Clinically reviewed by What is female lower back pain
Lower back pain is pain between the bottom of the ribs and the top of the buttocks. In Urdu it is kamar dard. It is the commonest reason people come to physiotherapy, and in women it often has causes that get missed.
The structures are the same in men and women. What differs is the load they have carried: pregnancy, delivery, a weak pelvic floor, periods, carrying children, and hours spent bending or squatting at floor level.
Most lower back pain is mechanical, which means it comes from how the back is moving and loading rather than from damage. That is good news, because mechanical problems respond to treatment.
Symptoms you might have
- A deep ache across the lower back, on one side or both
- Pain that worsens with standing, bending, sweeping or washing clothes
- Pain spreading into the buttock or the back of the thigh
- Leaking urine or heaviness low down alongside the back pain, which points at the pelvic floor
- Pain that is worse in the days before and during your period
- Pain over the pubic bone or the back of the pelvis rather than the back itself, which is pelvic girdle pain instead
Why it happens
- Pregnancy and delivery, with the abdominal muscles and pelvic floor never properly restored
- Pelvic floor weakness, which removes part of the support system for the lower back
- Carrying a child on the same hip for hours every day
- Squatting and sitting on the floor to wash, cook, sweep and knead dough
- Period pain, which many women feel in the lower back
- Weak hip and back muscles with long hours of sitting
- After menopause, thinning bone, which raises the risk of a spinal fracture from a minor fall
When you should see a physiotherapist
Come in if the pain has lasted more than a week or two, if it keeps returning, or if it is stopping you doing housework or lifting your children. Most of what is treated here is ordinary mechanical back pain, and it responds.
Dr. Zahra is a female physiotherapist, which matters here, because a proper assessment includes asking about pregnancies, deliveries, leaking and periods. She treats men and children as well.
Go to a hospital immediately if you have numbness around the groin or back passage, if you have lost control of your bladder or bowels, or if both legs are weak. That is a nerve emergency.
See a doctor for back pain with fever, unexplained weight loss, pain that is worse at night, a past history of cancer, or pain after a fall if your bones are thin.
Al-Shama Physiotherapy Clinic
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اپائنٹمنٹ کے بارے میں پوچھیںAppointment ke liye poochein
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یہ فارم پُر کریں؛ واٹس ایپ پر آپ کی تفصیلات کے ساتھ پیغام تیار ہو جائے گا۔Yeh form bharein, WhatsApp aap ki tafseel ke saath khul jaye ga.
How it is treated
The assessment works out which structure is involved and what is loading it, including whether the pelvic floor and abdominal wall are part of the picture.
- Manual therapy to the lower back, hips and buttock muscles to restore movement and reduce guarding
- Exercise therapy, graded strengthening for the back, hips, glutes and deep abdominals. This is the part that keeps the pain away
- Pelvic floor training where the assessment shows weakness, which is common after childbirth
- Electrotherapy and ultrasound for pain and muscle spasm in the early stage
- TENS for pain relief, including period related back pain, which many women find useful at home
- Dry needling for muscles locked in spasm
- Hijama, cupping therapy, for persistent muscular back pain where it suits the patient
- Household ergonomics: raising work surfaces, using a low stool, changing how you carry children
Surgery is rarely needed for ordinary lower back pain, and that is a surgeon's decision. Physiotherapy does not treat gynaecological causes: if periods are very heavy or very painful, or the pain follows a strict monthly pattern, a gynaecologist needs to look for conditions such as endometriosis.
Exercises, and what to avoid
What helps
- Walking every day, starting with ten minutes and building up
- Glute bridges and side lying hip work, which take load off the back
- Deep abdominal and pelvic floor work done together, breathing normally
- Gentle hip flexor and hamstring stretches held twenty to thirty seconds
What to avoid
- Squatting for long periods to wash clothes, dishes or floors. Sit on a low stool instead
- Bending and twisting at the same time, which is how most backs are hurt
- Carrying a child on the same hip every time. Alternate sides, or carry in front with both arms
- Resting in bed for days. Beyond a day or two it makes the back weaker and the pain last longer
What you can do at home
Heat suits most lower back pain, because the muscles around the spine tighten protectively. A warm pack for fifteen to twenty minutes, a few times a day. Ice only in the first day or two after a sudden strain.
