By Dr Hrutvij Bhatt
Consultant Spine Surgeon
Jan 01, 2026
Lower back pain isn't just uncomfortable—it can be downright debilitating. If you're a woman experiencing that familiar ache in your lower back, you're far from alone. Studies suggest that women are actually more likely to experience chronic lower back pain than men, and the reasons why are fascinating, complex, and deeply connected to women's unique physiology.
Let me walk you through everything you need to know about lower back pain in women, from what might be causing yours to the treatments that actually work.
Before we dive into specific causes, it's worth understanding why women's backs are, well, different. Our spine carry us through pregnancy, menstruation, menopause, and everything in between.
Hormonal fluctuations affect our joints, ligaments, and muscles in ways that men don't experience. Add to that the fact that women's pelvic structures are wider to accommodate childbirth, and you've got a recipe for unique spinal stress patterns. It's not about being weaker—it's about being different. And understanding these differences is the first step toward finding relief.
Hormonal changes
Your hormones do more than regulate your mood and menstrual cycle—they directly impact your musculoskeletal system. During menstruation, the hormone relaxin increases, which loosens ligaments and joints. While this is crucial during pregnancy, it can also make your lower back more vulnerable to strain during your monthly cycle.
Many women notice their back pain worsens right before or during their period. It isn't in your head—it's biochemistry at work.
Pregnancy and postpartum changes
If you've been pregnant, you're familiar with the toll it takes on your back. As your baby grows, your centre of gravity shifts forward, putting tremendous strain on your lower back muscles. The hormone relaxin floods your system, loosening the ligaments that stabilise your spine and pelvis.
But here's what many women don't realise: postpartum back pain can linger long after delivery. Your body spent nine months adapting to pregnancy, and it needs time—and often specific exercises—to recover. The constant bending, lifting, and feeding positions with a newborn don't help either.
Endometriosis
This often-misunderstood condition occurs when tissue similar to your uterine lining grows outside the uterus. While most people think of endometriosis as causing pelvic pain, it frequently causes referred pain to the lower back, especially during menstruation. The inflammation and nerve irritation can create a deep, persistent ache that's often dismissed or misdiagnosed.
Osteoporosis
After menopause, women's bones lose density more rapidly due to declining estrogen levels. It can lead to compression fractures in the spine—small breaks that cause sudden, severe back pain. Sometimes these fractures happen so gradually that women assume they're just experiencing normal ageing aches.
If you're over 50 and experiencing new or worsening back pain, especially if you've gone through menopause, osteoporosis should be on your radar.
Pelvic inflammatory disease (PID)
This infection of the reproductive organs can cause lower back pain along with pelvic pain, fever, and unusual discharge. PID needs prompt medical attention—it's not something that will resolve on its own, and delayed treatment can lead to serious complications.
Fibromyalgia
Women are diagnosed with fibromyalgia far more often than men. This chronic condition causes widespread pain, including persistent lower back discomfort, along with fatigue, sleep problems, and cognitive difficulties. The pain tends to be diffuse rather than localised to one specific spot.
Everyday culprits
Of course, women aren't immune to the same back issues that affect everyone. Poor posture—common with desk work or frequent phone use—can create muscle imbalances that put strain on the lower back. Carrying heavy purses on one shoulder, wearing high heels regularly, weak core muscles, extra weight around the midsection, and previous injuries all contribute to back pain regardless of gender.
Recognising the symptoms
Lower back pain isn't one-size-fits-all. The type of pain you're experiencing offers clues about what's causing it:
Dull, aching pain that's constant or comes and goes often points to muscle strain or postural issues. It is the most common type of back pain and usually feels like a tired, heavy sensation.
Sharp, stabbing pain that occurs with movements might indicate a herniated disc or joint problem. This pain makes you catch your breath and tends to be very specific about which positions trigger it.
Radiating pain that shoots down your leg suggests nerve involvement, possibly sciatica. It can feel like electricity running down your buttocks and legs, sometimes all the way to your feet.
Pain that worsens during your period likely has a hormonal or reproductive component, such as endometriosis or regular menstrual-related muscle tension.
Morning stiffness that improves as you move around typically indicates arthritis or an inflammatory condition.
