What can cause lower back pain in women?

Lower back pain in women is a common complaint, ranging from a dull ache to a sharp, debilitating pain. Understanding the causes can help guide treatment, reduce further pain, and prevent long-term complications.

Pain in the lower back can come from the spine and its muscles, joints and nerves, or from the pelvis. Factors like pregnancy and menopause put even more pressure on the back. The pattern of symptoms matters more than which side hurts. Most back pain improves on its own and doesn't need a scan. What matters most is noticing the symptoms that point to a more specific cause.

Muscle, Joint and Nerve Pain

Lower back pain in itself is very common and usually improves within a few weeks. It isn't always obvious what causes the pain, however. A common cause is an injury such as a pulled muscle. Sometimes conditions such as a slipped disc, sciatica (a trapped nerve) or ankylosing spondylitis are responsible.

In many areas, you can refer yourself to NHS musculoskeletal (MSK) services, such as physiotherapy, without seeing a GP first.

Pelvic Causes

Back pain that follows your menstrual cycle, comes with pain during sex or when you pee or poo, may have a pelvic cause. Endometriosis is one example. Its symptoms can include pain in the lower tummy and back, severe period pain, pain during or after sex, and pain when relieving yourself. Other conditions, such as fibroids, adenomyosis, and irritable bowel syndrome, can cause similar symptoms.

Pelvic causes are investigated differently from spinal causes. For suspected endometriosis, NICE recommends that GPs offer a transvaginal ultrasound, with a scan through the tummy if that isn't possible. A normal scan doesn't rule out endometriosis, and referral may still be needed. For suspected deep endometriosis, specialists may use a pelvic MRI or specialist ultrasound that is planned and interpreted by someone with expertise in gynaecological imaging. An MRI of the lower spine is not designed to answer these questions.

Pregnancy

Back pain is very common in pregnancy. The ligaments naturally soften and stretch to prepare for labour, which can strain the joints of the lower back and pelvis.

Some women develop pregnancy-related pelvic girdle pain (PGP), which affects up to 1 in 5 pregnant women to some degree. It can cause pain across one or both sides of the lower back, over the pubic bone, in the perineum, or spreading to the thighs. A midwife or GP can refer you to a physiotherapist who specialises in pregnancy-related pelvic problems.

In pregnancy, contact your GP or midwife urgently if you have back pain and you're in your second or third trimester, as pain could be a sign of early labour. Do the same if you also have a fever, bleeding from your vagina, pain when you pee, or pain in one or both sides under your ribs.

Post-Menopause

Osteoporosis doesn't cause pain by itself, but it makes bones more likely to break. Spinal fractures can happen without a fall. Some fractures cause no pain, others cause severe back pain, and several spinal fractures can lead to height loss and a curved spine.

When to Get Help

See a GP if your back pain doesn't improve after a few weeks, stops you doing everyday activities, or worries you in general. Also see a GP if you've lost weight without trying, there's a lump or change in the shape of your back, or the pain is worse at night or doesn't ease with rest.

Ask for an urgent GP appointment or contact NHS 111 if you have back pain and you feel hot, cold, shivery or unwell, or the pain is severe, starts suddenly or is getting worse quickly.

Call 999 or go to A&E if you have back pain with any of these symptoms:

1. Pain, tingling, weakness or numbness in both legs
2. Loss of feeling around your genitals or anus
3. Changes in your bladder or bowels, such as difficulty peeing, or peeing or pooing yourself
4. Changes in how your vagina feels during sex, or not being able to orgasm
5. Chest pain
6. Pain that started after a serious accident

Note: a planned scan is not the right route for any of these symptoms.

When a Scan Helps

For most low back pain, with or without sciatica, NICE advises against routine imaging in a non-specialist setting. It recommends considering imaging in specialist care only if the result is likely to change how the pain is managed. Imaging is appropriate when a clinician suspects a serious underlying cause after a full exam.

If a clinician has identified potential issues and suggested an MRI, see our private MRI scan page. The body area and protocol still need clinical review.

Conclusion

Lower back pain is a multifaceted issue that can stem from everyday strain, posture, hormonal changes, or underlying medical conditions. Identifying the specific cause allows you to take the right steps toward relief. Early awareness and proper management of lower back pain in women help prevent chronic discomfort and improve your overall quality of life.

FAQ

What does constant lower back pain indicate?

It may suggest a chronic issue like arthritis, disc problems, or even cancer, especially if it doesn't improve with rest. Always seek help if you are unsure.

Is dull lower back pain a serious issue?

Not always, but if it lasts longer than 6 weeks or worsens, seek medical advice. If you’re concerned, see your doctor.

When is lower back pain considered intense or horrible?

If it's sharp, sudden, affects movement, or is associated with other symptoms like numbness, it's best to get checked.

What causes lower left side back pain in females?

Possible causes include muscle strain, ovarian cysts, kidney infections, or endometriosis.

How can I fix lower back pain at home?

Try rest, heat or ice packs, light stretches, and OTC pain relief. If it doesn’t improve in a few days, see a healthcare professional.

Is lower back pain common in early pregnancy?

Yes. Hormonal and postural changes can start affecting the back from early stages.

What’s the best sleeping position for lower back pain?

Sleeping on your side with a pillow between your knees is usually most supportive.

Can lower back pain affect the hips or abdomen?

Yes, especially if there’s nerve involvement or if the underlying cause is from pelvic or abdominal organs.

Why does lower back pain occur when walking or running?

It may be due to posture, disc issues, joint inflammation, or poor core strength.

References

1. NHS. Back pain. Last reviewed 5 March 2026.
2. NHS. Endometriosis.
3. National Institute for Health and Care Excellence. Endometriosis: diagnosis and management (NG73). Diagnosis section updated November 2024.
4. National Institute for Health and Care Excellence. NG73 resource impact summary report.
5. NHS. Back pain in pregnancy. Last reviewed 10 January 2024.
6. NHS. Pelvic pain in pregnancy. Last reviewed 12 December 2022.
7. BackCare / Royal Osteoporosis Society. Osteoporosis: the facts behind spinal fractures and back pain.
8. National Institute for Health and Care Excellence. Low back pain and sciatica in over 16s (NG59).
9. Academy of Medical Royal Colleges, Evidence-Based Interventions. Low back pain imaging.