Uterine fibroids are common, non-cancerous growths that can develop in or on the uterus, affecting many women during their reproductive years. While some experience no symptoms, these growths can lead to various issues, including back pain. This article explains the mechanisms behind fibroid-related back pain.
Understanding Fibroids
Uterine fibroids are benign growths of muscle and fibrous tissue that form within the uterus walls, on its outer surface, or within the uterine cavity. Also known as leiomyomas or myomas, they are common, affecting many women by age 50, though many remain unaware due to a lack of symptoms.
Fibroid size varies greatly, from microscopic to as large as a grapefruit or even a melon. Individuals can have a single fibroid or multiple growths. Their specific location, number, and size significantly influence whether symptoms, including back pain, develop.
Direct Mechanisms of Back Pain
Fibroids can directly cause back pain through physical pressure on surrounding structures. Large fibroids, particularly those growing on the back (posterior) side of the uterus, can press against nerves, muscles, and organs in the pelvic and lower back regions.
Subserosal fibroids, which grow on the outside of the uterus, are most commonly associated with back pain because they can protrude outwards and compress nearby nerves and the spine. Intramural fibroids, located within the uterine wall, can also contribute to back pain if they grow large enough to expand the uterus and exert pressure on surrounding tissues. This pressure can affect the lower spine or the lumbosacral plexus, a network of nerves in the lower back and pelvis, leading to dull, aching pain or stiffness.
The weight of large fibroids can also strain the back muscles, causing discomfort. When fibroids press on the sciatic nerve, which runs from the lower back down the legs, it can cause radiating pain, tingling, or numbness in the hips, buttocks, and legs, known as sciatica.
Indirect Mechanisms and Associated Symptoms
Back pain from fibroids can also arise through indirect mechanisms, including referred pain. The uterus shares nerve pathways with other areas of the body, including the lower back. Pain originating in the uterus can therefore be perceived in the lower back, hips, or legs due to this shared neural connection, even without direct compression.
Large fibroids can lead to subtle postural changes. An enlarged uterus can alter a person’s center of gravity, causing them to adjust their posture to compensate. This altered posture can strain back muscles over time, resulting in secondary back pain.
Other common fibroid symptoms often accompany back pain. Heavy menstrual bleeding, a frequent symptom of fibroids, can lead to anemia and fatigue. Fibroids can also press on the bladder or rectum, causing frequent urination or constipation, which can add to pelvic discomfort that may extend to the back.
When to Seek Medical Advice
Individuals experiencing persistent or worsening back pain, especially if it interferes with daily life, should consult a healthcare professional. Back pain that is chronic, severe, or accompanied by other fibroid-related symptoms warrants medical evaluation. These symptoms include heavy or prolonged menstrual bleeding, pelvic pressure, frequent urination, or constipation.
A healthcare provider can diagnose fibroids through examinations and imaging, such as an ultrasound or MRI. They can then discuss management options to alleviate symptoms and improve quality of life.