You should seek immediate medical attention if your back pain comes with fever, unexplained weight loss, loss of bladder or bowel control, severe pain that doesn't improve with rest, numbness or weakness in your legs, or pain following a significant injury.
Getting the right diagnosis
When you visit your doctor about lower back pain, be prepared to describe your symptoms in detail. When did the pain start? What makes it better or worse? Does it coincide with your menstrual cycle? Have you had any pregnancies or gynaecological issues?
The doctor will conduct a physical examination to assess your range of motion, reflexes, and pinpoint the exact location of your pain.
Conservative treatments
Most lower back pain improves with conservative treatment, and these approaches are worth trying before moving to more invasive options
Physical therapy is genuinely transformative for many women. A good physical therapist will assess your specific muscle imbalances, posture issues, and movement patterns, then create a customised program to address them. Core strengthening is usually central to treatment because a strong core supports your spine better than anything else.
Heat and ice therapy can provide immediate relief. Ice reduces inflammation in the first 48 hours after an injury, while heat relaxes tight muscles and improves circulation. Many women find alternating between the two most effective.
Over-the-counter pain relievers, such as ibuprofen or naproxen, can help reduce both pain and inflammation. Acetaminophen helps with pain but doesn't address inflammation. Always follow dosing instructions and consult your doctor if you're taking these regularly.
Posture correction might seem simple, but it's powerful. Sit with your feet flat on the floor, your back supported, and your computer screen at eye level. When standing, keep your weight evenly distributed on both feet and avoid locking your knees.
Hormone management
If your back pain is clearly tied to your menstrual cycle, hormonal birth control can help by stabilising hormone fluctuations. For menopausal women, hormone replacement therapy might be worth discussing with your doctor, especially if you're also dealing with other menopausal symptoms or osteoporosis risk.
Specialised treatments
When conservative approaches aren't enough, your doctor might recommend:
Prescription medications, including muscle relaxants for spasms, stronger anti-inflammatories, or nerve pain medications if you have sciatica or neuropathic pain.
Injections such as epidural steroid injections can provide significant relief for nerve-related pain, though the effects are usually temporary.
Surgery (When it's necessary)
Surgery is typically a last resort, reserved for severe cases like herniated discs that aren't responding to other treatments, spinal stenosis causing significant nerve compression, or compression fractures from osteoporosis that need to be stabilised.
Lifestyle changes for long-term relief
Managing lower back pain isn't just about treating symptoms—it's about preventing recurrence
Exercise regularly, focusing on activities that strengthen your core and improve flexibility. Swimming, yoga, Pilates, and walking are all excellent choices. Avoid high-impact activities if they aggravate your pain.
Maintaining a healthy weight helps reduce stress on your spine, as excess weight places additional strain on it. Even losing 5-10 pounds can make a noticeable difference.
Practice good posture all day long. Set reminders on your phone to check your posture if needed. It takes time to build new habits, but the payoff is worth it.
Lift properly by bending at your knees, not your waist, and holding objects close to your body. Never twist while lifting.
Take charge of your stress because emotional overload often leads to physical tension in the back and shoulders. Whatever helps you relax—whether meditation, deep breathing, time with friends, or hobbies—isn't frivolous; it's therapeutic.
Sleep right on a mattress that supports your spine properly. Side sleepers often benefit from placing a pillow between their knees, while back sleepers might need one under their knees.
Lower back pain in women is common, but it doesn't have to be your norm. Whether your pain stems from hormonal changes, pregnancy, a specific condition, or everyday wear and tear, effective treatments exist. The key is understanding what's causing your pain and working with doctors who take your symptoms seriously.
Don't ignore persistent back pain or assume you have to live with it. Your back supports you through everything life throws your way—it deserves the same support in return. With the right approach, most women find significant relief and get back to living their lives fully and comfortably.
Listen to your body, advocate for yourself, and remember that finding the proper treatment sometimes takes patience and persistence. You deserve a pain-free life—and at KD Hospital, our experienced doctors combine compassionate care with advanced medical technology to deliver precise diagnosis, effective treatment, and lasting relief. With the right expertise and innovation, a healthier, pain-free life is absolutely within reach.
