According to the Virginia Spine Institute, back pain that comes on during menstruation is generally caused by the same thing that causes your cramps: overactive muscles. Thank the chemical prostaglandin, which tells your uterine muscles to contract (and thus shed the built-up uterine lining) during your period. If your body goes overboard making prostaglandin, those contracting muscles can cause some major cramping—creating pain that can radiate to your lower back. (Hello, back pain.)
- Adrienne Potts, MD, FACOG, board-certified OB/GYN based in Maryland
However, Adrienne Potts, MD, FACOG, an obstetrician-gynecologist specializing in family planning and preventative care, says that there are some other factors that can cause PMS back pain. For example, she says having a retroverted (aka tilted) uterus may make some women experience cramping in the lower back instead of (or in addition to) the abdomen. And there are other health conditions, like endometriosis or uterine fibroids, that can also contribute to cramping and lower back pain during menstruation.
“It can be hard to disentangle the cause without a more in-depth examination, particularly in separating the more ‘typical’ pain that women commonly experience from pain that could suggest a secondary condition," Dr. Potts says. She says women should check in with their OB/GYN if they experience back pain or any other menstrual symptoms that regularly interfere with their daily activities or are not adequately managed with at-home remedies (more on those in a sec).
How to treat your PMS back pain
Though it may feel like there’s no way around the insane back aches during your period, there are actually a lot of things you can do to help deal with the pain. Dr. Potts recommends starting out with OTC medications and home remedies—that's generally pretty effective for most people. Here are some of the best options:
1. Non-steroidal anti-inflammatories (NSAIDs)
There is a large body of research showing that NSAIDs (the fancy name for OTC pain relievers like ibuprofen and aspirin) are super-effective in relieving period-related pain. However, side effects—which can range from benign (indigestion, drowsiness) to much more serious (increased risk of a heart attack or stroke)—are also common with prolonged use of these drugs. If you find that you need to use NSAIDs for more than 10 days, talk to your doctor.
2. Heat therapy
Dr. Potts recommends heating pads to help soothe lower back pain and abdominal cramping during your period. And it's pretty legit: In a review of the clinical evidence available to support various treatments for PMS symptoms, applying heat directly to the site of the cramping was shown to be pretty effective. One older study from 2001 even found that continuous heat delivered via an abdominal patch provided pain relief that was comparable to the pain management achieved by treatment with ibuprofen.
Many women swear by the calming, healing powers of yoga to alleviate pain and bloating while also inducing all the tranquil Zen feels we could totally use during that time of the month. And some research has found that yoga can help reduce period pain (both how intense it is and how long it lasts), although more clinical trials are needed. So go ahead and take that hot yoga class. Or, try one the below flow for relieving menstrual cramps.
4. Aerobic exercise
Okay, working out is probably the last thing on your mind when you have cramps and PMS back pain, but a small 2018 study found that eight weeks of aerobic exercise three times a week helped alleviate menstrual pain. Yet another reason to keep up with a consistent workout routine.
5. Supplements and herbal remedies
Over the centuries women have experimented with a variety of alternative treatments, including supplements and herbal remedies, to deal with their period pain. And while lots more research is needed on this front, there is some evidence available to suggest that thiamine (vitamin B1), vitamin E, toki-shakuyaku-san (a Japanese herbal remedy), and magnesium can help with period cramps and pain. Just be sure to talk with your doctor before taking any supplements or herbal remedies to make sure that they won't interfere with other meds or treatments you're taking.
If none of this works... visit your doc. “If women aren’t able to achieve relief through these measures, they should schedule an appointment to rule out secondary causes of pain and consider alternative treatments, such as hormonal contraceptives,” says Dr. Potts. As mentioned earlier, there might be another condition at play that requires different treatment than just a few Advil and yoga stretches.
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