Endometriosis Back Pain: Causes And Treatments

Endometriosis flares exacerbate symptoms

Medically reviewed by Peter Weiss, MD

Back pain from endometriosis (endo) stems from muscle tension or lesions and scarring near pelvic organs and nerves. Nerve irritation can trigger radiating pain in the lower back, legs, hips, or buttocks. Back pain is one of the most common symptoms associated with endo, alongside chronic pelvic pain and pain during menstruation (dysmenorrhea).

This article reviews how endo back pain feels, reasons for the pain, how endo affects nonreproductive organs, how to recognize and manage flares, and specialists who can help.

Endometriosis Back Pain: Causes And Treatments 1

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Describing Back Pain From Endometriosis

Pain from endometriosis typically affects the lower back, pelvis (between the hips), and sacrum (base of the spine). Pain also can radiate to the upper back or down the legs, hips, and buttocks. This pain may feel like a nagging, dull ache or sharp, stabbing sensations, pulling, or throbbing. It often worsens during menstrual cycles or ovulation and can impact daily functioning.

Endometriosis Staging

Endometriosis staging categorizes the severity of endo, as follows:

Stage 1: Minimal (small lesions with no scarring)
Stage 2: Mild with more lesions but less than two inches of scarring
Stage 3: Moderate with deeper lesions, potentially with ovarian cysts and scar tissue
Stage 4: Severe, with multiple lesions, potentially with larger cysts, and extensive scar tissue

Reasons Endometriosis Causes Lower Back Pain

Endo back pain can occur with muscle tension or when lesions or scar tissue inflame or press against nearby structures, leading to irritation of nerves, fibers, blood vessels, and muscles.

Pain From Lesions on Other Organs

Endometriosis can grow around nonreproductive structures, causing referred back pain and varying symptoms. For example, bladder involvement may also result in urinary urgency (feeling a need to urinate), frequency, pain, or incontinence (leaking).

Involvement of the intestines (tubes that carry food out of the body) can cause abdominal bloating, diarrhea, or constipation. You can also experience upper abdominal or chest pain if endo grows around the chest cavity.

Endometriosis, Back Pain, and Sciatica

Compression on the pelvic nerves (sciatic, obturator, femoral, pudendal) can cause sharp, shooting pain in the leg, hips, or buttocks. Symptoms may be cyclical and worsen during ovulation or menstruation. In addition to pain, you may experience:

Bladder, bowel, or sexual dysfunction
Changes in gait (your manner of walking)
Numbness, tingling, or weakness

Do Herniated Disc Symptoms Occur With Endo?

A herniated disc occurs when the inner core of a spinal disc protrudes through the outer layer. This compresses (presses against) nearby nerves. Symptoms can overlap with endo, including back pain, radiating pain down the arms or legs, numbness or tingling, and muscle weakness. Each disease can mask or worsen the other condition.

How to Manage Chronic Endometriosis Back Pain

Managing back pain may involve a combination of medical and self-care, home remedies, over-the-counter (OTC) medications, and complementary and alternative medicine (CAM) treatments.

Medical Treatment

Medical treatment may include:

Hormonal contraceptives (birth control)
Hormone suppressants
Muscle relaxers
Nerve blocks or Botox (onabotulinumtoxinA) injections
Pain medications
Surgery

Home Remedies and Self-Care

Home remedies and self-care include:

Cannabis
Chamomile
Exercise and stretching
Ice or heat application
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as Advil and Motrin (ibuprofen)
Omega-3, vitamin C & D, magnesium, zinc supplements
Stress reduction
Topical medications
Trigger point release (by hand or by rolling on a tennis ball)
Wearing comfortable, low heel shoes (to reduce pressure on the lower back)

Ice vs. Heat Therapy

It may take some trial and error to recognize if your back pain comes from nerve inflammation or muscle tension. Ice reduces inflammation, whereas heat relaxes muscle tension.

