Symptom of Endometriosis: Back Pain

Experiencing back pain at some point in life is a common occurrence. It has been estimated that as many as eight out of every ten people will experience back pain sometime, and this pain can be incredibly varied.1 For some, back pain may be the result of a fall, fracture, or other injury, while for others, there may be no obvious cause of discomfort. Back pain can be short-term (also called acute pain) or long-term (called chronic pain), and may vary in its location and intensity. Some may report that their back pain is dull or makes them ache all over, while others may have stabbing, sharp pain that can be pinpointed to one specific spot. In some cases, back pain may go away on its own after a few days and not need medical attention, and in others, may need serious treatment.1-3

What can cause back pain?

A variety of different conditions can cause back pain, including conditions not directly related to the back. Some of these issues include, but are not limited to:

  • Back injuries such as muscle strain, sprains, fractures, or falls
  • Lack of physical fitness
  • Being overweight or obese
  • Psychological and physical stress
  • Poor posture
  • Kidney stones
  • Endometriosis
  • Pregnancy
  • Infections, such as urinary tract infections
  • Curving of the spine (also called scoliosis)
  • Arthritis, including arthritis of other areas besides the back, such as the hips
  • Fibromyalgia
  • Narrowing of the spinal column (also called spinal stenosis)
  • Slipped or ruptured disks within the spinal canal
  • The breakdown or weakening of bones (also called osteoporosis)
  • Psychological conditions (such as depression and anxiety)1-3

In relation to endometriosis, the mechanism by which back pain occurs is not well understood. Back pain related to endometriosis may be due to inflammation, endometriosis lesions that invade nerves involved in back pain perception, or, in very rare cases, endometriosis lesions that are on the spine itself.4,5 Some women with endometriosis-related back pain experience pain fluctuations that coincide with their menstrual cycle, while others’ pain does not have a pattern.6,7 More research is needed to fully determine how endometriosis contributes to back pain.

How is back pain evaluated?

If your back pain is the result of a hard fall or trauma, it is important to seek medical attention as soon as possible. Additionally, if your back pain is persistent and lasts for several days, it may be beneficial to consult a healthcare provider as well. However, if your back pain radiates to other parts of your body, you have a fever, you start experiencing numbness of your limbs, or if you have bowel or bladder-related issues, seek medical attention immediately.1-3

Once you consult your provider, they will try to figure out what’s leading to your pain. Determining a cause can be quite challenging, as many conditions can affect the back. Because of this, your provider will weigh the possibility of many different conditions against one another, based on your personal medical history and any other symptoms you’re experiencing, to try to rule potential causes out. This is called a differential diagnosis. Your provider may recommend imaging exams, such as an x-ray, CT scan, or MRI to better view your spine and other surrounding structures to look for an obvious cause. In some cases, these will all appear normal, and your provider may need to continue investigating. They may then recommend exams of your nerves or blood tests. If your provider suspects that endometriosis may be the cause of your pain, they might recommend a laparoscopy to definitively diagnose the condition.2,3

How is back pain treated?

Treating back pain often requires treating the underlying issue contributing to the pain. For those experiencing back pain related to their endometriosis, endometriosis treatment options such as hormonal therapy or laparoscopic excision of endometriosis lesions may lead to pain relief.6 In other cases, medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, or narcotics may be used to alleviate pain. Surgery may be needed in rare cases where trauma has occurred, or the spine has narrowed greatly. Medications used to treat other underlying conditions, such as antibiotics for infection or arthritis treatments may help relieve pain if these issues were the source of the discomfort. Your provider will work with you to create the most efficient treatment regimen for your specific situation.2,3

How can I manage back pain?

Outside of the medical interventions that your healthcare provider might recommend, there are other strategies for managing back pain. Some of these include, but are not limited to:

  • Physical therapy
  • Seeing a chiropractor
  • Yoga or regular stretching
  • Working on improving posture
  • Utilizing heat (such as heating pads or warm baths)
  • Massage
  • Acupuncture
  • Exercising regularly, within your capabilities2,3

Before trying a new method of managing your back pain, consult your healthcare provider to ensure that it is safe for your situation, and that it doesn’t interfere with any other treatments that you’re using.

Written by: Casey Hribar | Last reviewed: June 2018
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