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, including 192 women ages 18 to 45, found that about 95% reported pain during menstruation, which is called dysmenorrhea. About 72% of people who reported period pain also had 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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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 are abundant throughout the body and 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 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. 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. In rare instances, some people may 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 pain, including back pain, during periods.

Even fibroids that cause severe symptoms may go away without treatment. However, in some cases, a doctor may recommend surgery to remove them.

Tissues that line the uterus sometimes grow into the muscles of the uterus. The medical name for this is adenomyosis.

A person with adenomyosis may experience:

A doctor may also 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 helps.

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 an NSAID is ibuprofen (Advil).

The following may also help:

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 a person requires a new tampon or pad after less than 2 hours

Why does my lower back hurt during my period?

A person may experience lower back pain during their period due to uterine contractions.

Chemicals called prostaglandins are also released during a period and are the main cause of cramps, which may radiate to the lower back.

What is extreme pain during periods?

Extreme pain during periods is known as dysmenorrhea. There are two types: primary and secondary dysmenorrhea.

Primary dysmenorrhea refers to pain as a direct result of a person’s period, while secondary dysmenorrhea refers to pain during a period because of a medical condition such as endometriosis.

What are the 4 phases of the menstrual cycle?

The four phases of the menstrual cycle are as follows:

  1. Menstruation: This phase involves the shedding of the uterine lining, resulting in menstrual bleeding. It typically lasts 3 to 7 days and marks the start of the menstrual cycle
  2. Follicular phase: Lasting about 13 to 14 days, this phase starts with menstruation. Hormones spur follicle growth in the ovaries, housing immature eggs. Rising estrogen levels thicken the uterine lining for pregnancy readiness.
  3. Ovulation: Occurring around the cycle’s midpoint, ovulation sees the release of a mature egg from an ovary. It is often accompanied by changes in cervical mucus or mild abdominal discomfort.
  4. Luteal phase: The uterus prepares for pregnancy. If fertilization does not occur, the cycle restarts.

What is a phantom period?

A phantom period is a term sometimes used colloquially to describe symptoms similar to those experienced during menstruation, such as bloating, cramping, and sudden mood shifts, without actually having a menstrual period.

It is called ‘phantom’ because the symptoms mimic those of a menstrual cycle, but there is no actual bleeding or shedding of the uterine lining.

This may occur due to hormonal fluctuations or other factors that affect the body’s menstrual cycle without leading to menstruation.

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 professional, especially if the pain is severe. They can rule out underlying causes and recommend ways to relieve the pain.