There are a number of back pain and related conditions that women are more susceptible to developing. Moreover, for women, back pain is more likely to become chronic over time.1

Lower back pain can be caused by a variety of problems in the lumbar spine.
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Lower Back Pain Symptoms, Diagnosis, and Treatment

Several conditions are more common (and can be exclusive) in women. Back pain-related problems are typically seen in the post-menopausal age (above 50 years). Read on to learn more about the common causes of back pain in women and the reasons why they occur.

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1. Piriformis syndrome

Pain originating from spasms in your piriformis muscle, a large muscle located deep in the buttock, is called piriformis syndrome.2 Women are affected more due to hormone and pregnancy-related changes in the pelvis.

Piriformis syndrome often causes irritation or compression of the sciatic nerve, mimicking sciatica pain. Piriformis syndrome may cause3:

  • Chronic pain in the buttock and hip area that is worsened by hip movements
  • Pain when you get out of bed
  • Inability to sit for a long time
  • Radiating pain in the back of your thigh and leg

The symptoms typically get better when you lie on your back.

Read more about Symptoms and Diagnosis of Piriformis Syndrome

2. Sacroiliac joint dysfunction

Pain from your sacroiliac (SI) joint that connects the bottom of your spine to your pelvis is called sacroiliac joint dysfunction or sacroiliitis. SI joint problems are among the more common causes of lower back pain.

Women typically have a smaller SI joint surface area compared to men, resulting in a higher concentration of stresses across the joint. The sacrum is also wider, more uneven, less curved, and tilted more backward in women, which may cause problems in the SI joint.4

These factors and several other anatomical differences can lead to a higher risk of SI joint misalignment, especially in younger women.5

SI joint dysfunction can also cause sciatica-like symptoms. Common features include6:

  • Lower back pain
  • A dull or achy pain directly over the buttock, which may occasionally flare into a sharp pain
  • A sharp, stabbing, or shooting pain down your thigh, typically not going past your knee

SI joint pain typically increases while you sit, lie on the affected side, and/or climb stairs.6

Read more about Sacroiliac Joint Dysfunction Symptoms and Causes

3. Spinal osteoarthritis

Wear and tear arthritis (osteoarthritis) of the facet joints (joints that connect your vertebrae) is common in women. The risk is more with an increase in age and/or weight.7

See Osteoarthritis of the Spine

Spinal osteoarthritis causes a breakdown of the fibrous cartilage in the facet joints. Without the cushioning provided by the cartilage, your bones may rub together, causing pain. Osteoarthritis of the lower back can cause:

  • Pain in your upper or lower back, groin, buttocks, and thighs7
  • Back stiffness and pain in the morning
  • Occasional flares of severe pain

The pain may occur on one side of your back, increase when external pressure is applied, and/or be relieved when you bend the spine forward.7

Read more about Symptoms of Arthritis of the Spine

4. Degenerative spondylolisthesis

When a vertebra in your spine slips over the one below it due to degeneration, it is called degenerative spondylolisthesis. The condition is more common in post-menopausal women due to lower levels of estrogen.8

When estrogen is low, there is increased degradation of the vertebral disc and loosening of the ligaments that hold the vertebrae together—causing spinal instability. There is also a higher chance of associated spinal osteoarthritis among this age group, increasing the risk of vertebral slippage.8

Degenerative spondylolisthesis can cause9:

  • Lower back pain with radiating pain in your legs
  • Neurogenic claudication (pain while walking) if the spinal cord gets compressed

Pain relief is typically experienced when you bend forward.9

Read more about Degenerative Spondylolisthesis Symptoms

5. Coccydynia (tailbone pain)

Pain in the tail end of your spine (coccyx) occurs largely due to trauma. The condition is more common in women due to the differences in the shape and angle of the pelvis and from injury during childbirth.10

See Coccydynia (Tailbone Pain)

The coccyx serves as a weight-bearing support while you sit.11 An injury to this region can cause pain while10:

  • Sitting down
  • Leaning partly backward while sitting
  • Sitting on hard surfaces
  • Standing up from a seated posture

Coccydynia pain is abruptly relieved once you stand up. You may prefer to sit by leaning forward or lean onto one buttock at a time to avoid the tailbone pain.10

Read more about Coccydynia (Tailbone Pain) Symptoms

6. Endometriosis

Endometriosis is a gynecological disorder that affects women exclusively. The condition causes the tissues of the uterus to grow outside the womb.12 Typical symptoms include12:

  • Painful menstrual cycle with severe pelvic and lower abdominal pain
  • Pain in the genital region
  • Lower back pain, especially during menstruation

The pelvic and/or back pain may become chronic, with flaring during menses.

