8 Major Causes of Back Pain in Women

Back pain in women and men is one of the most frequent complaints amongst adults, with the majority of cases involving mechanical issues, such as injury to the spine, intervertebral discs or soft tissues. While many common back pain causes occur independent of gender, there are a number that occur more frequently in women, usually due to hormonal changes after menopause or pregnancy. Back pain in women is also more likely to become chronic over time.

Here are some causes of back pain in females specifically:

Sacroiliac Joint Dysfunction

The bottom of the spine is connected to the pelvis by the sacroiliac (SI) joint. Issues with pain, inflammation or dysfunction in this area are called SI joint dysfunction or sacroiliitis. While this is a common form of back pain in women and men, it is one of the more frequent causes of back pain in females. This is because their SI joint typically has a smaller surface area than men’s and is therefore susceptible to a higher concentration of stress. Plus, their sacrum is wider, less even and curved, and tilted further backward. Dysfunction is typically experienced as a dull pain in the lower back, which can intensify when sitting or climbing stairs. It may also flare up to present as a sharp pain down the thigh. For this reason, this type of back pain in women is often mistaken for sciatica.

Spinal Osteoarthritis

Known as “wear and tear arthritis”, spinal osteoarthritis occurs when fibrous cartilage in the vertebrae connectors (facet joints) breaks down. Without the shock absorbing cushion of cartilage, bones may rub together and cause pain in the upper and lower back, buttocks, groin and thighs. Pain and stiffness may occur in the morning, and there may be flare ups on the side of the body when bending. This is a more commonly occurring back pain in women, and risk increases with age and weight.

Spinal Osteoporosis Fracture

Osteoporosis occurs when the rate of bone loss is higher than that of new bone formation. Decreases in bone density make bones brittle and more susceptible to fractures. Women are significantly more at risk of developing osteoporosis due to dropping levels of estrogen – an essential hormone for healthy bones. While osteoporosis in itself may contribute to bone and therefore back pain in women, it is more commonly responsible for compression fractures in the spine. These can cause acute pain in a specific area that typically occurs between the mid and lower back, and may need emergency medical attention. This pain may also be referred to the front of the body and mistaken for lung or heart issues.

Piriformis Syndrome

The piriformis muscle is a large muscle located deep in the buttocks. Pain originating from spasms in this muscle is called piriformis syndrome. Women are affected more by this due to changes in the pelvic area brought on by pregnancy and hormones. Piriformis syndrome can cause irritation or compression of the sciatic nerve, which can lead to: pain that radiates down the back of the leg, pain in the hips and buttocks that increases with hip movement or when getting out of bed, and pain that is aggravated when sitting for long periods of time. These symptoms usually get better when you lie on your back.

Degenerative Spondylolisthesis

This condition occurs when degeneration causes one vertebra to slip over the vertebra below it. Due to decreased estrogen levels in the body after menopause, this condition is more prevalent in older females, and is generally a more common type of back pain in women than men. This hormonal change can cause spinal instability, through the increased degradation of spinal discs and loosening of ligaments that hold vertebrae together. Degenerative spondylolisthesis frequently results in female lower back pain that radiates to the legs, and pain while walking, due to compression of the spinal cord. Bending forward to take pressure off the spine can assist with pain relief.

Coccydynia

Also referred to as tailbone pain, coccydynia usually occurs as a result of chronic irritation or injury. As the coccyx provides weight-bearing support while sitting, pain is usually experienced when seated, particularly when leaning back or sitting on a hard surface, as well as when rising from a seated position. Pain usually decreases when leaning forward, or onto one buttock at a time, and may cease entirely upon standing. This is a more common form of back pain in women due to differences in the angle or shape of the pelvis, or as a result of injury during childbirth.

Endometriosis

Exclusive to women, endometriosis is a painful gynecological issue where tissue similar to that which lines the uterus interior grows outside the uterus. It presents as a painful menstrual cycle together with intense pain in the abdomen and, frequently, the lower back. This form of back pain in women may be chronic throughout the month.

Pregnancy

Back pain in women is common during pregnancy, due to weight gain and a shift in the body’s gravitational center. A change in hormones also softens ligaments surrounding the pelvis to prepare for birth, which may induce pain. Superficial abdominal muscles known as the recti abdominis may separate during later stages of pregnancy, worsening existing back pain. This form of female lower back pain is usually experienced where the pelvis meets your spine – at the sacroiliac joint – and generally below the waist. While most cases of back pain in women can be resolved at home over time with simple remedies or exercises (see our suggestions on back pain relief), some symptoms may require medical intervention. It is important to consult with a professional if you experience ongoing or acute back pain that doesn’t decrease over time.