Pain in the lower back during a period is usually not a sign of a serious medical problem. However, some conditions, such as endometriosis or uterine fibroids, can cause intense lower back pain during periods.

One study of females aged 18–25 found that about 84% reported pain during menstruation, which is called dysmenorrhea. About 16% of those who reported period pain also had lower back pain.

Below, we look at why this type of pain occurs during menstruation and describe medical treatments and home remedies.

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Many people experience lower back pain during a period.

Primary dysmenorrhea means that getting a period causes pain — the pain does not result from a medical condition.

Most people who menstruate experience some form of primary dysmenorrhea, be it cramping, aching, or lower back pain.

Chemicals called prostaglandins are the main cause of cramps during periods. Immediately before a period, the endometrial cells in the uterus manufacture many prostaglandins.

These chemicals, which are abundant throughout the body, play an important role in inflammation and healing. However, the accumulation of prostaglandins can cause cramping.

As the uterine lining sheds during menstruation, the body releases fewer prostaglandins. This usually means that the pain gets better.

Uterine contractions also play a role in period cramps. The uterus contracts to get rid of its old lining. This is a much weaker version of the contractions of childbirth.

For some people, the pain of these muscular contractions radiates to the lower back.

Secondary dysmenorrhea refers to back pain during a period because of a medical condition or injury.

In some cases, the pain is present at other times but it worsens during periods.

Below, learn about some common causes of secondary dysmenorrhea and their treatments.

In some people, uterine tissue grows outside of the uterus. It can wrap around other organs, causing intense pain.

This medical condition is called endometriosis, and it can also cause a person to have very heavy or clotty periods, as well as bleeding between periods.

A person may experience pain in the area with the endometrial tissue. Some people have spinal endometriosis, which causes the tissue to grow around the spine or other areas of the lower back. This can cause intense back pain.

To treat endometriosis, a doctor may recommend birth control pills or, sometimes, surgery.

Uterine fibroids are noncancerous growths in the uterus, and some become quite large. They cause intense pain, including back pain, during periods.

Even fibroids that cause severe symptoms may go away without treatment. In some cases, though, a doctor recommends surgery to remove them.

Sometimes, tissues that line the uterus grow into the muscles of the uterus. The medical name for this is adenomyosis.

A person with adenomyosis may experience:

  • painful periods
  • pain during sex
  • bleeding between periods

Also, a doctor may suspect it if a person’s uterus feels enlarged during a pelvic exam.

Hormone therapy, surgery — and, in severe cases, removal of the uterus — can treat this condition.

For some people with back problems, symptoms get worse before or during their periods. This may be because the prostaglandins that accumulate in the uterus release inflammatory chemicals that can make back pain worse.

Though treatment depends on the person’s overall health and the specific back condition, some people find that exercise or physical therapy help.

People with more serious conditions, such as severely herniated disks, may need surgery.

Nonsteroidal anti-inflammatory drugs (NSAIDs) can help ease the pain by reducing the inflammation that prostaglandins cause. This makes NSAIDs an ideal treatment for period cramps. A common example of a NSAID is ibuprofen (Advil).

The following may also help:

  • applying warmth to the painful area, with a heating pad or hot water bottle, for example
  • doing stretches or exercising
  • having sex or masturbating
  • practicing relaxation and mindfulness techniques, such as yoga, meditation, or deep breathing
  • taking certain supplements, such as those that contain magnesium, vitamin B-1 (thiamin), or both
  • trying alternative treatments, such as acupuncture
  • having a massage

If these techniques do not relieve the pain, and especially if the pain is severe, contact a doctor. They may prescribe stronger pain medication.

Hormonal birth control pills may also help reduce the intensity of period cramps and ease some symptoms of endometriosis.

A doctor will want to identify the cause of the pain. When dysmenorrhea is secondary, treating the underlying condition can reduce or even eliminate the pain.

A person should receive medical care for period pain if any of the following occur:

  • Home care techniques do not work or stop working.
  • Medication offers no relief.
  • There are accompanying symptoms, such as bleeding between periods, pain during sex, or pain in the vagina.
  • Period pain is new or worsening.
  • The pain is so intense that it prevents the person from going to work or school.
  • There are other back or muscle symptoms, such as pain when walking, difficulty lifting things, or muscle spasms.
  • Bleeding is so heavy that it soaks through one or more tampons or pads per hour for more than 2 hours in a row.

Painful periods are common. While back pain is not the most common symptom, many people experience it during at least some of their periods.

Home care techniques can often ease the pain and any other symptoms.

However, it is often a good idea to see a healthcare provider, especially if the pain is severe. They can rule out underlying causes and recommend ways to relieve the pain.