Fibroid Symptom: Back Pain

Pelvic pain is one of the “Big 3” fibroid-related symptoms along with heavy uterine bleeding and increased urinary frequency. Back pain is somewhat less common but often goes unrecognized as a symptom that is due to a woman’s fibroids. Less than 3% of back pain and low back pain in women are related to fibroids.

Can Fibroids Cause Back Pain?

Uterine fibroids are the most common pelvic tumor seen in women. They are usually spherical masses of rock-hard muscle tissue that grows in the uterus or sometimes is attached to it by a stalk-like tissue.

Fibroid size, number, and location determine symptoms they might cause. You may be surprised to learn that fibroid location is actually more important than size in determining these symptoms. Fibroids that cause back pain are typical subserosal fibroids that are present in the posterior wall of the uterus.

Subserosal fibroids develop on the outer part of the uterus and continue to grow outwardly, i.e. away from the uterus. Fibroids are hard tumors and those that are located in the back of the uterus will mechanically press against pelvic nerves that result in low back, buttock, and hip pain which can radiate down either one or both legs aka sciatica. Because this type of pain is typically the result of a problem with the lumbar spine, e.g. herniated lumbar disc, this can mislead the physician caring for the fibroid patient into unnecessary testing and referral to a back doctor when the true issue is fibroids and not the lumbar spine. Large intramural fibroids growing in the uterine muscle can have a similar effect as the subserosal fibroids and lead to back pain and sciatica too.

Types of uterine fibroids: submucosal, subserosal, intramural, and cervical
Types of uterine fibroids: submucosal, subserosal, intramural, and cervical

How Do I Know That the Pain in My Back Is Caused by Fibroids?

Fibroids cause lower back pain more often than people realize. Because the fibroids that cause back pain are located in the posterior aspect of the uterus, they can also press on the adjacent colon. Therefore, lower back pain that is also associated with chronic constipation one should think of fibroids as a possible etiology.

When suffering from lower back pain and suspecting uterine fibroids, one should talk to a doctor. A routine physical examination can suggest or confirm the presence of uterine fibroids. In equivocal cases, this can be confirmed with a pelvic ultrasound exam. However, for more accurate information about the number, size, and location of fibroids, it’s recommended to perform a pelvic MRI exam. MRI can also reveal if the fibroid is pressing against the spine and evaluate for other causes of back pain too, e.g. herniated lumbar disc.

How to Relieve Back Pain from Fibroids

Back pain from fibroids do not typically respond to treatments used in lower back strain. However, medicines used to treat fibroid symptoms are not much better, e.g. hormonal therapy like birth control pills or a progestin-containing IUD.

If a woman suffers from fibroid pain and other fibroid-related symptoms, she is often offered only surgical treatment options, e.g. myomectomy or hysterectomy. While surgery may be an option for some, in most cases, it is completely unnecessary, and women are often unaware about the effective, non-surgical, outpatient fibroid treatment called uterine fibroid embolization (UFE). Patients that undergo UFE get the relief of symptoms (including lower back pain), they avoid the risks and long recovery of surgery, and they get to keep their uterus!

Can UFE Treat Back Pain and Other Fibroids Symptoms?

The purpose of any adequate medical treatment must be to successfully treat the underlying reason of the condition. That’s why addressing the fibroids should be the target for the physician caring for the fibroid patient. Fibroids, when treated with UFE, are no longer alive. They begin to soften and shrink, and this results in the woman’s symptoms resolving.

Uterine fibroid embolization is a minimally invasive procedure that does not require a hospital stay. Patients are discharged home on the day of the procedure. The recovery time is very short, usually about five days. The UFE procedure works by blocking the blood supply to the fibroids in the uterus leading to the death of every fibroid. The uterus remains completely alive however. Without a blood supply, the hard and firm fibroid tumors begin to soften. Then, they begin to shrink. This combination eliminates the ability for the fibroids to press on adjacent structures with any force. When this occurs, a woman’s symptoms begin to resolve. Within 3 months after the procedure, fibroids shrink by 50%, and by 60-70% in 6-12 months.

To learn more about back pain from fibroids and how UFE can help, contact the leaders in fibroid care, the Atlanta Fibroid Center via phone or make an appointment online at ATLii.com.

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