Can Fibroids Cause Back Pain?
Yes, fibroids can cause or add to lower back pain. Larger fibroids or groups of fibroids may create pressure in the pelvis. Fibroids that grow toward the back of the uterus may also cause pressure that you feel in your lower back. Some people feel it in the hips, buttocks, or legs.
Isolated back pain is not a definite indication that you have fibroids. Muscle strain, back problems, kidney or bladder problems, pregnancy, and other pelvic conditions can cause similar pain. A doctor can review all your symptoms and decide which tests may help determine the underlying cause.
Uterine fibroids are noncancerous growths made from muscle and connective tissue in or around the uterus. Some fibroids cause no symptoms. Others may cause heavy bleeding, pelvic pressure, frequent urination, constipation, pain during sex, or lower back pain. The National Institute of Child Health and Human Development lists lower back pain among the possible symptoms of uterine fibroids.
What Does Fibroid Back Pain Feel Like?
Fibroid back pain does not feel the same for everyone. The pain may be mild and come and go, or it may affect sleep, work, exercise, or daily activities. The American College of Obstetricians and Gynecologists notes that pain in the belly or lower back is often dull, heavy, or aching. The pain can sometimes feel sharp.
Possible patterns include:
- A dull or persistent ache in the lower back.
- Pelvic pressure or heaviness that extends toward the back.
- Discomfort in the hips, buttocks, or legs.
- Back pain that occurs with abdominal fullness or a larger-looking lower abdomen.
- Pain or pressure that becomes more noticeable during parts of your menstrual cycle.
Pain that travels into a leg may resemble sciatica, which is pain that follows the sciatic nerve from the lower back or buttock into the leg. Pressure from a fibroid may feel similar, but a back problem is a much more common cause and can be investigated through a proper exam.
Why Can Fibroids Cause Back Pain?
Fibroid symptoms often depend on the growths’ size, number, and location. A larger uterus or a fibroid growing toward the back of the pelvis may crowd nearby muscles, the bowel, or other pelvic structures. That pressure may be felt as pelvic heaviness, lower back discomfort, or pain that spreads toward the hips or legs.
Location may matter as much as size. A large fibroid at the front of the uterus may affect the bladder. A fibroid near the back may contribute to constipation or pressure that you feel closer to your back. Several smaller fibroids can also enlarge the uterus and reduce space in the pelvis.
Fibroids do not always press directly on the spine or a nerve. Imaging can show the size and position of a fibroid. The doctor still needs to compare those findings with your symptoms and consider other causes of back pain.
Which Fibroids Are More Likely to Cause Back Pain?
No single fibroid type will create back pain but doctors consider the patterns below because the fibroid’s position and size usually affect where pressure is felt. The table below describes possible links, but not guaranteed proof that a fibroid caused the pain.
to see the entire table
| Fibroid Type or Location | Why It May Matter |
|---|---|
| Posterior fibroids | Posterior means located toward the back of the uterus. These fibroids may create pressure closer to the bowel, lower back, or other structures behind the uterus. |
| Subserosal fibroids | Subserosal fibroids grow from the outer surface of the uterus. A larger growth that extends toward the back of the pelvis may contribute to pressure symptoms. |
| Large intramural fibroids | Intramural fibroids grow within the muscular wall of the uterus. Large intramural fibroids or several of them may enlarge the uterus and crowd nearby structures. |
| Pedunculated fibroids | Pedunculated fibroids grow on a narrow stalk. Their symptoms depend on their size and position. A stalk can sometimes twist and cause sudden pain that needs medical attention. |
A pelvic ultrasound or MRI may find these fibroids and show where they sit. The scan cannot always prove that a fibroid is the only cause of your pain. A back or pelvic condition may also be present.
Fibroid Pain And Other Symptoms
How Can You Tell If Fibroids Are Causing Your Pain?
A combination of back pain and other fibroid symptoms may give your doctor useful clues. The pattern still cannot diagnose fibroids or prove that they caused the pain.
Symptoms that may occur with fibroid-related back pain include:
- Heavy or prolonged periods.
- Pelvic pressure, heaviness, or pain.
- Abdominal fullness or enlargement.
- Frequent urination or trouble emptying the bladder.
- Constipation or pressure during bowel movements.
- Pain during sex.
