Many women experience lower abdominal pain at some point in their lives. It may start as mild discomfort in the lower belly but slowly begin to spread to the lower back. For some, it feels like menstrual cramps.
For others, it may be sharp, constant, or even severe enough to disrupt daily life.
But why does this happen? Why does pain that begins in the abdomen move toward the back?
Doctors say this pattern is common because the organs in the abdomen and pelvis share nerve connections with the lower spine. This means the body is sometimes “confused” about where the pain is actually coming from.
As a result, discomfort in the uterus, ovaries, bladder, intestines, or even kidneys can be felt in the lower back.
To better understand this, we spoke with Dr Sakshi Goel, Senior Consultant, Obstetrics & Gynaecology, at Rainbow Children’s Hospital, Delhi, and Dr Tripti Raheja, Director – Obstetrics & Gynaecology, at CK Birla Hospital, Delhi.
According to Dr Sakshi Goel, lower abdominal pain that spreads to the lower back is common because organs in the abdomen and pelvis share nerve pathways with the lower spine.
“When structures like the intestines, urinary tract, or reproductive organs become inflamed, stretched, or infected, pain signals travel along the same spinal segments that also supply the lower back,” she explains.
This overlap in nerve supply leads to what doctors call “referred pain.” In simple terms, the pain starts in one area but is felt in another.
Dr. Tripti Raheja adds that pelvic organs and the lower spine are connected through common nerves. So when there is a problem in the uterus, ovaries, bladder, or intestines, the discomfort may be felt in both the abdomen and the back.
Tight connective tissues, muscle strain, or pelvic inflammation can also increase tension in nearby spinal structures, making the back pain worse.
GYNAECOLOGICAL CAUSES: THE MOST COMMON REASONS IN WOMEN
Both doctors say that gynaecological conditions are among the most common reasons for this type of pain in women.
Common causes include:
- Menstrual cramps: Many women feel pain in both the lower abdomen and lower back during periods.
- Endometriosis: A condition where tissue similar to the lining of the uterus grows outside it, causing chronic pain.
- Adenomyosis: When the inner lining of the uterus grows into the muscular wall.
- Ovarian cysts: Fluid-filled sacs on the ovaries that may cause pressure and pain.
- Pelvic inflammatory disease (PID): An infection of the reproductive organs that can cause ongoing pain.
- Uterine fibroids: Non-cancerous growths in the uterus that may cause pressure and discomfort.
Dr. Goel explains that irritation of pelvic ligaments and nerves in these conditions can make pain move toward the lower back.
In some cases, early pregnancy-related problems like an ectopic pregnancy can also present with lower abdominal pain that spreads to the back. This condition requires urgent medical attention, especially if it is accompanied by abnormal bleeding, dizziness, or fainting.
NON-GYNAECOLOGICAL CAUSES YOU SHOULD NOT IGNORE
Lower abdominal pain that radiates to the back is not always related to reproductive health.
Dr. Raheja notes that several non-gynaecological conditions can cause similar symptoms, including:
- Urinary tract infections (UTIs)
- Kidney stones
- Constipation
- Irritable bowel syndrome (IBS)
- Early appendicitis
- Musculoskeletal problems like lumbar strain or disc issues
Dr. Goel explains that kidney stones often cause intense pain that begins in the lower abdomen or flank and radiates to the back or groin. This pain can be severe and may come in waves.
Similarly, digestive problems like IBS or constipation can cause pressure and discomfort that spreads to nearby areas, including the lower back.
Muscle strain or spine-related problems may also mimic abdominal pain, making diagnosis tricky without proper evaluation.
WHEN SHOULD YOU SEE A DOCTOR?
While mild and short-lived pain may not be serious, both experts stress that persistent or severe symptoms should never be ignored.
You should consult a doctor if:
- The pain is severe or worsening
- It lasts for a long time
- You have a fever
- There is abnormal vaginal bleeding
- You notice urinary problems
- You are pregnant
- There is nausea, vomiting, or dizziness.
Early medical evaluation helps identify the exact cause and ensures timely treatment. In some cases, imaging tests or blood tests may be needed to confirm the diagnosis.
Lower abdominal pain that spreads to the lower back is common, especially in women. In many cases, it may be linked to periods or minor digestive issues.
However, because several important organs share the same nerve pathways, this pattern of pain can sometimes signal a more serious underlying condition.
Understanding why this happens empowers women to seek help early rather than dismissing the pain as “normal.”
As doctors emphasise, persistent discomfort is the body’s way of asking for attention. Listening to it could make all the difference.
