Back pain can be a surprising symptom for many conditions, and it is a common concern whether it might be related to diverticulitis. While diverticulitis primarily affects the digestive system, it is possible for pain from this condition to manifest in the back. Understanding the nature of diverticulitis and how it can influence surrounding areas of the body helps clarify this connection.
Understanding Diverticulitis
Diverticulitis originates from diverticula, small, bulging pouches that form in the lining of the large intestine, also known as the colon. These pouches develop in weakened areas of the colon wall and are common, especially in individuals over 40. The presence of these pouches without inflammation is diverticulosis, which does not cause symptoms.
If these diverticula become inflamed or infected, the condition progresses to diverticulitis. This inflammation occurs if stool or bacteria become trapped within a pouch. The most common symptom is severe abdominal pain, located in the lower left side of the abdomen. Other symptoms include fever, nausea, vomiting, chills, and changes in bowel habits like constipation or diarrhea.
The Link Between Diverticulitis and Back Pain
Diverticulitis can cause back pain, often in the lower back. This occurs due to referred pain. The colon, particularly the sigmoid colon where diverticula often form, shares nerve pathways with the lower back and pelvic region. When inflammation or infection occurs in the colon due to diverticulitis, pain signals travel along these shared nerves, causing discomfort to be felt in the back, even though the problem originates in the bowel.
The proximity of the inflamed colon to spinal structures and muscles also plays a role. Inflammation or an abscess in the colon can irritate nearby nerves or muscles, leading to localized back discomfort or muscle spasms in the lower back. While abdominal pain is the primary symptom, back pain can emerge as inflammation spreads or intensifies, sometimes radiating into the hip and buttock. This referred pain is common, with over half of patients experiencing lower left-sided back pain during an acute episode.
Distinguishing Back Pain Sources
Identifying whether back pain stems from diverticulitis or another cause can be challenging, as back pain is a common symptom with many origins, including musculoskeletal issues, kidney problems, or gynecological conditions. Back pain related to diverticulitis is accompanied by other gastrointestinal symptoms. These include persistent lower abdominal pain, changes in bowel habits like constipation or diarrhea, fever, nausea, or vomiting. The abdominal pain precedes or occurs concurrently with the back pain.
Conversely, purely musculoskeletal back pain results from injury or strain, may worsen with movement, and lacks associated digestive symptoms. Kidney problems, such as kidney stones or infections, can also cause back pain in the flank area, accompanied by urinary symptoms like frequent urination or painful urination. The distinguishing factor for diverticulitis-related back pain is its connection to digestive symptoms and its common location on the lower left side, reflecting the common site of inflammation in the colon.
When to Seek Medical Care
Seek medical attention if you experience back pain accompanied by concerning symptoms that indicate diverticulitis or its complications. Seek evaluation if back pain is severe, sudden, or rapidly worsening, especially when combined with a fever of 100.4°F (38°C) or higher, persistent abdominal pain, nausea, vomiting, or chills. Changes in bowel movements, such as significant constipation or diarrhea, or blood in the stool, also require immediate medical consultation.
These symptoms could signal a serious complication, such as an abscess (a pocket of pus), a perforation (a tear in the colon), or a bowel obstruction, requiring urgent medical intervention. Self-diagnosis should be avoided, as a healthcare professional can accurately diagnose the cause of your symptoms through physical examination and imaging tests like a CT scan. Addressing diverticulitis promptly can help manage symptoms and prevent more severe health issues.