What Causes Lower Back Pain in Women?

Pelvic Floor Doctor

Medically Reviewed By Dr. Amanda Olson,DPT, PRPC

Lower back pain is a very common injury, but it can be debilitating while it lasts and seriously impact your quality of life. Chronic lower back pain is a bit more common in those assigned female at birth (Schneider, Randoll, & Buchner, 2006). While this relationship is still being studied, here are a few things we know about the most common causes of lower back pain in women.

Lower Back Pain in Women

Note: while you might think that your breast size impacts your lower back pain (particularly if you have large breasts), research shows that heavy breasts are more likely to cause pain in the upper back (McGhee et al, 2018). 

Injury

A back injury is one of the more common causes of lower back pain, though this is usually acute (short-term). Actions like falling (particularly if you fall on your spine or butt), lifting an object incorrectly, exercising or stretching improperly, lifting an object incorrectly, or having poor posture can all cause temporary pains in your lower back.

However, their temporary nature does not mean you shouldn’t take them seriously; workin a hurt back muscle further can exacerbate your symptoms. 

Drinking water, hot baths, and hot or cold compresses can all help relieve your pain. If your pain persists more than a few days, seek medical attention so you can get the proper diagnosis and treatment. To avoid lower back pain due to injury, try to stretch before doing any physical activity, and remember to lift from your legs--not your back.

Poor Pelvic Support

There’s another type of exercising you can do to help relieve your lower back pain, and it’s one you probably wouldn’t expect. Emerging research has been examining the link between pelvic floor function and lower back pain (Dufour et al, 2018).

Your pelvic floor muscles support your pelvis and its organs, and weak pelvic floor muscles are associated with things like urinary incontinence and sexual dysfunction.

One study looking into this link found that 78% of those with lower back pain also experienced urinary incontinence (Eliasson et al, 2008); another found that women who reported lower back pain also reported having sex less often and more discomfort during sex (Maigne & Chatellier, 2001).

There can certainly be other causes for sexual dysfunction and urinary incontinence, but if you are experiencing both of these together with lower back pain, consider seeing a pelvic physical therapist for an evaluation and to determine if your pelvic floor is contributing to your back pain. 

If you have weak pelvic floor muscles that are not properly supporting your pelvis, hips, and spine, it is possible that adding kegel exercises to your regular exercise or stretching routine is indicated.

Kegels have been shown to help with pelvic floor function, and while we still need more research, there have also been some studies showing that kegels can help relieve back pain when combined with other efforts (Bi et al, 2013).

Curved Spine

The human spine has a natural curvature, but if your spine is curving too much or curving in the wrong direction, this can cause pain. Sometimes the cause of an abnormally curved spine is unknown, sometimes it is genetic, and sometimes it is caused by poor posture. A few types of spine curvature include:

  • Scoliosis: the spine curving sideways to the left or right
  • Kyphosis: the upper spine curving forwards
  • Pelvic tilt: anterior (where the pelvis curves upward), posterior (where the pelvis curves downward), or lateral (where the pelvis curves to one side or the other)

You will want to be seen by a medical professional for proper treatment and diagnosis if you suspect or know that your spine is curving and it’s causing you back pain.

Discs and Joints

Your spine is made up of a number of discs and joints surrounded by cartilage and nerves. There are a number of things that can go wrong with these parts of the spine, including a herniated disc(the center of the disc rubbing against a nerve ending) or degenerative disc disease(a progressive chronic health condition that causes discs to wear down) which can sometimes lead to osteoarthritis (loss of cartilage in the joint). 

Closing Thoughts

We’ve gone over a few main causes of lower back pain, but there are many more. In addition, there are many different treatments for your acute or chronic lower back pain. Physical therapy for orthopedic or pelvic floor rehabilitation is often indicated and helpful. 

References

  1. Schneider, S., Randoll, D., & Buchner, M. (2006). Why do women have back pain more than men? A representative prevalence study in the federal republic of Germany. The Clinical journal of pain, 22(8), 738–747. https://doi.org/10.1097/01.ajp.0000210920.03289.93 
  2. McGhee, D. E., Coltman, K. A., Riddiford-Harland, D. L., & Steele, J. R. (2018). Upper torso pain and musculoskeletal structure and function in women with and without large breasts: A cross sectional study. Clinical Biomechanics, 51, 99-104. https://doi.org/10.1016/j.clinbiomech.2017.12.009 
  3. Dufour, S., Vandyken, B., Forget, M. J., & Vandyken, C. (2018). Association between lumbopelvic pain and pelvic floor dysfunction in women: A cross sectional study. Musculoskeletal Science and Practice, 34, 47-53. https://doi.org/10.1016/j.msksp.2017.12.001 
  4. Eliasson, K., Elfving, B., Nordgren, B., & Mattsson, E. (2008). Urinary incontinence in women with low back pain. Manual therapy, 13(3), 206-212. https://doi.org/10.1016/j.math.2006.12.006  
  5. Maigne, J. Y., & Chatellier, G. (2001). Assessment of sexual activity in patients with back pain compared with patients with neck pain. Clinical Orthopaedics and Related Research (1976-2007), 385, 82-87. https://doi.org/10.1097/00003086-200104000-00014 
  6. Bi, X., Zhao, J., Zhao, L., Liu, Z., Zhang, J., Sun, D., Song, L., & Xia, Y. (2013). Pelvic floor muscle exercise for chronic low back pain. Journal of International Medical Research, 146–152. https://doi.org/10.1177/0300060513475383