Fibroids are noncancerous growths in or around a person’s uterus. If fibroids press against the nerves or muscles in a person’s back, they can cause back pain.
Fibroids can grow on the inside or outside of the uterus or between the muscle layers that make up the walls. Most people who experience back pain have fibroids growing on the outside of their uterus.
Fibroids also vary in size and number. Some people may have just one, while others may have clusters, or they may be in multiple places. Some fibroids grow to the size of a grapefruit, while others may only be as large as an apple seed. Fibroids can also grow to fill a person’s pelvic cavity.
This article explains what fibroids are and why they can cause back pain. It also looks into the symptoms of fibroids and explains how doctors may treat them.
Do fibroids cause back pain?
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Fibroids can cause back pain. Fibroids are a type of benign tumor that many people have but are not aware of. Although not life threatening, fibroids can adversely affect a person’s life.
Most people who experience back pain with fibroids have subserosal fibroids, meaning they grow on the outside walls of the person’s uterus. Sometimes the tumors grow from the muscle walls, but they can also develop a stalk that connects them to the muscle walls. Fibroids that grow on stalks are called pedunculated fibroids.
Subserosal fibroids take up space in the pelvic cavity and can press against other organs or nerves. If they are pushing against a person’s back or nerves in the person’s back, they can exert pressure on the spine, causing pain. Many people also experience constipation, bloating, and diarrhea.
A 2017 study reports that as many as 60% of people with uterine fibroids experienced lower back pain.
Types of fibroids that can cause back pain
There are three main types of fibroids:
- submucosal fibroids that grow on the inside of the uterus
- intramural fibroids that grow between the muscle layers of the walls
- subserosal fibroids that grow on the outside walls of the uterus
Subserosal fibroids are most likely to cause back pain. However, if any intramural fibroids grow significantly, they can push the person’s uterus out of shape, putting pressure on the spine.
Other fibroid symptoms
Most people with fibroids experience changes in their menstruation. They usually have a heavier and longer period with cramps, and pain. Some estimates indicate that people with fibroids are 2.5 times more likely to experience severe heavy bleeding than those without fibroids.
The American College of Obstetricians and Gynecologists (ACOG) adds that fibroids can cause such heavy bleeding in some people that they develop anemia.
Other symptoms people with fibroids may experience include:
- feelings of fullness, or pressure, in the lower belly area
- constipation
- diarrhea
- rectal pain
- enlarged uterus, leading to a larger abdomen
- spotting, or bleeding between periods
- pain during sexual activity
- passing blood clots
- general fatigue
- irregular periods
In a 2021 paper, researchers explain that while subserosal and intramural fibroids do not affect fertility or pregnancy outcomes, submucosal fibroids may contribute to fertility issues.
Treatment for fibroid back pain
Some people can manage their fibroid back pain with over-the-counter (OTC) pain medication or hot water bottles. Doctors may prescribe low dose birth control pills, which may stop fibroids from growing and help with heavy bleeding.
Doctors may also recommend gonadotropin-releasing hormone (GnRH) agonists, which shrink the fibroids and stop the person’s menstruation. While this can help people recover from anemia, the fibroids may return when they stop taking the hormones.
Doctors may recommend surgery if a person has large fibroids that are causing severe symptoms. Some procedures, including myolysis and uterine artery embolization, are less invasive surgeries designed to shrink the size of the fibroids either by freezing or blocking the blood vessels that supply them.
Doctors may be able to remove the fibroids surgically, but this depends on their size and location. The procedure called a myomectomy, preserves the healthy tissue of the person’s uterus. Doctors recommend this procedure if the person wants to have biological children.
The Office on Women’s Health explains that a hysterectomy is the only way to cure uterine fibroids, as this surgery involves removing the uterus. Doctors usually recommend this to people who do not want biological children or are near or past menopause.
Frequently asked questions
The following are some questions people frequently ask about fibroids and back pain.
What does back pain from fibroids feel like?
Everyone experiences pain differently. Some people may have a dull ache in their lower back, while others may find the pain spreads through their hips and legs. Their legs may feel numb or feel tingly, with pins and needles.
Many people feel stiff, particularly after standing or sitting for a long time, while others may have difficulty walking.
What size fibroids can cause back pain?
The National Institute of Child Health and Human Development (NICHD) explains that fibroid size does not always relate to the severity of a person’s pain. Pain levels also depend on the location of the fibroid and where it is pressing on the person’s spine.
What triggers fibroid pain?
According to ACOG, fibroids need the hormones estrogen and progesterone to grow. So, people may experience pain at different times in their menstrual cycles.
A 2022 study found that more people experienced back pain during their period than at other times.
What happens if fibroids go untreated?
According to one study, untreated or under-treated fibroids may adversely affect a person’s quality of life. However, a person’s pain may reduce before and during menopause when estrogen and progesterone levels drop.
The study adds that many people have fibroids but are unaware of them. These people do not seek any treatment and the fibroids do not interfere with the quality of their lives.
Summary
Fibroids can cause back pain, especially those that grow on the outside walls of the person’s uterus or in between the muscle layers toward the back of the uterus.
The fibroids may exert pressure on the person’s spine, which can cause pain in their legs, hips, and lower back.
Doctors typically treat smaller fibroids with medications but may recommend surgery if the person is experiencing severe symptoms.
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