Intrauterine devices (IUDs) are a highly effective form of long-acting reversible contraception. Some people express concern about potential side effects, including whether an IUD can cause back pain. While not a universal experience, back pain is a recognized side effect for some IUD users.
How IUDs Can Lead to Back Pain
An IUD’s presence within the uterus can trigger contractions, similar to menstrual cramps. These contractions can radiate discomfort from the pelvic area to the lower back, often described as a dull ache or pressure.
The insertion process can cause temporary irritation of the uterine lining. This may contribute to cramping that extends to the back. Both hormonal and copper IUDs can cause cramping and backaches.
In rare instances, more serious complications can lead to back pain. If an IUD expels from its correct position, it can cause increased cramping and discomfort, including back pain. Uterine perforation, where the IUD punctures the uterine wall, is another rare complication. This can result in severe abdominal and pelvic pain, which may also be felt in the back.
Timing of Back Pain with IUD Use
Back pain associated with IUDs often follows a predictable pattern, particularly after insertion. Many individuals experience cramping and backaches immediately following the procedure. This discomfort typically subsides within 24 hours, though for some, it may last a few days or a week.
The uterus requires an adjustment period. During the first three to six months, intermittent cramping and back pain might persist. For those with copper IUDs, periods might become heavier and more painful, potentially exacerbating back pain during menstruation. Hormonal IUDs can also cause irregular bleeding and cramping initially, but typically lead to lighter periods or no periods over time, which may reduce menstrual back pain.
Other Potential Causes of Back Pain
Back pain is a common experience with numerous possible origins, many unrelated to IUD use. Musculoskeletal issues frequently cause back pain, stemming from muscle strains, ligament sprains, poor posture, or lack of exercise. Arthritis can also lead to chronic back discomfort.
Back pain can arise from issues with internal organs or other medical conditions. Kidney stones or kidney infections may cause pain that radiates to the back. Certain gynecological conditions, such as endometriosis, uterine fibroids, or pelvic inflammatory disease (PID), are also known to cause lower back pain. These conditions can irritate nerves or exert pressure on surrounding structures, leading to referred pain in the back.
When to Seek Medical Advice
While some back pain is expected after IUD insertion and during the adjustment period, certain symptoms warrant medical attention. Contact a healthcare provider if back pain becomes severe, worsens, or is not relieved by over-the-counter pain medication. Persistent pain lasting more than three to six months should also be evaluated, as it could indicate the IUD is out of place.
Other concerning signs include fever or chills, which might suggest an infection like pelvic inflammatory disease (PID). Unusual or foul-smelling vaginal discharge, heavy or abnormal bleeding, or pain during sexual intercourse also require prompt medical assessment. If the IUD strings feel shorter, longer, or cannot be felt, or if the plastic part of the IUD is felt, contact a doctor. This could signal IUD displacement or expulsion.