See Lower Left Back Pain from Internal Organs

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7. Spinal osteoporosis fractures

When the density of your bone decreases, making it brittle and susceptible to fracture, the condition is called osteoporosis. Osteoporosis occurs when there is a higher rate of bone loss compared to new bone formation. Women in the post-menopausal age are 4 times more likely to develop osteoporosis than men. This disparity may be due to the deficiency of the estrogen hormone, loss of bone at a younger age, and loss of bone at a more rapid pace.13

See Why Women Are at Greater Risk for Developing Osteoporosis

Osteoporosis itself can cause bone pain,14 but more commonly, it may cause compression fractures in your spine, resulting in acute back pain.1 Spinal compression fractures can cause1:

  • An acute, localized back pain that occurs typically in your mid-back or region between the mid and lower back
  • The pain may spread in front and be confused with heart or lung problems

Depending on the severity, this condition may become a medical emergency.1

Read more about Vertebral Fracture Symptoms

Women may also experience back pain due to no unidentifiable cause. Typical changes in a woman’s lifecycle, including pregnancy, childbirth, hormonal imbalances, weight gain (especially in the abdomen) can trigger a cascade of events leading to back pain.15

If you have back pain that is not relieved by self-care, causes neurological symptoms (numbness or weakness), or affects your daily work, consult a doctor. A doctor can help identify and treat the cause of your back pain. A trained medical professional can also recommend necessary lifestyle modifications, such as following an anti-inflammatory diet and a structured exercise routine to prevent recurrences.

Learn more:

What You Need to Know About Osteoporosis

Low Back Pain in Older Adults

References

  • 1.Wong AY, Karppinen J, Samartzis D. Low back pain in older adults: risk factors, management options and future directions. Scoliosis Spinal Disord. 2017;12:14. Published 2017 Apr 18. doi:10.1186/s13013-017-0121-3
  • 2.Singh U, Meena R, Singh CA, Singh AKj, Singh Am, Langshong R. Prevalence of piriformis syndrome among the cases of low back/buttock pain with sciatica: A prospective study. Journal of Medical Society. 2013;27(2):94. doi:10.4103/0972-4958.121573
  • 3.Hicks BL, Varacallo M. Piriformis Syndrome. [Updated 2018 Nov 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-.Available from: https://www.ncbi.nlm.nih.gov/books/NBK448172/
  • 4.Joukar A, Shah A, Kiapour A, et al. Gender Specific Sacroiliac Joint Biomechanics During Standing Upright. SPINE. March 2018:1. doi:10.1097/brs.0000000000002623
  • 5.Vleeming A, Schuenke MD, Masi AT, Carreiro JE, Danneels L, Willard FH. The sacroiliac joint: an overview of its anatomy, function and potential clinical implications. J Anat. 2012;221(6):537–567. doi:10.1111/j.1469-7580.2012.01564.x
  • 6.Raj MA, Varacallo M. Sacroiliac (SI) Joint Pain. [Updated 2019 May 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470299/
  • 7.Gellhorn AC, Katz JN, Suri P. Osteoarthritis of the spine: the facet joints. Nat Rev Rheumatol. 2013;9(4):216–224. doi:10.1038/nrrheum.2012.199
  • 8.Wang YXJ, Káplár Z, Deng M, Leung JCS. Lumbar degenerative spondylolisthesis epidemiology: A systematic review with a focus on gender-specific and age-specific prevalence. J Orthop Translat. 2016;11:39–52. Published 2016 Dec 1. doi:10.1016/j.jot.2016.11.001
  • 9.Shamrock AG, Donnally III CJ, Varacallo M. Lumbar Spondylolysis And Spondylolisthesis. [Updated 2019 Jun 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448122/
  • 10.Foye PM. Coccydynia. Physical Medicine and Rehabilitation Clinics of North America. 2017;28(3):539-549. doi:10.1016/j.pmr.2017.03.006
  • 11.Lirette LS, Chaiban G, Tolba R, Eissa H. Coccydynia: an overview of the anatomy, etiology, and treatment of coccyx pain. Ochsner J. 2014;14(1):84–87.
  • 12.Alimi Y, Iwanaga J, Loukas M, Tubbs RS. The Clinical Anatomy of Endometriosis: A Review. Cureus. 2018;10(9):e3361. Published 2018 Sep 25. doi:10.7759/cureus.3361
  • 13.Alswat KA. Gender Disparities in Osteoporosis. J Clin Med Res. 2017;9(5):382–387. doi:10.14740/jocmr2970w
  • 14.Mattia C, Coluzzi F, Celidonio L, Vellucci R. Bone pain mechanism in osteoporosis: a narrative review. Clin Cases Miner Bone Metab. 2016;13(2):97–100. doi:10.11138/ccmbm/2016.13.2.097
  • 15.Bailey A. Risk factors for low back pain in women. Menopause. 2009;16(1):3-4. doi:10.1097/gme.0b013e31818e10a7
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