Raise your work level. A stool to sit on for washing, a table instead of the floor for chopping and kneading. This is the single most useful change in most Pakistani homes.
Change sides when carrying a child, and keep the load in front of you rather than on one hip.
Sleep on your side with a pillow between the knees, or on your back with a pillow under the knees. A very soft mattress makes morning pain worse.
Keep moving on the bad days. Short, frequent movement rather than rest.
How long it takes
Most sudden lower back pain improves substantially within four to six weeks, and you should feel some change within two weeks of starting treatment.
Back pain that has come and gone for years takes longer. Expect eight to twelve weeks of consistent strengthening for a lasting change, because the muscles have to be rebuilt, not just relaxed.
Back pain linked to pregnancy and delivery often settles well once the pelvic floor and abdominal wall are retrained, even years later. Three months is a realistic target.
What slows it: stopping the exercises as soon as the pain eases, and squatting and bending at floor level all day. What speeds it up: daily walking, strengthening twice a week, and changing two or three household habits for good.
Urdu / Roman Urdu
Choose your reading script / اپنی پسند کا رسم الخط منتخب کریں
اردوUrdu script
خواتین میں کمر درد کی کچھ وجوہات مردوں سے مختلف ہوتی ہیں: زچگی کے بعد پیٹ اور پیڑو کے پٹھے کے پٹھوں کی کمزوری، ماہواری کا درد، بچے کو ایک ہی کولہے پر اٹھانا، اور گھر کے کام کے لیے دیر تک اکڑوں بیٹھنا۔
زیادہ تر کمر درد کی وجہ کوئی بڑی بیماری نہیں ہوتی، بلکہ پٹھوں پر غلط بوجھ ہوتا ہے۔
علاج میں مینول تھراپی، ورزش، الیکٹروتھراپی، الٹراساؤنڈ، ٹینس، ڈرائی نیڈلنگ اور حجامہ شامل ہیں۔ سب سے بڑا فائدہ پٹھوں کی مضبوطی سے ہوتا ہے۔
گھر میں دو تبدیلیاں کریں: برتن اور کپڑے دھونے کے لیے اسٹول پر بیٹھیں، اور بچے کو بڑی بڑی دونوں طرف اٹھائیں۔
فوراً ہسپتال جائیں اگر پیشاب یا پاخانے پر کنٹرول ختم ہو جائے، یا دونوں ٹانگیں کمزور ہوں۔
Roman Urdu
Khawateen mein kamar dard ki kuch wajohat mardon se mukhtalif hoti hain: delivery ke baad pait aur pelvic floor ke pathon ki kamzori, mahwari ka dard, bachay ko ek hi kolhe par uthana, aur ghar ke kaam ke liye der tak ukdu baithna.
Zyada tar kamar dard ki wajah koi bari bimari nahi hoti, balke pathon par ghalat bojh hota hai.
Ilaj mein manual therapy, warzish, electrotherapy, ultrasound, TENS, dry needling aur hijama shamil hain. Sab se bara faida pathon ki mazbooti se hota hai.
Ghar mein do tabdeeliyan karen: bartan aur kapre dhone ke liye stool par baithen, aur bachay ko bari bari dono taraf uthayen.
Foran hospital jayen agar peshab ya pakhane par control khatam ho jaye, ya dono taange kamzor hon.
Treatment at the clinic, and online
INFORMATION → INDIVIDUAL CARE
A plan built around you.
Talk with Dr. Zahra Fatima, DPT. Understand your next steps, with guidance for your own symptoms and daily routine.
Talk it through
Discuss your symptoms, what you find difficult and what you want to get back to.
Understand your next steps
Use the consultation to discuss which care and exercises fit your situation.
Take your plan with you
Your online consultation includes a written plan you can refer to afterwards.
Questions people ask
Why do women get lower back pain more often?
Can a weak pelvic floor cause back pain?
Is back pain during periods normal?
Is squatting for housework damaging my back?
Do you treat men as well?
Related conditions
- Pelvic floor weakness and exercises
- Back pain in pregnancy
- Diastasis recti treatment
- Recovery after a C-section
- Pelvic girdle pain treatment