Clinically reviewed by What is period back pain
Back pain with periods is a cramping, dragging ache across the lower back that starts a day or two before bleeding and lasts through the first days of it. It usually comes with cramps low in the abdomen and sometimes pain down the front of the thighs.
In Urdu it is mahwari ke dinon mein kamar dard. It happens because the womb contracts, and the nerves supplying the womb enter the spine at the same levels as the nerves supplying your lower back, so the pain is felt in both places.
Pain that has always been there and is manageable is called primary. Pain that started later or is worsening year on year is secondary, and that kind has a cause worth finding.
Symptoms you might have
- A cramping ache across the lower back a day or two before bleeding
- Cramps low in the abdomen at the same time, often coming in waves
- Pain spreading into the hips, buttocks or the front of the thighs
- Pain that follows your cycle, which is what separates it from ordinary back pain
- Pelvic or back pain now present outside your period too, which points to a cause that needs investigating
Why it happens
- Prostaglandins, the chemicals that make the womb contract. More of them means stronger cramps and more referred back pain
- Pain referred from the womb to the lower back through shared nerve levels
- Weak hip, back and abdominal muscles, plus long hours of floor level housework
- Endometriosis, where tissue like the womb lining grows outside the womb. It is a common cause of severe period pain and it is commonly missed
- Fibroids and adenomyosis, both of which cause heavy, painful periods
When you should see a physiotherapist
Come to physiotherapy when the pain is the ordinary kind and you want more than painkillers every month. TENS, heat and exercise all have a real effect, and a stiff, weak back feels every cycle more.
See a gynaecologist if your period pain is severe, if it has worsened over the years, if it stops you working, studying or sleeping, if it began after years of normal periods, if there is pain during intercourse or when passing stool, if your periods are very heavy, or if you are finding it hard to conceive. Endometriosis goes undiagnosed for years in many women, mostly because severe period pain is treated as normal. It is not normal.
Go to a hospital the same day for severe one sided pelvic pain, fever with pelvic pain, fainting, bleeding heavy enough to soak a pad every hour, or any severe pain if you could be pregnant.
Al-Shama Physiotherapy Clinic
Ask about an appointment
اپائنٹمنٹ کے بارے میں پوچھیںAppointment ke liye poochein
Fill this in and WhatsApp will open with your details ready to send.
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 separates how much of this is the womb referring pain into the back, and how much is a back that is stiff, weak or already painful. The second part is what physiotherapy changes.
- TENS, which has good evidence for period pain and is the most useful item here, because you use it at home on the days you need it
- Heat, which for cramps works about as well as a simple painkiller and has no side effects
- Exercise therapy, regular aerobic exercise through the whole month plus hip and abdominal strengthening, which reduces how severe each period is
- Manual therapy to the lower back, hips and pelvic joints, most useful where the back is stiff
- Dry needling for tight bands in the lower back and buttock muscles, used between periods rather than during them
Physiotherapy treats the pain, not the cause inside the womb. Hormonal treatment, scans and any surgery for endometriosis or fibroids are decisions for your doctor. A physiotherapist does not prescribe medicine.
Exercises, and what to avoid
What helps
- Thirty minutes of walking or any aerobic exercise on most days of the month, not only in the painful week
- Knees to chest, child's pose and gentle cat cow, which ease the cramping ache
- Hip and glute strengthening between periods, which gives the lower back better support
- Slow breathing with the belly expanding during a cramp, which settles the muscle guarding
What to avoid
- Lying still for two days. It feels right and it makes the ache and the stiffness worse
- Heavy lifting and hard abdominal work on the worst days
- Forcing a stretch into pain. Gentle and repeated beats strong and brief here
- Doing nothing for three weeks then expecting exercise to help in the fourth
What you can do at home
Heat, not ice. A hot water bottle or warm pack low on the abdomen or across the lower back for fifteen to twenty minutes. For cramps this is as effective as a simple painkiller, so use it early rather than waiting.
Keep moving on your period days. A short walk twice a day does more than lying down all afternoon.
Sleep on your side with the knees bent and a pillow between them, or on your back with a pillow under the knees.
Painkillers are not a physiotherapist's area. Needing more of them every month is itself a reason to be examined.
Back pain that is there every day rather than only with your period is a different problem. The lower back pain page covers that one.
How long it takes
TENS and heat work in the moment, during the cramp. They are not treatments that need weeks to build up.
Exercise takes two to three cycles before you can judge it fairly. Most women with ordinary period pain report clearly easier periods by the third one.
Where a stiff or weak lower back is adding to it, that part responds in four to six weeks.
If three months of proper treatment and regular exercise change nothing, the answer is not more physiotherapy. That is the point to see a gynaecologist and look for endometriosis, adenomyosis or fibroids, rather than repeating treatment that has not worked.
Urdu / Roman Urdu
Choose your reading script / اپنی پسند کا رسم الخط منتخب کریں
اردوUrdu script
ماہواری کے دنوں میں کمر درد عام ہے۔ بچہ دانی سکڑتی ہے اور اس کی نسیں کمر کی نسوں کے ساتھ ایک ہی جگہ ریڑھ کی ہڈی میں جاتی ہیں، اس لیے درد کمر میں بھی محسوس ہوتا ہے۔
آرام کے لیے گرم پیک کمر یا پیٹ کے نیچے پندرہ سے بیس منٹ، ٹینس مشین، اور ان دنوں میں تھوڑا چلنا۔ لیتے رہنا درد بڑھا دیتا ہے۔
اگر ماہواری کا درد بہت سخت ہو، ہر سال بڑھ رہا ہو، کام یا پڑھائی روک دے، یا ماہواری کے علاوہ دنوں میں بھی رہے، تو خاتون ڈاکٹر سے ضرور ملیں۔ اینڈومیٹریوسس ایک عام وجہ ہے جس کی تشخیص برسوں تک نہیں ہوتی۔
دوا اور ٹیسٹ ڈاکٹر کا کام ہے۔ فزیوتھراپی درد میں مدد کرتی ہے، بچہ دانی کی وجہ کا علاج نہیں کرتی۔
Roman Urdu
Mahwari ke dinon mein kamar dard aam hai. Bachadani sikurti hai aur us ki nasen kamar ki nason ke sath ek hi jagah reedh ki haddi mein jati hain, is liye dard kamar mein bhi mehsoos hota hai.
Aaram ke liye garam pack kamar ya pet ke neeche pandra se bees minute, TENS machine, aur in dinon mein thora chalna. Lete rehna dard barha deta hai.
Agar mahwari ka dard bohat sakht ho, har saal barh raha ho, kaam ya parhai rok de, ya mahwari ke ilawa dinon mein bhi rahe, to lady doctor se zaroor milen. Endometriosis ek aam wajah hai jis ki tashkhees barson tak nahi hoti.
Dawa aur test doctor ka kaam hai. Physiotherapy dard mein madad karti hai, bachadani ki wajah ka ilaj nahi karti.
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 does my back hurt during my period?
Does heat or ice help period back pain?
Does TENS work for period pain?
When is period pain not normal?
Can physiotherapy cure endometriosis?
Related conditions
- Pelvic floor weakness and exercises
- Back pain in pregnancy
- Diastasis recti treatment
- Lower back pain in women
- Recovery after a C-section