Back pain during your period: why it happens and what helps
Lower back pain around your period is extremely common, and often dismissed. It's usually part of normal period pain, and there are effective ways to ease it. It's also worth knowing when it might point to something that deserves medical attention.
Is back pain during your period normal?
Period pain is very common. A meta-analysis of 38 studies including 21,573 young women found 71% experienced period pain, and about one in five had missed school or university because of it (Armour et al., Journal of Women's Health, 2019). Pain is typically felt in the lower abdomen and commonly spreads to the lower back and thighs.
Why does my period cause back pain?
The lining of the uterus releases chemicals called prostaglandins, which make the uterus contract. Higher levels cause stronger cramps. The uterus shares nerve pathways with the lower back, pelvis and upper thighs, so the pain is felt there too. Fluid retention and changes in pain sensitivity around your period may add to it.
Why does my usual back pain flare around my period?
Many women with existing back or pelvic pain notice it's worse in the days before and during their period. Pain sensitivity tends to increase at this point in the cycle, and sleep is often poorer. It doesn't mean your back is being damaged.
Does heat help?
Yes. A systematic review of randomised trials found heat therapy, such as a heat patch or heating pad on the lower abdomen or back, relieved period pain, with some trials showing it worked as well as or better than pain medication (Jo and Lee, Scientific Reports, 2018). It's simple and low-risk.
Does exercise help?
It appears to. A Cochrane review found low-quality evidence that regular exercise, about 45 to 60 minutes three or more times a week, may give a clinically significant reduction in period pain intensity (Armour et al., Cochrane, 2019). The studies used exercise throughout the month, not just during the period. Walking, cycling, swimming, strength training and yoga are all reasonable.
Should I exercise during my period?
If you feel up to it, yes. There's no need to avoid training. Many women find gentle movement eases cramps and back ache; on heavy or painful days, reduce the intensity.
What else helps?
Anti-inflammatory pain relief works by reducing prostaglandins and is most effective when started at the first sign of pain; ask your pharmacist or GP whether it's suitable for you. Gentle stretches for the lower back and hips, such as knees-to-chest and child's pose, and getting enough sleep, also help.
When could it be endometriosis?
Endometriosis is a condition where tissue similar to the lining of the uterus grows elsewhere in the pelvis. See your GP if period pain is severe enough to stop you going to work, school or normal activities, isn't controlled by simple pain relief, is getting worse over time, or comes with pain during or after sex, pain with bowel movements or passing urine around your period, very heavy bleeding, or difficulty getting pregnant.
What other conditions can cause it?
Adenomyosis, fibroids and pelvic infection can all cause period-related back and pelvic pain. Pain that starts later in life after years of manageable periods, or changes in pattern, should be discussed with your GP.
How do I tell period-related back pain from a back problem?
Period-related pain follows your cycle: it starts shortly before or with your period, lasts one to three days, feels like a deep ache or cramp, and isn't much affected by movement or position. Mechanical back pain changes with bending, sitting, lifting and position, and doesn't follow the cycle. The two can overlap.
Does the contraceptive pill or other treatment help?
Hormonal treatments are commonly used to manage period pain and are something to discuss with your GP, who can talk through the options and whether further investigation is appropriate.
Why is the pain worse some months?
Stress, poor sleep, illness and changes in activity can all affect how strongly pain is felt from one cycle to the next. A marked or lasting change in your usual pattern is worth mentioning to your GP.
Can an osteopath help?
We don't treat the cause of period pain. Where there's a musculoskeletal contribution, such as a stiff or sensitive lower back and pelvis that flares around your period, hands-on treatment, movement and strengthening can help with that part. We'll suggest you see your GP if your symptoms point to a gynaecological condition.
When should I see a doctor?
See your GP for severe or worsening period pain, pain that doesn't follow your cycle, bleeding between periods or after sex, very heavy periods, or pain with fever or unusual discharge. Seek urgent care for sudden, severe pelvic or abdominal pain, particularly if you could be pregnant.
See our posts on women's health and the pelvic floor and back pain red flags, or our low back pain guide. Book an assessment at our Berwick clinic. A 60-minute initial consultation is $149, with no referral needed and HICAPS on-site.
Sources
Armour M, et al. Exercise for dysmenorrhoea. Cochrane Database of Systematic Reviews, 2019.
Book an initial consultation at RISE Sports & Spinal in Berwick. Clear diagnosis, hands-on treatment, and a plan that actually gets you better.
Related articles
