause rubbing and irritation on your central spinal nerve root. It is thought that it appears in around 3 women to every man, although there is no specific reason for it. 

Speculation puts the reason down to hormonal changes, although the increased incidence of osteoarthritis is also thought to play a significant part.

Compression Fractures

A compression fracture occurs when a bone in the spine breaks due to osteoporosis. The fracture typically occurs after some sort of spinal movement (even as small as an innocent cough) and normally affects the front of the bone.

Although it can cause considerable pain, there is no guarantee that it will – many people feel no pain at all. 

Sometimes, it can be visible if it occurs to the upper back, as a lump (or hump) just below the neck with subsequent loss of height.

Women are thought to be more than twice as likely to develop a compression fracture due to their increased risk of developing osteoarthritis.

Coccydynia (Tailbone Pain)

As discussed above, coccydynia is likely to lead to considerable pain when just trying to sit down.

Thankfully, it is relatively uncommon, but does occur in 5 times as many women as men.

Childbirth is the most common reason for it to develop, although it can also be caused by a backward fall, landing on your lower back. Around 40 is the average 40 for onset if it related to childbirth.

While it can be treated and in some cases, simple back pain treatments such as massage or physio can cause the pain to go altogether, it can also become chronic in some cases (lasting more than 3 months).

In these cases, your ability to do normal things such as sitting for periods of time or even driving, are likely to be permanently affected.

Spinal Stenosis

This is an abnormal narrowing of the spinal canal, often resulting in morning stiffness and pain if you stand for too long.

It normally occurs if your intervertebral discs start getting thinner as you age. A minor bang can cause sciatica if you already suffer with spinal stenosis – so you need to be extra careful.

Slipped Discs (aka Herniated Or Prolapsed Discs)

The vertebrae in your spine are separated by jelly-like intervertebral discs. If their soft centre bulges through the hard outer layer, then it can easily compress one of the many nearby nerve roots.

The pain again is not dissimilar to that of sciatica.

Unfortunately, there are certain occasions when back ache or a stabbing back pain is actually the result of something else in the body transferring pain to your back, as the central framework of your body. Causes of back pain, where the back itself in not the actual source in women typically fall under 3 main areas – 

Causes Of Lower Back Pain In Women That Are NOT Actually Back-Related….

Check out our article on Lower Back Pain Red Flags for details of the main symptoms that indicate if your back may be something else or can’t wait for a normal doctor’s appointment.

Endometriosis

Endometriosis occurs when the tissue that makes up the lining of your uterus grows on the outside of your uterine cavity. This tissue can grow on your bowel or your ovaries and even spread beyond your pelvic region (but this is very unlikely).

As your hormones change during your menstrual cycle, the misplaced tissue changes in shape and often becomes inflamed and irritated.

Eventually it may break off and become trapped in your pelvis, ultimately applying pressure to your lower back (among other common symptoms).

The severity of back pain from endometriosis can vary from mild to severe, and unfortunately it does not correspond directly to the degree or stage of the condition.

You can therefore have very mild endometriosis, but suffer severe back pain as a symptom or have a very advanced form of the disease but little or no back pain.

The timing of your back pain in relation to your menstrual cycle is also no help as this can occur at any stage, meaning the diagnosis of endometriosis from back pain is almost impossible and would only be picked up by your doctor as a result of other symptoms. 

Pelvic Inflammatory Disease

PID, as it’s often referred to, is an infection of the reproductive organs. A number of different types of bacteria can cause such an infection, including those that cause STIs such as chlamydia and gonorrhoea.

This can be life threatening if the infection spreads to your blood, so requires urgent medical attention.

PID can often cause severe pain in the lower abdomen and sometimes this can spread to the lower spine as well.

Cancer

Abdominal pain can frequently radiate to the lower back and cause considerable discomfort.

This lower back pain may actually mask the real root of the problem – and there are a whole host of lower abdominal cancers that could be slowly spreading in your abdomen to transmit this pain.