Physical Therapy

A physical therapist utilizes manual therapy, myofascial (muscle and facial tissue) release, and gentle stretching to reduce muscle tension. They also teach you pain-management strategies and how to improve flexibility, strength, and posture.

Pelvic Floor Physical Therapy (PFPT)

Pelvic floor physical therapy utilizes therapeutic exercises, kegel exercises, biofeedback, and manual therapy to release tension and strengthen the pelvic floor muscles.

Dry Needling

Dry needling involves the insertion of thin needles into specific trigger points to deactivate pain signals and promote muscle relaxation.

Diaphragmatic Breathing

Diaphragmatic breathing helps you breathe in more oxygen and exhale more carbon dioxide, promoting muscle relaxation. It also builds core strength, stabilizing the spine and reducing nerve compression.

Massage

Self-massage, massage chairs, or professional massage involve gentle pressure, stretching, or trigger point release and offer the following benefits:

Reducing muscle tension
Improving circulation
Releasing endorphins (natural painkillers)
Lowering cortisol (stress hormone)

Transcutaneous Electrical Nerve Stimulation (TENS) Therapy

A TENS unit is a small device that delivers low-voltage electrical stimulation to nerves through electrodes. The electrical current disrupts pain signals in the brain. You can adjust the amount of voltage so it is comfortable for you. Limit sessions to 15–30 minutes.

Acupuncture

Acupuncture involves the insertion of fine needles at specific points of the body to alleviate pain. Unlike dry needling, acupuncture utilizes traditional Chinese medicine philosophy to balance the body’s energy flow rather than targeting specific trigger points.

Chiropractics

Chiropractic care involves manual spinal adjustments to improve or enhance nervous system function and reduce nerve irritation.

Recognizing Endometriosis Back Pain Triggers

Tracking symptoms and identifying triggers can help you anticipate and manage flares. Common endo symptoms include:

Diarrhea, constipation, or nausea
Fatigue (overwhelming tiredness)
Headaches
Mood swings
Painful sex
Pelvic, back, leg, hip, or buttock pain
Period pain
Stomach bloating
Urinary problems

Examples of endometriosis triggers include:

Alcohol, caffeine, and cigarettes
Hormonal fluctuations (particularly around ovulation or period)
Physical overexertion
Processed, sugary, fatty foods
Sexual intercourse
Stress

Specialists and Multidisciplinary Care for Endo-Related Back Pain

When endometriosis affects other organs or if pain control becomes complex, treatment often requires a multidisciplinary approach. In addition to your primary care and obstetrician-gynecologist (ob-gyn) or other gynecology provider, medical care may involve the following specialists:

Colorectal surgeon (performs surgeries like bowel resections)
Endometriosis specialist (oversees endo care)
Gastroenterologist (for digestive problems)
Mental health provider (for the psychological effects of endo)
Nutritionist/dietitian (to help in choosing the proper diet)
Pain-management specialist (to provide nerve blocks or Botox injections)
Pathologist (examines tissue in the lab)
Physical therapist (to train you in exercises to reduce pain)
Radiologist (for imaging tests)
Reproductive endocrinologist (for hormone and fertility treatments)
Urogynecologist (for pelvic floor and urinary disorders)
Urologist (for urinary problems or a painful bladder)

Summary

Endometriosis lesions can inflame nerves, leading to back pain and pelvic pain that may radiate to the hips, buttocks, and legs. The pain may be a persistent deep ache. But it can also be a sharp, stabbing sensation, pulling, or throbbing.

Endo pain typically worsens around ovulation or your period. There are medical and alternative treatments to help manage endo and reduce pain.

Read the original article on Verywell Health.

Rene Bennett

Rene Bennett is a graduate of New Jersey, where he played volleyball and annoyed a lot of professors. Now as Zobuz’s Editor, he enjoys writing about delicious BBQ, outrageous style trends and all things Buzz worthy.

Tags: back pain