The fibroid symptom overview explains how bleeding and pressure symptoms may appear together. The articles about fibroid pain and fibroids and constipation provide more detail about two related symptom patterns.
Keeping A Symptom Journal
Writing down notes related to dates and times you experience symptoms in a symptom journal can help your doctor see patterns that may be hard to remember at an appointment. It is helpful if you record the following information:
- The date, time, and location of the pain.
- The pain level and whether it feels dull, sharp, heavy, or burning.
- Any pain that spreads into a hip, buttock, or leg.
- Your menstrual cycle dates and any change in the pain around your period.
- Bleeding changes, including heavier flow, longer periods, or bleeding between periods.
- Abdominal fullness or a change in how your clothing fits.
- Bladder or bowel changes, including frequent urination or constipation.
- Activities, positions, or medicines that make the pain better or worse.
Bring the journal to your appointment. The details may help your doctor decide the appropriate diagnostic testing needed to determine the underlying cause.
Other Possible Causes of Lower Back Pain
Fibroids are only one possible cause of lower back pain. Other causes include:
- Muscle or spinal conditions, such as a strained muscle, arthritis, a herniated disc, or pressure on a spinal nerve.
- Kidney or urinary problems, such as a urinary tract infection or kidney stone.
- Endometriosis or adenomyosis. Endometriosis involves tissue like the uterine lining growing outside the uterus. Adenomyosis involves that type of tissue growing into the uterine muscle.
- Ovarian cysts, which are fluid-filled sacs that form on or inside an ovary.
- Pregnancy-related changes or complications.
- Gastrointestinal conditions, including constipation or irritable bowel syndrome.
The Johns Hopkins Medicine overview of back pain in women explains that more than one condition can contribute to the same pain. A fibroid diagnosis should not stop you from getting a needed back, bladder, digestive, pregnancy, or pelvic exam.
How Fibroid-Related Back Pain Is Diagnosed
Doctors will use a combination of your medical history, an examination, and imaging rather than relying on one symptom or scan for a diagnosis.
Medical and menstrual history. Your doctor will ask when the pain began, where you feel it, and what makes it change. Questions may also cover bleeding, pelvic pressure, bladder symptoms, constipation, and pain during sex.
Physical and pelvic examination. An exam may find tenderness, changes in the uterus, or signs that point to a muscle, back, bladder, or pelvic cause.
Pelvic ultrasound. Ultrasound uses sound waves to create pictures of the uterus and other pelvic organs. It is a common first imaging test when fibroids are suspected.
MRI when more detail is needed. Magnetic resonance imaging, or MRI, uses a strong magnetic field and radio waves to create detailed pictures. A doctor may order it when ultrasound leaves questions or when treatment planning needs a clearer view. MRI can show fibroid size, number, and location.
Testing for other causes. Your symptoms may lead the doctor to consider urine testing, pregnancy testing, blood tests, or a back, nerve, digestive, or pelvic exam.
The American College of Radiology’s fibroid imaging guidance describes pelvic ultrasound as usually appropriate when fibroids are suspected. MRI may be appropriate in selected situations and is often useful when treatment is being planned for a person with known fibroids.
Back pain plus heavy bleeding, pelvic pressure, or changes in bladder or bowel habits deserves a closer look. Schedule an appointment with Atlanta Fibroid Center to discuss fibroids and your treatment options.
Treatment Options for Fibroid-Related Back Pain
Treatment should match the confirmed cause of your pain. The plan may depend on how much the symptoms affect you and the fibroids’ size and location. Your medical history and goals for pregnancy or keeping your uterus also matter.
Options for treatment may include:
- Monitoring. Fibroids that cause mild or no symptoms may only need occasional follow-up.
- Symptom-relief medication. A doctor may recommend medicine for pain or heavy bleeding. These medicines may ease symptoms without removing the fibroids.
- Medical fibroid management. Certain hormone-based or hormone-blocking medicines may control bleeding or shrink fibroids for a limited time. Benefits, side effects, and treatment length vary.
- Myomectomy. This surgery removes fibroids while leaving the uterus in place. The surgical method depends on the fibroids’ size, number, and location.
- Uterine fibroid embolization. UFE is a minimally invasive procedure that blocks blood flow to fibroids so they shrink over time and often reduce or eliminate symptoms.
