Reading Time: 11 min read 
Published: 23/01/2024 
Last Updated: 13/03/2024 
Lower back pain is a common condition that can affect anyone of any gender. There are many potential causes for lower back pain, some of which are specific to women and people who menstruate. These include causes relating to pregnancy, the menstrual cycle and endometriosis.
In this article, we’ll explore what causes lower back pain in females, how a hospital can help with lower back pain, and how to relieve lower back pain at home. We’ll also discuss when it’s important to get assessed by a healthcare professional. Harley Street Specialist Hospital has a team of highly specialised doctors, surgeons, physiotherapists, and radiographers who can provide expert assessments for lower back pain.
What causes lower back pain in females?
Here, we’ll go through some causes of lower back pain that only affect women and people with a menstrual cycle. These include causes relating to pregnancy, endometriosis, the menstrual cycle and more.
Pregnancy
More than two-thirds of pregnant women experience lower back pain [1]. This is mainly due to the changes that happen in a woman’s body during pregnancy, including hormones, posture and changes to their centre of gravity. Sciatica in pregnancy, which often includes low back pain as a symptom, is also very common.
Unfortunately, the intensity of lower back pain tends to get worse as pregnancy progresses. Symptoms are often worse at night and when standing up [2]. Maternity belts, gentle exercise and physiotherapy can improve lower back pain in pregnancy. Of course, labour itself can cause back pain and many women require pain relief in labour.
Endometriosis
Endometriosis is a chronic inflammatory condition where extra tissue grows in places like the ovaries and fallopian tubes. This tissue is similar to the tissue found in the lining of the womb (uterus), but it causes problems by growing in the wrong place. Endometriosis affects 10-15% of reproductive-aged women [3].
Lower back pain can be one of the symptoms of endometriosis. Other symptoms include pelvic pain, fertility issues, pain during sexual intercourse, gastrointestinal issues and pain during menstruation.
Treatment for endometriosis includes pain medication and hormonal treatments that can suppress menstruation and stop painful periods. If these treatments aren’t effective, surgery can remove the endometriosis. The surgical approach used most often is laparoscopy (keyhole surgery).
Dysmenorrhea
Dysmenorrhea (period pain) describes pain associated with menstruation. This can be during the days of menstruation or the days immediately before or after.
Dysmenorrhea is very common and affects up to 90% of reproductive-aged women [4]. Symptoms range from mild to severe and are a leading cause of absenteeism from school and work [4]. Lower back pain is one of the main symptoms of dysmenorrhea, as well as leg pain and lower abdomen pain.
Heat, such as a warm bath or shower, can help to relieve pain from dysmenorrhea. Pain relief medication, gentle massage, and gentle exercises like yoga, swimming or walking can also help symptoms.
Ovarian cysts
Ovarian cysts are sacs that develop on an ovary, usually filled with fluid. Small ovarian cysts may not cause symptoms, and some people are unaware they have them. Larger cysts can cause lower back pain and pelvic pain.
In reproductive-aged women, most ovarian cysts are benign and don’t affect daily life, so no surgical intervention is needed [5]. However, complications of ovarian cysts include cyst rupture, pain, blood loss and torsion (a twisted cyst) [5]. These complications require management, which can include surgery to remove the ovarian cyst.
Pelvic inflammatory disease
Pelvic inflammatory disease (PID) is an infection of the female reproductive system, including the womb, ovaries and fallopian tubes. It mainly affects sexually active young women [6].
Symptoms of PID include lower back pain, as well as pain in your lower abdomen and pelvis. Other symptoms include pain when passing urine, pain during sex, fever, unusual or heavy vaginal discharge, and unusual vaginal bleeding between periods or after sex.
Mild to moderate cases of PID can be treated with antibiotics in an outpatient setting [6]. However, more severe cases or cases of PID in pregnant women require hospitalisation for intravenous antibiotics [6].
Adenomyosis
Adenomyosis is similar to endometriosis. While endometriosis causes extra tissue to grow outside of the womb, adenomyosis causes it to grow into the muscle of the womb itself. Most women diagnosed with adenomyosis are 40-50 years old [7].
Symptoms are similar to those of endometriosis and include lower back pain, pelvic pain, menstrual pain and heavy periods. Treatment includes pain management with hormone therapies and pain medication. If symptoms are severe, a hysterectomy (removal of the womb) may be required [7].
Fibroids
Fibroids are muscular growths that grow in the lining of the womb. They are also known as uterine myomas or leiomyomas. Fibroids are almost always benign (non-cancerous) and can be as small as a pea or as large as a melon.
Symptoms include lower back pain, pelvic pain, heavy menstrual bleeding and frequent urination. Treatments include pain medication, hormonal therapies and surgery to remove the fibroids. A hysterectomy may be needed in many cases – around three-quarters of all fibroid treatments are hysterectomies [8].
What else causes lower back pain?
There are many causes of back pain that can affect anyone of any gender. Depending on the cause, you may feel pain in different positions, such as lower back pain in standing or sitting. Here, we’ll take a look at some of the most common causes of lower back pain that are not gender-specific. These include:
- Herniated discs – This is where the ‘cushioning’ tissue between your vertebrae (the bones in your spine) moves out of place. This can cause pain and difficulty with movement.
- Spinal stenosis – Over time, your spinal canal (the space where your spinal nerves pass through) can become too narrow. This can compress the nerves, causing pain.
