Some treatment methods for back pain during your period may include nonsteroidal anti-inflammatory drugs (NSAIDs), hormonal birth control, acupuncture, and nerve stimulation, among others.

If you’re one of the many women who experience period pain, you’re likely familiar with lower back pain during your period. Lower back pain is a common symptom of PMS, a condition most women experience during menstruation.

However, severe lower back pain may be a symptom of conditions like PMDD and dysmenorrhea. It may also be a symptom of a more serious condition called endometriosis.

There are a handful of causes of severe lower back pain during your period. Many of these causes are related to gynecological conditions.

PMS

PMS (premenstrual syndrome) is a condition that affects most people who menstruate. PMS symptoms commonly occur within the week before your period and stop once your period starts.

Common symptoms of PMS include:

  • bloating
  • abdominal cramps
  • achy breasts
  • constipation or diarrhea
  • headaches
  • emotional changes or mood swings

For some people, severe lower back pain is a frequent symptom. This may be related to increased inflammation during menstruation.

In one study, researchers found that women with higher inflammatory markers during their period were more likely to experience abdominal cramping and back pain.

PMDD

PMDD (premenstrual dysphoric disorder) is a more severe condition than PMS. It’s characterized by severe PMS symptoms that can interfere with your daily life, including work, school, and personal relationships.

Common symptoms of PMDD include:

  • psychological changes, such as depression, anxiety, and severe mood swings
  • allergies, acne, and other inflammatory conditions
  • gastrointestinal symptoms, such as vomiting and diarrhea
  • neurological symptoms, such as dizziness and heart palpitations

Like PMS, an increase in inflammation can be a cause of severe lower back pain in PMDD. However, it could also be a side effect of other PMDD symptoms, such as:

  • diarrhea
  • vomiting
  • pelvic pressure

Dysmenorrhea

Dysmenorrhea is a condition characterized by painful period cramps. With dysmenorrhea, the uterus contracts more than normal, leading to severe and sometimes debilitating cramps.

Symptoms of dysmenorrhea include:

  • abdominal cramping
  • lower back pain
  • pain radiating down the legs
  • nausea or vomiting
  • diarrhea
  • headaches or lightheadedness

Period cramps from dysmenorrhea can radiate throughout the entire lower and upper back.

In one study of more than 300 women aged 18 to 25, researchers found that more than 84 percent of them experienced primary dysmenorrhea. Of those 261 participants, 16 percent reported lower back pain. The pain was reported as feeling like:

  • spasmodic
  • shooting
  • piercing
  • stabbing

Endometriosis

While some lower back pain is normal during your period, severe and constant lower back pain can indicate a more serious issue, such as endometriosis.

Endometriosis is a condition characterized by the displacement of uterine tissue outside of the uterus. This tissue most commonly gravitates toward other areas of the pelvis. It can cause:

  • severe pain
  • scarring
  • organ dysfunction

Common symptoms of endometriosis include:

  • chronic pelvic pain, especially during and after sex
  • pelvic pain outside of menstruation
  • heavy periods that may be longer in length
  • severe period pain, including lower back pain

Back pain from endometriosis might feel different than back pain from PMS, PMDD, or dysmenorrhea.

When the endometrial lining relocates to other locations, it can cause a deep pain that’s not easily fixed with traditional methods, such as massage or chiropractic adjusting.

Endometriosis is a serious condition. It requires a formal diagnosis to be treated properly.

Medication, complementary therapies, and surgery are the most common treatments for severe lower back pain during your period.

Hormonal birth control

Hormonal birth control is commonly prescribed for people who have painful periods. Combination birth control methods contain both estrogen and progesterone. Alternative options contain only progesterone.

Hormonal birth control can reduce how heavy and painful your period is, which can provide relief from:

  • PMS
  • PMDD
  • dysmenorrhea
  • endometriosis

NSAIDs

NSAIDs (nonsteroidal anti-inflammatory drugs) like aspirin, ibuprofen, and naproxen are medications that effectively reduce pain and inflammation. You can buy them over the counter (OTC).

One systematic review found that NSAIDs, such as ibuprofen and naproxen, are extremely effective at reducing dysmenorrhea pain in clinical trials, even more than aspirin.

TENS

TENS stands for transcutaneous electric nerve stimulation. It’s a procedure that utilizes electrodes to deliver electric shocks to the skin, which releases the body’s natural endorphins to reduce pain.

In one case study on a 27-year-old female patient, a combination of spinal manipulation, TENS, and heat was used to reduce dysmenorrhea pain. The patient experienced a decrease in average and worst lower back pain after three to four cycles of monthly treatment.

Acupuncture and acupressure

Acupuncture and acupressure are two complementary therapies that focus on applying pressure to various areas of the body to reduce pain and promote healing.

In one smaller study, researchers found that 12 sessions of acupuncture were able to significantly reduce period pain for up to 1 year.

In another systematic review, researchers discovered that acupressure effectively reduced period pain in the majority of clinical trials. However, more research is needed, as the science is still contradictory.

Surgery

Endometriosis may require surgery to remove the uterine tissue that’s causing symptoms. In some cases, your doctor may only need to remove the small portions of displaced uterine tissue.

If the scarring and damage is extensive enough, it could require a full hysterectomy.

If you decide to have a hysterectomy for your endometriosis symptoms, it may involve removing the:

  • uterus
  • ovaries
  • cervix

For severe lower back pain during your period that’s not caused by a more serious condition, home remedies can effectively reduce the pain. Here are some you can try today:

  • Use heat. Apply a heating pad or water bottle filled with hot water to your lower back to ease the pain. Try to relax your back muscles, which can reduce pain as well.
  • OTC medications. Ibuprofen, aspirin, or even pain-relief cream can help relieve your lower back period pain. Most pain-relief creams are formulated with capsaicin, a potent anti-inflammatory compound that can reduce pain. These types of creams can be massaged into the lower back, which may also help the muscles relax.
  • Rest and relaxation. If you’re finding it difficult to do many things with severe lower back pain from your period, take a few days for yourself. Relaxing with a good book, some gentle yoga, or simply a hot bath may help increase the endorphins that naturally fight pain.

Certain activities, such as smoking and drinking alcohol, can make inflammation worse. In addition, too much caffeine and salty or fatty foods can make your period symptoms worse.

Drinking water and eating plenty of fruits, vegetables, and other anti-inflammatory foods may help reduce inflammation and relieve PMS symptoms like lower back pain.

Regular exercise releases natural endorphins that can help ease pain. If you find it hard to exercise with lower back pain, try more gentle activities, such as yoga or swimming.

If you’re feeling up to it, you might even try having sex with a partner or solo. Having an orgasm can relieve period cramps, which may help reduce your lower back pain.

If your lower back pain is so severe that you’re unable to perform daily activities, it’s time to see your doctor. They might perform a variety of tests to see whether you have endometriosis or another condition causing your severe pain.

Even if there’s no underlying condition, you and your doctor can discuss both medical and at-home treatment methods to reduce the pain.

Lower back pain during your period is a common symptom of period-related conditions, such as PMS. The pain may be more severe with certain conditions like PMDD, dysmenorrhea, or endometriosis.

Treatments for severe lower back period pain may include birth control, NSAIDs, alternative therapies, and surgery.

There are also plenty of at-home remedies to help ease lower back pain, including heat, rest, and gentle exercise. However, if your lower back pain is so severe that it doesn’t respond to traditional treatment options, it’s time to visit your doctor.