10 Causes of Back Pain in Females

Dr. Eric DePopas, MD

Dr. Eric DePopas, MD

PainTheory Chief Medical Officer
Vascular & Interventional Radiologist

Table of Contents

Did you know that approximately 16 million people in the United States struggle with chronic back pain? That’s 8% of all adults. 

Not only can back pain be extremely uncomfortable and affect mobility, but it can also be difficult to find immediate treatment because the cause is often unclear. 

For women, back pain can be especially troublesome. Studies show thatpost-menopausal women  have a higher prevalence of back pain compared to men. While the reasons for this are currently unknown, there is a theory that a gene variant that promotes chronic pain in women suppresses chronic pain in men. There are also a number of conditions that only women suffer from that can be related to back pain.

What can cause lower back pain in women?

Women suffering from lower back pain may have difficulty identifying the specific cause of their pain, because there are so many possibilities, for example pregnancy and fibroids.

Below, we list the most common causes for lower and upper back pain in females, as well as ways to alleviate discomfort and potentially stop the pain altogether. 

Fibroids

Fibroids are growths made up of muscle and fibrous tissue, found in or around the uterus. In the United States, 26 million women between the ages of 15 and 50 have fibroids; 15 million of those women experience associated symptoms like back pain. 

The pain occurs when large fibroids form and press against the muscle and nerves of the lower back. The location of the fibroid also matters as fibroids located on the back of the uterus are closer to the spinal column and more likely to pinch nerves in that area.

To treat fibroids and back pain, Uterine Fibroid Embolization (UFE) is a non-surgical procedure that is highly effective. The process involves a radiologist using x-rays to block the blood flow to fibroids in order to shrink or completely destroy them. Studies show that nearly 90% of women who undergo fibroid embolization experience dramatic or complete resolution of their fibroid-related symptoms.

Adenomyosis

Adenomyosis is a condition where the inner lining of the uterus (called the endometrium) grows into the muscular wall of the uterus. When the endometrium invades the muscle wall of the uterus, the tissue continues to grow, break down, and bleed. However, once it stretches into the muscle layer of the uterus it can cause an enlarged uterus and/or heavy periods, both of which can be quite painful.

Women with adenomyosis often feel pain in their back and legs, which is believed to be caused by intense pelvic cramping and pressure extending to those areas.

Uterine Artery Embolization (UAE) is a non-surgical treatment for adenomyosis. The procedure cuts the blood supply to the endometrial tissue that has invaded the muscle wall of the uterus, meaning the endometrial tissue can no longer grow beyond what it should. A 2021 study that followed women with adenomyosis, who were treated with UAE, for seven years showed 82% of patients achieved significant long-term improvements in symptoms, including back pain.

Premenstrual syndrome (PMS)

Commonly referred to as PMS, premenstrual syndrome is used to describe a variety of symptoms that women experience before their period. It typically starts three days before a period and lasts a couple of days after the period starts.

Lower back pain is one of the most reported symptoms of PMS and can be caused by two main factors. The first is an excess of prostaglandins (the hormones that are released during menstruation) which affect the muscles in the lower back. The second is heavy contractions that can radiate from the lower abdomen into the lower back. In both scenarios, women feel a heavy ache in the lower back.

Lower back pain due to PMS can be part of dysmenorrhea (painful periods), which is a condition where the uterus contracts more than normal and results in severe cramps that radiate to the back.

Endometriosis

Women with endometriosis are likely to experience back pain. The condition is diagnosed when endometrial tissue (the tissue that lines the uterus) grows outside of the uterus, sometimes on the fallopian tubes or ovaries. Endometrial cells can also stick to the lower back and the front of the pelvic cavities, resulting in lower back pain. 

Other endometriosis symptoms include bloating and diarrhea, which can exacerbate the back pain already caused by the condition.

Pregnancy

Pregnancy has a big impact on your back. As you gain weight, your ligaments relax in preparation for the birth, and your center of gravity moves, placing a lot more strain on your back. For the majority of women, the pain is concentrated below the waist and along the tailbone, however, others say that the center of the back and the waistline become sore.

Women who have back pain prior to pregnancy have a higher chance of severe back problems during their pregnancy.

Sciatica

The sciatic nerve is the longest nerve in your body, traveling from the lower spine through the buttocks and down the back of the legs. People with sciatica have compressed or injured this nerve, which can send burning pain or sharp pain throughout the lower back. Normally, the pain from sciatica extends down one leg; it can also stimulate weakness or numbness in that leg.

What causes upper back pain in women?

There are also many possible causes of upper back pain in women. These conditions are different from the common causes of lower back pain and require different treatments. Below, we cover the most common causes of upper back pain in women.

Muscle strain and overuse

If you significantly overwork a muscle or ligament, it could lead to back spasms and pain in the upper area of the back. Heavy lifting, sudden twisting, awkward movements, and overstretching can all spark back pain. Repetitive actions have the same effect, and if you ignore the early signs of back pain, it can turn into a chronic condition.

Poor posture

Humans can decondition their muscles by not using them properly. Slouching and sitting incorrectly for long periods of time ​result in pressure being applied to other parts of the body to compensate, primarily the back. For example, when you slouch, your body pushes on the spine, neck, discs, and ligaments, which can be painful. In extreme cases, you can also cause a misalignment of the spine.

Osteoarthritis

Bones and joints can be a source of back pain if the cartilage that protects the bones starts to wear down. This process is called osteoarthritis and can cause the cartilage to wear away completely, meaning that the bones rub directly together. In this scenario, pressure is placed on nerves in the spine and leads to back pain.

Herniated disc

Although more common in the lower back, herniated discs can happen in the upper back as well. Damaged disks are a sure way to experience painful sensations. Discs are essentially the cushions between your vertebrae, and when they push through the vertebrae, they put pressure on your spine. Your spine is delicate and even the slightest amount of pressure on it can be agonizing, so a herniated disc should be taken seriously.

In most cases, people with a herniated disc don’t need surgery and can recover with rest and anti-inflammatory medications, or in other circumstances receive injections of cortisone or something similar to ease pain.

Conclusion

There’s a reason that costs related to back pain total $100 billion per year. Back pain can disrupt daily life and cause feelings of anxiety. For those suffering from back pain pinpointing the cause of the pain is a big step toward overcoming it.

The above conditions are just a few common causes of back pain. We recommend speaking with a doctor immediately if your back pain persists or worsens.

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The information included in this document in no way substitutes for medical advice.

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