- Other procedures. Radiofrequency ablation uses heat and can often reduce bleeding but it does not treat the fibroids and leads to sterilization. MRI-guided focused ultrasound uses sound waves to treat selected fibroids. Availability and whether each option is right for you can vary.
- Hysterectomy. This surgery removes the uterus and may be appropriate when other options do not fit a person’s symptoms, fibroid size and location, health needs, or goals.
The ACOG uterine fibroid guide provides an overview of monitoring, medication, myomectomy, uterine artery embolization, radiofrequency ablation, focused ultrasound, and hysterectomy.
Can UFE Help With Fibroid Back Pain?
Uterine fibroid embolization may help when an exam shows that fibroid pressure is contributing to back pain. An interventional radiologist, like Dr. John Lipman, is a doctor who performs procedures with the help of medical images. The doctor guides a thin tube called a catheter into the uterine arteries to release tiny particles that reduce blood flow to the fibroids, which causes them to shrink over time.
Shrinking a fibroid can often reduce pressure on nearby pelvic structures and relieve pain. If there is a separate back, muscle, bladder, or other pelvic condition, it may continue to cause pain even after the fibroids are treated.
UFE is not the right choice for everyone, but it is a good option to explore before undergoing invasive surgery. Your OBGYN may not provide you with information about UFE because they do not perform this procedure. If you are told you need surgery for fibroids, getting a second opinion is recommended. Dr. John Lipman at the Atlanta Fibroid Center can review your symptoms, imaging, health history, fibroid size and location, and plans for future pregnancy and explain your options for treatment.
The Atlanta Fibroid Center® UFE page explains the procedure, preparation, recovery, benefits, and risks in more detail.
A consultation can help you compare UFE with medication, myomectomy, other uterus-sparing procedures, and hysterectomy. Request an appointment to review your symptoms and imaging with the Atlanta Fibroid Center team.
When to Seek Medical Care
Persistent or worsening back pain deserves medical attention. A doctor should also know if it occurs with heavy bleeding, abdominal enlargement, pelvic pressure, frequent urination, constipation, or pain during sex. Symptoms that affect sleep, work, exercise, or daily activities are also worth discussing.
Prompt medical care is needed for:
- Sudden, severe pelvic or abdominal pain.
- Very heavy vaginal bleeding.
- Dizziness, fainting, marked weakness, or shortness of breath with bleeding.
- Fever with pelvic pain.
Possible pregnancy needs urgent assessment when pelvic, abdominal, or back pain occurs with vaginal bleeding, fainting, or shoulder pain.
Emergency care is needed for new leg weakness or numbness or loss of bladder or bowel control. These signs can point to a serious spinal problem, so care should not wait for a fibroid appointment.
Frequently Asked Questions
Can small fibroids cause back pain?
It is possible, but pressure-related back pain is less likely with a small fibroid than with a large fibroid or enlarged uterus. Size alone does not predict how you will feel. A small fibroid may cause other symptoms based on its location. A doctor should also look for other causes of the pain.
Where is fibroid back pain usually located?
Fibroid-related back pain is usually described in the lower back. Some people also feel pelvic pressure, hip discomfort, or pain in the buttocks. The location of pain cannot confirm its cause.
Can fibroid pain radiate to the hips or legs, and can fibroids cause sciatica?
Yes, pressure or pelvic pain related to fibroids may spread toward the hips, buttocks, or legs. Fibroids may cause a sciatica-like pattern in uncommon cases when their size and position create pressure near pelvic structures. Sciatica is more often linked to an irritated or pinched nerve in the back. A medical exam can help separate a pelvic cause from a back or nerve condition.
Can fibroid back pain come and go?
Yes, fibroid-related pain may be constant or may come and go. Some people notice changes around their menstrual cycle, while pressure symptoms may occur at other times of the month. A symptom journal can help your doctor compare the timing with bleeding and other pelvic symptoms.
How do doctors confirm whether fibroids are causing back pain?
Doctors compare your symptoms and exam with imaging. Pelvic ultrasound is often the first scan, while MRI may add detail or help with treatment planning. Imaging can show fibroids, but it cannot always prove that they are the only cause of the pain. Your doctor may also check for back, bladder, digestive, pregnancy-related, or other pelvic causes.
Back pain can have more than one cause. A focused evaluation can show whether fibroids may be part of the problem and help you compare appropriate next steps. Make an appointment with Atlanta Fibroid Center to discuss your symptoms and treatment options.