- Osteoarthritis – Osteoarthritis, also known as ‘wear and tear’, is a natural part of the ageing process. It describes the process of cartilage in your joints breaking down with age. In healthy joints, a layer of cartilage prevents direct contact between the bones. If your cartilage deteriorates, these bones rub against each other which leads to mechanical damage and pain. This is why osteoarthritis in your lower back can cause lower back pain and stiffness.
- Sciatica – This is pain caused by an irritated nerve in your back. It can cause lower back pain, buttock pain, leg pain, and referred groin pain along with other symptoms like weakness or altered sensation. Sciatica usually occurs on one side, but sciatica on both sides (bilateral sciatica) also happens in rarer cases.
- Muscular pain – Tight muscles or muscle strains can cause lower back pain. This can be due to muscles in your lower back or surrounding areas like your hip, which can put extra pressure on your lower back when they’re not working as they should.
- Scoliosis – Scoliosis is a curvature of the spine which is fairly common and can cause lower back pain. Many people have it without realising it because symptoms can be very mild. More rarely, symptoms can also be severe and require surgery.
- Ligament sprains – If you overstretch or tear ligaments in your spine, this is called a ligament sprain. Ligament sprains can cause pain and inflammation in your lower back.
When to get medical advice
If your pain has lasted several days without improvement, or you can’t move with sudden, severe lower back pain, it’s worth seeking advice from a healthcare professional. If you’re unsure where to start, your general practitioner can point you in the right direction.
Some symptoms may indicate a medical emergency. If you experience any of these symptoms, it’s best to get medical advice straight away:
- Severe pain
- Altered sensation or numbness in your groin region
- Pain, weakness or altered sensation in both legs
- New, sudden changes to your bladder and bowel habits
How can a hospital help with lower back pain?
Hospitals can help by providing diagnosis and treatment for your lower back pain. Specialists, including pain management doctors, surgeons, and physiotherapists, can identify the root cause of your pain and provide treatment options. However, waiting lists can be long on the NHS, so many people opt to be seen sooner by visiting a private hospital.
Harley Street Specialist Hospital has a multi-gender team of specialists who can put you at ease when discussing personal conditions. You can always request to see a specialist of your preferred gender and we’ll do our best to accommodate. We can help you find the best treatment to relieve severe lower back pain.
Diagnostic imaging
Diagnostic imaging can help to provide a clear picture of why your lower back is painful. Harley Street Specialist Hospital has a state-of-the-art imaging centre, with access to X-rays, ultrasound scans, MRI and CT scans as needed. Our expert radiographers with extensive experience and knowledge will put you at ease throughout the process.
Pain management
Harley Street Specialist Hospital has a dedicated pain management unit (PMU) that provides rapid access to pain specialists. Often, you can receive treatment within the same visit. The team is made up of senior experts, including radiologists, physiotherapists, pain management consultants, spinal surgeons and neurosurgeons.
Treatments include expert reviews of pain medication and steroid injections that can treat your lower back pain. Many types of injections for back pain are ultrasound-guided, meaning the specialist can accurately guide the injection into the area causing your pain.
Lumbar epidural steroid injections are just one of the types of injections we can offer for lower back pain. Although you can get a cortisone injection on the NHS, waiting lists can be long which is why many people opt for private treatment.
Physiotherapy
Physiotherapists aim to restore movement and function when you are affected by an injury or illness. Research shows that physiotherapy effectively improves pain and function for people with lower back pain [9].
Harley Street Specialist Hospital has a leading physiotherapy department staffed by highly experienced physiotherapists with expert knowledge of lower back pain. They work regularly with people following operations or trauma, as well as chronic conditions that need long-term management.
Physiotherapy usually involves education and simple exercises for back pain. Treatment can also include acupuncture, manual therapy, massage and other hands-on treatments to improve movement and reduce pain.
Surgery
If other treatments aren’t effective at treating your pain, you may be considering surgery. Harley Street Specialist Hospital has a team of world-class neurosurgeons and spinal surgeons who are highly skilled at treating lower back pain.
How can you relieve lower back pain at home?
For some of the conditions we’ve discussed, specific medical treatments are required, like antibiotics or surgery. If this is the case, these home-based methods of pain relief are unlikely to be effective. When symptoms are mild to moderate, and you’ve already sought medical advice if you need it, here are some general ways to relieve lower back pain:
- Gentle exercise – You need rest to heal, but your back can stiffen up and become more painful if you sit in the same position for hours. Going for a gentle walk, doing some stretching or gentle swimming can help to loosen the muscles and joints in your back and relieve pain in some cases. It’s important not to push too hard with exercise while your back is sore, for example lower back pain and running can be a problem for some people.
- Hot and cold therapy – Heat can help to relax your muscles, while ice can help to numb pain and reduce inflammation. Choose the method that works best for you – both can be applied for 20 minutes at a time, several times per day. If both methods work, feel free to alternate.
- Non-prescription pain relief – Over-the-counter pain relief like paracetamol or ibuprofen can help to reduce your pain temporarily. This can allow you to move more normally, which can help to prevent your back from becoming too stiff.
- A pillow – Try placing a pillow between your knees when you sleep on your side or under your knees when you sleep on your back. This can help to take some of the pressure off your lower back and reduce back pain.
Treating lower back pain at Harley Street Specialist Hospital
After reading this article, you have some insight into what causes lower back pain in females and which treatments are available. Finding the root cause of your lower back pain is essential to choose the best treatment options.
If you’d like a diagnosis for your lower back pain, book an appointment at Harley Street Specialist Hospital. Our team of expert doctors, physiotherapists and pain management consultants can diagnose and treat your pain so you can get back to doing what you enjoy.
