Lower back pain affects more than 80% of people at some point. It is especially common in women and adults over 40. Sometimes, back pain occurs after lifting something, sitting too long, or twisting your body. Other times, it begins without a clear reason. Knowing the causes and recognizing which symptoms need attention from a healthcare provider can help.
Your symptoms may vary in location, intensity, and frequency. You might notice:
- A dull ache in your lower back
- Morning stiffness or discomfort
- Pain that radiates to your hips, buttocks, or legs
- Sharp or shooting pain
Symptoms may come and go, stay constant, or gradually worsen. Pain may feel worse after rest, when getting out of bed, lifting groceries, standing, or sitting for long periods.
Lower back pain in females can happen due to hormone changes, gynecological (reproductive) conditions, musculoskeletal (muscle and nerve) problems, or issues with internal organs that cause radiating pain.
Hormone Changes
Hormone changes and uterine cramps during your period can cause pain that radiates to your lower back. During menopause, the end of your reproductive years, lower estrogen levels can affect your spine and joints, increasing your risk of back pain.
Pregnancy
Almost 70% of pregnant people have back pain, especially in the third trimester. When you are pregnant, your posture shifts and joints loosen, adding strain to your spine. You may continue to have back pain a few months after delivery as your body readjusts.
Gynecological Conditions
Gynecological conditions that affect female reproductive organs can cause pain in the lower back. Examples include:
- Endometriosis: When tissue similar to the uterine (womb) lining grows outside the uterus
- Fibroids: Non-cancerous growths in the uterus
- Pelvic inflammatory disease (PID): Infection of the reproductive organs
Muscle Strain or Overuse
If you lift improperly or move suddenly, you can overstretch the muscles and ligaments in your lower back. Reaching or bending when your muscles are tight or tired can strain them and cause soreness, stiffness, or spasms.
Sciatica
Sciatica is when a spinal disc or bone presses on the sciatic nerve, the largest nerve in your body, traveling from your lower back down both legs to the feet. This pressure can cause sharp pain that radiates from your lower back down one leg. You may notice tingling, numbness, or burning.
Poor Posture or Weak Core Muscles
Slouching or sitting for long periods without support can stress your spine, leading to lower back pain. Weak core muscles make it harder for your body to maintain proper alignment, which could affect your posture.
Other Causes
Chronic conditions and internal organ problems can also lead to lower back pain. Examples include:
- Degenerative disc disease and osteoarthritis: These affect the discs and bones in the spine, causing stiffness, inflammation, and pain.
- Fibromyalgia: This condition causes widespread musculoskeletal pain.
- Internal organ infections or conditions: Inflammation or infection in the kidneys, gallbladder, or pancreas can radiate to your back, causing pain.
- Scoliosis: This is an uneven curve in the spine that can strain muscles and joints.
While most lower back pain improves with time and self-care, some signs require medical attention. Contact your healthcare provider if you experience back pain with any of the following symptoms:
- Fever
- Unexplained weight loss
- Numbness, tingling, or weakness in your legs
- Pain lasting longer than a few weeks
- Pain that limits your ability to sleep, move, or complete daily tasks
- Trouble controlling your bladder or bowels
Your provider will start with a physical exam and ask about your symptoms, medical history, lifestyle, and recent injuries. They may order the following tests to help find the cause:
- Blood tests: An erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) test can help detect infection or inflammation.
- Electromyography (EMG): This test measures how well your nerves and muscles work.
- Imaging tests: X-rays use radiation to identify bone problems, like arthritis or fractures. Magnetic resonance imaging (MRI) or computed tomography (CT) scans show problems with soft tissues, discs, or nerves.
Many people can improve their lower back pain with home care. If your pain worsens, your provider may suggest medical treatments.
Home Treatments
These methods can help with immediate pain relief at home:
- Ice therapy: Use ice packs for 15-20 minutes a few times daily for the first two to three days after an injury or flare-up. Ice helps reduce swelling.
- Heat therapy: After the first few days, switch to heat to relax muscles and improve blood flow. Heat is also a good choice for pain during your period.
- Rest: Avoid lifting heavy weights or objects until your pain resolves.
Over-the-Counter (OTC) Treatments
Over-the-counter medications can offer quick relief for lower back pain. Oral OTC pain relief medications include:
- Advil (ibuprofen)
- Aleve (naproxen sodium)
- Tylenol (acetaminophen)
Topical (on the skin) medications include:
- Arnica cream or gel (arnica)
- Aspercreme with lidocaine (lidocaine)
- Capzasin-HP (capsaicin)
- Salonpas (menthol, methyl salicylate, camphor)
- Voltaren (diclofenac sodium 1%)
Activity and Exercise
Staying active and building strength can help prevent lower back pain from returning. Gentle exercises like walking, stretching, yoga, Pilates, tai chi, or aquatic therapy may ease stiffness and improve strength. Avoid extended bed rest unless your provider recommends it. Practicing good posture and strengthening your core can also help take pressure off your lower back.
Lifestyle Changes
The following everyday habits may help ease lower back pain and reduce your risk of it coming back:
- Improve your workstation: Sit in a chair with good back support, keep your feet flat on the floor, and position your screen at eye level. Take movement breaks every 30-60 minutes.
- Lose weight if needed: Reducing extra weight can ease pressure on your lower back and joints.
- Manage stress: Relaxation techniques like deep breathing, meditation, or progressive muscle relaxation can help reduce tension.
- Wear supportive shoes: Choose cushioned shoes with arch support. Avoid high heels and completely flat shoes, which can affect your posture.
Medical Treatments
If your pain continues or worsens, your provider may recommend prescription medications such as:
- Anti-inflammatory medications
- Muscle relaxers
- Pain relievers, including opioids
- Certain antidepressants that also help with pain
- Steroids
Other possible medical treatments include:
- Physical therapy
- Acupuncture
- Chiropractic care
- Steroid injections
- Cognitive behavioral therapy (CBT) or talk therapy
- Numbing injections
- Surgery, if other treatments don’t help
Lower back pain is common in females. It can result from muscle strain, hormonal changes, pregnancy, or spinal conditions. Many cases improve with home care, lifestyle changes, and light activity. If your pain doesn’t go away or gets worse, a healthcare provider can help find the cause and recommend treatment options.