While it is important to emphasize that the chances of your back pain being a cancer are statistically pretty low, it is however always worth getting a clinical diagnosis first.

This is especially true if you also have lower abdominal pain and do not have any specific causative factor such as an injury that would give a clear reason as to what caused the pain in the first place.

Fibromyalgia

Lower back pain is often an early hallmark of the onset of fibromyalgia – a rheumatic condition typified by chronic pain and exhaustion. You can read more about Fibromyalgia from our other articles.

Back pain because of fibromyalgia is likely to come and go for no particular reason in the early stages. It could also be accompanied by other symptoms such as irritable bowel syndrome or arthritis.

Unfortunately, as many as 80-90% of fibromyalgia sufferers are women, although exactly why is open to speculation – the reduction in estrogen after menopause being the most offered reason.

Piriformis Syndrome

The piriformis muscle is designed to enable rotation of the thigh within your hip joint.

Pirformis syndrome occurs if this muscle spasms, ultimately pushing against your sciatic nerve.

Typical symptoms include lower back pain, tingling down your leg and a dull ache in your bum.

Spondylosis (Osteoarthritis Of The Spine)

Osteoarthritis can strike at any joint in your body, and spinal osteoarthritis is surprisingly common. 

Cartilage in your facet joints starts to break down leading to increasingly intense pain. Most common symptoms include stiffness in the lower back in the morning combined with a dull ache that can suddenly become agony.

Women do have a bias towards spinal all forms of osteoarthritis, although it is only fairly small, varying slightly according to which data you use.

Seeing a doctor and taking preventative steps early is essential to slow and even halt it’s progress.

Sacroiliac Joint Dysfunction

Lower back or leg pain, similar to that often experienced with sciatica, is sometimes indicative of sacroiliac joint dysfunction.

Your sacroiliac joint (aka as the SI joint) is effectively a shock absorber between your pelvis and your upper body. Your pain will usually get worse for the longer you stand or if you climb stairs.

It is not clear what triggers sacroiliac joint pain, although a change in the movement of the joint is the likely reason.

Again, very frequently this change in the movement has been caused by pregnancy, so it should come as no surprise that this condition most commonly affects women between the ages of 20 and 45.

The Final Word –

Unfortunately it is a fact of biology that a number of causes of lower back pain in women are very difficult to ‘cure’ and just have to be managed, such as that caused by pregnancy or physical make-up.

However, just as there are unique reasons for back pain, there are also menacing problems that may actually have nothing to do with a back injury, but where time to treatment is absolutely essential.

A trip to the doctors is always a good idea if your lower back pain has not healed within a week or two at maximum. 

If nothing else, ruling out more serious complications can at least give you the confidence to proceed and get the best quality of life around your lower back pain.

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References –

1. Yì Xiáng J, Wáng, Jùn-Qīng Wáng, Zoltán Káplár. (April 2016). Increased low back pain prevalence in females than in males after menopause age: evidences based on synthetic literature review. Quantitative Imaging in Medicine and Surgery.
2. Damian Hoy, Lyn March, Peter Brooks, Fiona Blyth, Anthony Woolf, Christopher Bain, Gail Williams, Emma Smith, Theo Vos, Jan Barendregt, Chris Murray, Roy Burstein, Rachelle Buchbinder (2014). The Global Burden Of Low Back Pain: Estimates From The Global Burden Of Disease 2010 study. The BMJ Journals.
3. Hend Riahi, Meriem Mechri Rekik, Mouna Bouaziz and Mohamed Ladeb. Pelvic Musculoskeletal Disorders Related to Pregnancy. (2017) Journal of the Belgian Society of Radiology. 
4. Alice J. Sophia Fox MSc, Asheesh Bedi MD, and Scott A. Rodeo MD. (Nov 2009). The Basic Science of Articular Cartilage. Sports Health Journal

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