Low Back Pain in Females

Ladies, we are different. We are special. We’re strong, and we’re capable. And…we have specific attributes that are unique to us. These differences extend beyond the obvious anatomical and hormonal differences. Labor, menstruation, and menopause, just to name a few.

Some of the things that make us unique and special also can contribute to a potential for back pain. Let’s look at some of the causes of back pain and how they may be more likely for us as women.

Sacroiliac (SI) Joint Anatomy Differences:

SI joint dysfunction is a common cause of low back pain in men and women, but women are more commonly affected for many reasons. First off, the SI joint surface area is smaller most often compared to men, resulting in a higher concentration of stresses across the joint. The sacrum is also wider, more uneven, less curved, and more rotated in women, which may cause problems in the SI joint.

Hormone Changes in Pregnancy:

A common cause of low back and SI joint pain occurs with labor and delivery. When a woman gets pregnant, her body begins to produce increased amounts of progesterone and relaxin hormones which causes a greater extensibility and pliability of ligaments and joints causing hypermobility. This is a good thing because it allows for the pelvic musculature to accommodate the growing baby. However, ligaments and muscles provide stability. When laxity is increased, support is decreased leading to joint instability or muscle tightness causing pain and discomfort. Additionally, this hormonal shift is a common cause of coccydynia or “tail bone” pain.

Hormone Changes in Menopause:

As we age, degenerative changes will occur. Arthritis is a part of life for most all of us as we get older, but women have some specific issues they deal with, and can be at play with back pain. After menopause, estrogen production decreases, causing increased resorption of bone. This makes post-menopausal women more at risk of developing osteoporosis and osteopenia. These changes may cause nerve root compression causing radiating pain down the legs, numbness, tingling or burning sensation. These changes may also affect the curvature of your spine causing muscle shortening, increased joint stress and muscle deficiencies leading to pain.


Endometriosis is a condition where the tissue that normally lines the uterus begins to grow outside the uterus. This is a gynecological disorder that affects women exclusively. Symptoms may include painful menstruation cycle, pain in the genital region, or low back pain during menstruation. Low back pain may even become chronic with this condition due to the nature of recurring menstruation cycles.

Pelvic Floor Dysfunction:

Lastly, but certainly not least, pelvic floor dysfunction is a common link to low back pain.

If you are someone who is experiencing urine leakage when you cough, or feel you have to run to the bathroom right away or you’ll have an accident, you are experiencing a form of pelvic

floor dysfunction. Some examples of pelvic floor dysfunction include urinary incontinence, fecal incontinence, pelvic organ prolapse, dysuria (pain with urination), constipation, nocturia (frequent urination at night), dyspareunia (painful intercourse).

The pelvic floor muscles make up the bottom of our core. If we are not addressing dysfunction in this area, we are leaving out the foundation causing unequal force distribution and increased stress and load through our lumbar spine when we are performing functional activities.

So, what’s a lady to do?? First, MOVE! Regular exercise increases your muscle strength, improves your balance, decreases your risk of bone fracture, improves your posture and decreases your pain.

These issues are complicated, however, so if simple exercises aren’t helping you, you need a pro in your corner. At WPT, we get to the root of these issues with comprehensive diagnosis, and treat these problems to not only address your deficits but prevent them from recurring throughout your lifetime.

Stay strong, ladies!

– Tyra Abdalla, DPT