Back Pain in Women: Causes, Symptoms and When to See a Doctor

What Are the Causes of Back Pain in Women?

Back pain may happen at various stages of life, and there are many possible reasons for it. Typical causes include muscle strain, sitting for long periods, reduced physical activity, injuries and spinal disorders.

Back pain may also occur as a result of periods, pregnancy, endometriosis, kidney problems or osteoporosis. Since the same type of pain can have different causes, other symptoms and the way the pain occurs are also important.

10 Possible Causes of Back Pain in Women

1. Period-Related Pain

Some women have lower back pain either before or during their period. Period-related pain may cause cramps in the lower abdomen or back and is linked to contractions of the uterus.

The discomfort may improve by the time the period finishes. However, if the pain is severe, getting worse or preventing you from carrying out normal activities, it should be discussed with a healthcare professional. Conditions such as endometriosis can also cause severe pain.

2. Endometriosis

Endometriosis is a condition in which tissue similar to the lining of the uterus grows outside the uterus. It may lead to chronic pelvic pain, especially before or during menstruation.

Some women may also experience pain during intercourse, painful bowel movements or pain while urinating.

Recurring lower back or pelvic pain around menstruation, particularly when period pain is severe, may require further medical evaluation.

3. Changes During Pregnancy and After Giving Birth

Back pain is common during pregnancy. As the uterus increases in size, it changes the body's centre of gravity and can place more strain on the back and joints. Hormonal changes during pregnancy may also affect the pelvic joints.

Back pain may continue after childbirth because lifting the baby, caring for the baby and changes in daily activities can place additional demands on the back.

If you are pregnant and experiencing severe or ongoing back pain, contact your healthcare professional, especially if the pain occurs with fever, painful urination or vaginal bleeding.

4. Osteoporosis and Vertebral Fractures

Osteoporosis causes bones to become weak and usually produces no symptoms until a fracture occurs. When a vertebra in the spine fractures, it may result in sudden or continuing back pain.

The chance of developing osteoporosis increases with age, and bone loss may become more pronounced around and after menopause.

Women who have risk factors for osteoporosis or a history of fractures should discuss their bone health with a healthcare professional.

5. Sitting for Long Periods and Reduced Physical Activity

Remaining in the same position for long periods, particularly when working at a desk, can lead to back discomfort. A lack of physical activity can also affect the muscles that support normal movement.

Taking frequent movement breaks, adjusting the workstation and gradually increasing physical activity may help support back health.

6. Herniated Disc and Sciatica

A herniated disc can irritate or put pressure on nearby nerves. This may result in back pain that radiates into the buttock or leg and may be accompanied by tingling, numbness or weakness.

Sciatica refers to pain resulting from irritation or compression of the sciatic nerve or its nerve roots.

Any new or significant weakness, increasing numbness or difficulty walking should be assessed by a medical professional.

7. Kidney Stones or a Kidney Infection

Not all back pain is caused by the spine.

Kidney stones may cause severe pain in the back, side, lower abdomen or groin. Other symptoms may include:

• Blood in the urine
• Painful urination
• Nausea
• Vomiting

A kidney infection can cause pain in the back or side along with:

• Fever
• Chills
• Painful or frequent urination
• Nausea
• Vomiting

A suspected kidney infection requires prompt medical attention.

8. Stress and Muscle Tension

Stress can lead to muscle tension and may make existing pain harder to manage. Poor sleep and changes in physical activity can also influence how pain is experienced.

However, persistent back pain should not simply be blamed on stress. When pain lasts, becomes worse or keeps returning, other possible causes should also be considered.

9. Nutritional Factors and Bone Health

Calcium and vitamin D are important for maintaining healthy bones. Vitamin D helps the body absorb calcium, while calcium helps maintain bone strength.

However, back pain should not automatically be attributed to low levels of vitamin D or calcium. Bone-related pain may have other causes, including osteoporosis and fractures.

If a nutritional deficiency or bone-health problem is suspected, a healthcare professional can decide whether testing is appropriate.

10. Arthritis and Age-Related Changes in the Spine

The discs and joints in the spine change with age. Conditions including osteoarthritis, spinal stenosis and degenerative disc disease may lead to back pain, stiffness or reduced mobility.

Many people can remain active through regular physical activity, suitable strengthening exercises and treatment based on the underlying condition.

When Does Back Pain Become an Emergency?

Most back pain is not caused by an emergency condition. However, some symptoms require immediate medical attention.

Seek Emergency Medical Care If Back Pain Occurs With:

• New loss of bladder or bowel control
• Difficulty passing urine
• Numbness around the genitals, anus or inner thighs
• Significant or rapidly worsening weakness or numbness in the legs
• Severe back pain following a serious injury

These symptoms may occur because of serious nerve compression, such as cauda equina syndrome, and require immediate assessment.

Seek Prompt Medical Assessment If Back Pain Occurs With:

• Fever or chills
• Severe pain that starts suddenly or worsens quickly
• Unexplained weight loss
• Worsening nerve-related symptoms
• Pain that does not improve or keeps getting worse
• Other symptoms that make you feel seriously unwell

How Can Women Reduce Their Risk of Back Pain?

It is not possible to prevent every cause of back pain, but some habits can help support back and bone health.

• Avoid remaining in the same position for extended periods.
• Take regular movement breaks when working at a desk.
• Make physical activity part of your daily routine.
• Strengthen the muscles that support your back and core.
• Use safe lifting methods.
• Maintain a healthy body weight when appropriate.
• Eat a balanced diet that includes enough calcium and other essential nutrients.
• Get sufficient vitamin D as recommended by your healthcare professional.
• Pay attention to sleep and stress management.
• During pregnancy, follow professional advice regarding safe activity and back care.

When Do You Need to See a Doctor About Back Pain?

Consider speaking with a healthcare professional if:

• The pain is severe or becoming worse.
• The pain keeps coming back.
• It affects your sleep, work or everyday activities.
• Pain travels into a leg or is accompanied by numbness or weakness.
• You have a fever or urinary symptoms.
• You have unexplained weight loss.
• The pain started after a serious injury.
• You are pregnant and have ongoing or concerning back pain.
• You have risk factors for osteoporosis or a history of fractures.

If you experience changes in bladder or bowel control, loss of sensation around the genitals or anus, or significant weakness in your legs, seek immediate medical attention.

FAQs

Is back pain a sign of osteoporosis?

Osteoporosis usually causes no symptoms until a fracture occurs. An osteoporosis-related fracture of a vertebra can cause severe or persistent back pain.

Why does back pain travel down my leg?

Pain travelling from the lower back into the buttock or leg can occur when nerves are irritated or compressed, including with sciatica. It may sometimes be accompanied by tingling, numbness or weakness.

When should I worry about back pain?

Seek emergency medical attention for new bladder or bowel problems, numbness around the genitals or anus, or significant leg weakness or numbness. Fever, severe pain after a serious injury, unexplained weight loss or worsening neurological symptoms also warrant medical assessment.

How can I reduce the risk of recurring back pain?

Regular movement, appropriate strengthening exercises, safe lifting practices, avoiding prolonged inactivity and maintaining overall health can help support back health.

Which doctor should I consult for persistent back pain?

For persistent back pain, you can consult an orthopaedic doctor or a spine specialist. Depending on the cause and symptoms, you may also be referred to a neurologist, physiotherapist, gynaecologist, or another specialist for further evaluation and treatment.