In the lower back, the muscles play an important role in supporting the spine and maintaining stability. When these muscles are strained or sprained, they may go into spasm as a protective mechanism, causing pain.
Disc bulging, herniation, or degeneration
Disc bulging, herniation, or degeneration is the most common diagnosis for persistent lower back pain in females.
However, high-quality research studies have found that the amount of disc damage in the back rarely reflects the amount of pain experienced. While some women experience ongoing pain from disc damage, many others experience no pain at all from similar levels of degeneration.
Research published in 2015 by the American Journal of Neuroradiology studied people living without back pain and found that almost a third of the 20-year-olds studied had a disc bulge, and 37% of the 20-year-olds had clear signs of disc degeneration. This rose to 96% in people aged 80.
Another study found that herniated discs exist in up to 70% of people; that disc degeneration can be found in up to 50% of people; and that tears in the disc exist in around 20% of people. Yet, not all of these people experience pain.
If you have been given a medical diagnosis of disc bulging, herniation, or degeneration as the cause of your lower back pain, it’s important to remember that these are normal structural changes that happen to most people at some point in their lives. Often these problems will resolve on their own and shouldn’t contribute to ongoing pain.
Pregnancy
Lower back pain can be a common complaint during pregnancy and is most often caused by changing muscles, hormones, and weight gain. If you are pregnant and experiencing lower back pain, it’s important you speak to your doctor.
Contributing factors can include:
increased strain on lower back muscles due to the expansion of the uterus
hormonal changes, including the release of relaxin which softens the ligaments and joints in preparation for birth and can lead to reduced stability in the pelvic area
added weight during pregnancy coupled with changes in posture to accommodate a growing belly can further stress muscles and structures supporting the spine
When to see a doctor
Most females will experience lower back pain at some point in their lives which resolves on its own. However, it’s important to seek medical advice if you are experiencing any of the following:
Severe pain: If your lower back pain is severe and persistent, especially if it's accompanied by other concerning symptoms.
Duration: If your lower back pain lasts for more than a few days or if it's getting worse over time.
Limited mobility: If your lower back pain is causing difficulty with movement, such as standing up straight or walking.
Numbness or tingling: If you experience numbness, tingling, or weakness in your legs, it could be a sign of nerve compression or other serious issues.
History of injury: If your lower back pain follows a recent injury, fall, or trauma, it's essential to have it evaluated by a healthcare provider to rule out fractures or other structural damage.
Fever or unexplained weight loss: If your lower back pain is accompanied by fever, unexplained weight loss, or other systemic symptoms.
First episode: If this is your first experience with lower back pain, or if you have a history of other medical conditions, it's wise to consult with a healthcare professional for an accurate diagnosis and appropriate management.
Self-care for lower back pain in females
There are effective strategies you can use to help self-manage your lower back pain at home:
Rest: Give your back time to heal by avoiding activities that may exacerbate the pain or modify your daily activities to reduce strain on your lower back.
Apply heat or cold: Use heat packs or cold compresses to alleviate pain and reduce inflammation. Apply heat for muscle spasms and stiffness, and use cold packs for acute injuries or swelling.
Over-the-counter pain medications: Non-prescription pain relievers, such as ibuprofen or acetaminophen, can help reduce pain and inflammation. Always follow recommended dosages and guidelines.
Gentle exercise: Engage in low-impact exercises to promote flexibility and strengthen the muscles supporting your spine. Activities like walking, swimming, or gentle yoga can be beneficial.
Stretching: Perform gentle stretching exercises to improve flexibility and reduce muscle tension. Focus on stretches that target the lower back, hamstrings, and hip flexors.
Cognitive behavioral therapy (CBT): This psychological therapy can help you better manage moods, feelings and behaviors you have towards your pain and help you to return to the activities you enjoy.
Hypnosis: Another psychological therapy is hypnosis. Therapy delivered via hypnosis can help modulate the brain’s perception of pain and help you better manage your response to pain.
Sleeping position: Use a mattress and pillows that support a neutral spine alignment while sleeping. Experiment with different sleeping positions to find what works best for you.
The Wrap Up
There are many causes of lower back pain in females, including premenstrual syndrome (PMS); pregnancy; endometriosis; and muscle sprains.
Despite disc-related issues being the most common diagnoses of lower back pain in females, new research shows that these issues occur in people of all ages and aren’t always predictive of back pain.
It’s important to seek medical attention for your pain if this is something you are worried about or the pain is severe, has lasted a long time, or is associated with fever or unexplained weight loss.
There are effective self-management strategies to help manage lower back pain such as rest, heat or cold packs, over-the-counter medications, gentle exercise, stretching, psychological therapies, and alterations to your sleeping environment or position.
References
Jensen, M (1994) Magnetic resonance imaging of the lumbar spine in people without low back pain. New Eng J Med 331: 69-73
Brinjikji W, Luetmer PH, Comstock B, Bresnahan BW, Chen LE, Deyo RA, Halabi S, Turner JA, Avins AL, James K, Wald JT, Kallmes DF, Jarvik JG. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015 Apr;36(4):811-6. doi: 10.3174/ajnr.A4173. Epub 2014 Nov 27. PMID: 25430861; PMCID: PMC4464797.
Lynch, ME, Craig, KD & Peng, PWH. (eds). (2010). *Clinical Pain Management.* 1st edn, Wiley.
Gold EB, Wells C, Rasor MO. The Association of Inflammation with Premenstrual Symptoms. J Womens Health (Larchmt). 2016 Sep;25(9):865-74. doi: 10.1089/jwh.2015.5529. Epub 2016 May 2. PMID: 27135720; PMCID: PMC5311461.
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