Curious about that persistent back pain you can't seem to shake? Believe it or not, uterine fibroids could be the culprit. These non-cancerous growths in the uterus are surprisingly common among women (and 3x more likely in Black women) and can bring along a wide range of symptoms – with back pain being one of them.
So, what’s the connection between fibroids and back pain? We spoke to Levica Narine, MD, FACOG of the Kofinas Fertility Group, who helped break it down for us.
So, what are fibroids, anyway?
“Fibroids are benign, meaning non-cancerous, growths that can occur within and around the uterus,” explains Dr. Narine. “The most common symptoms of fibroids are heavy bleeding, irregular bleeding, pelvic pain, and pelvic pressure.”
Fibroids can vary in size and number. Some women might have one, while others have a few or even clusters of them. Fibroids can be as small as a pea or as large as a softball. Very large fibroids can affect the inside and outside of the uterus, even filling the entire pelvic cavity.
Can fibroids cause back pain?
The short answer is yes, fibroids can cause back pain. It really depends on the size of the fibroid(s) and where they’re located within your reproductive organs.
“Fibroids cause back pain when they’re located on the posterior wall of the uterus, which is the back wall of the uterus. That’s the wall that faces the lower back, the spine, and the hips,” explains Dr. Narine.
When fibroids grow on the posterior wall of the uterus, particularly on the outside of the back wall, they can press against nearby organs and nerves. Subserosal fibroids, or the type of fibroid that grows on the outside of the uterus, can even develop stalks that connect to the muscle walls. These stalks are called pedunculated fibroids and can even cause more discomfort and pain by pressing on the muscles they’ve attached to.
How are fibroids treated?
In addition to potentially causing pain, irregular bleeding, and a frustrating ache in your lower back, fibroids can also cause fertility issues for women.
“Fibroids affect fertility primarily based on where they’re located. For example, if the fibroid is located in the cavity of the uterus where a pregnancy implants and grows, then that can cause issues with how well the pregnancy is going to develop,” says Dr. Narine. “If the fibroid is located within the wall of the uterus, that can cause pressure on the reproductive organs, causing issues with the woman being able to get pregnant.”
Depending on the woman’s level of pain, her symptoms, and her age, there are several different treatment options available. Some women may have fibroids and not even know it until after an ultrasound. Others may not need any treatment at all if their fibroids don’t cause pain or fertility issues, as fibroids are noncancerous and do not make women more likely to develop cancer in the future.
“At the Kofinas Fertility Group, we mainly perform myomectomies, a minimally-invasive surgery where we remove the fibroid(s),” says Dr. Narine.
A myomectomy is the optimal treatment option for women who have fibroids affecting their fertility or causing daily pain because it leaves the uterus intact, allowing the woman to still become pregnant.
“If a woman is done with child-bearing, then a hysterectomy is a possibility, but at Kofinas Fertility Group, we really aim to optimize fertility. Hysterectomies, uterine artery embolizations, and radio frequency ablations all take fertility out of the equation, which is why myomectomies are the preferred option,” explains Dr. Narine.
Talk with your doctor
If you suspect fibroids may be causing you to experience heavy or irregular bleeding or pelvic or back pain, you don’t have to suffer in silence. Be sure to consult with your healthcare provider, who can come up with the right treatment plan for you that takes into consideration your long-term family-planning goals, keeping in mind that minimally invasive surgery is an option.
Brighid Flynn is a freelance writer based in Philadelphia where she lives with her husband and puppy. She is just beginning her journey toward motherhood.