Low back pain is one of the most common ailments we treat as physical therapists. Of course, there are several causes for pain in this area, but there is one pattern in particular that we’ve seen lately in Manitowoc, WI, at Juniper Physical Therapy & Fitness.
Many of our female clients have noticed that their low back pain correlates with their menstrual or ovulation cycle. Their lower back symptoms vary amongst them from a general ache to a sharp stabbing or catching pain that is worse when transitioning from sitting to standing.
After a thorough evaluation, we generally discover a combination of specific muscle and joint stiffness, weakness, and/or poor movement patterns. We prescribe a customized plan of manual hands-on treatment and exercise. These things help. But, one thing we have found we have little control over is the pain that comes and goes with their cycle.
Low back pain around your period is not a new concept. Women of all ages have certainly experienced this. However, as health professionals who enjoy helping people feel better, we wanted to know more about what causes this.
Our brilliant intern and exercise science major, Maeve Sullivan, researched this topic. She found two reasons for this cyclical back pain and some treatment techniques you can try if you suffer from this often debilitating pain.
Two Researched Reasons for Cyclical Period Pain
Referred Pain from the Ovaries
Referred pain is pain that is perceived at a location other than the site of its origin. Many tissues and structures can create this referred pain, including muscles, organs, spinal segments, the SI joint, viscera, tumors, infections, or associated manifestations.
This type of pain is often overlooked as we can be accustomed to evaluating and blaming the structures located where we hurt. Brilliant neuroscientists and medical professionals have discovered common patterns for referred pain and have even mapped these out. Here are some examples of referred pain from two muscles, the iliopsoas, and infraspinatus:
Your lovely ovaries can create pain in locations further away from where they are located too. Ovarian pain can manifest in your lower abdomen, pelvis, or lower back. The cause of this pain varies from monthly ovulation and menstruation to cysts, endometriosis, fibroids, tumors, and pelvic inflammatory disease.
Ligament Laxity as a Source of Low Back Pain
Another reason for lower back pain during your monthly cycle is excessive joint movement from ligament laxity. As our hormones ride their rollercoaster at various times during the month, they can cause our ligaments to get stretchy or lax. Lower back pain can occur because of the increased movement that can happen at the pelvis and spine when these ligaments aren’t as stiff.
Various studies have shown that female hormones have an impact on ligaments. The most commonly studied ligament is the ACL due to the higher amount of ACL injuries in females vs males. However, as typical, these studies have different conclusions. THIS one reported ACL laxity increased significantly throughout the menstrual cycle, and THIS one showed no relationship between female hormones and laxity but demonstrated a fundamental significant difference between females and males laxity.
That sharp or sudden pain that happens when you get up from a chair is likely from this ligament laxity. It is often felt off to one side of the lower back along the SI joint. We see this a lot at Juniper.
How to Get Relief from Monthly Low Back Pain
Although we focus on long-term solutions like core stability and strength for low back pain, we understand that we often can’t control those cyclical occurrences. Therefore, we employ more temporary treatments during this time. Here are some of our favorites:
Sacroiliac belt
This belt is worn over a pair of cotton underwear and around your pelvis. It helps to provide support for your pelvic joints when your ligaments are slacking.
Kineasiotape
We love our Rock Tape to provide a sense of security to our client's lower back. THIS method is supported by the research which concluded that overall pain is reduced when applied for a few days before the menstrual cycle.
Taking it Easy During Your Workouts
Establish a "Happy Period Routine," as coined by a cyclical coach, and consider toning down your exercise intensity during your time of the month. Heavy load and impact work can be jarring and stressful to your joints and body during this time. Give yourself a break and consider lower-level activities such as walking and yoga. Or, if you love to lift, choose lighter weights and move slower, working on your form and control.
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