If you experience worsening back pain before your period, you are not alone. Many people notice that their usual back discomfort flares up or that they develop new, aching pain in the lower back in the days leading up to their period. This is not just your imagination—hormonal changes, inflammation and muscle tension all play a role.

Let’s break down why this happens and what you can do to manage it.

Why does back pain increase before your period?

1. Hormonal changes affect your muscles and joints

Your menstrual cycle is driven by hormone fluctuations, particularly oestrogen and progesterone. In the second half of your cycle (the luteal phase, after ovulation but before your period), these hormones fluctuate, which can impact your muscles, ligaments and pain sensitivity.

• Lower oestrogen levels. Oestrogen has a natural anti-inflammatory effect. When it drops before your period, you may feel more pain and stiffness, especially if you already have back issues.
• Progesterone effects. Progesterone helps relax smooth muscles, but when levels drop, muscle tension can increase, leading to tightness and discomfort in your lower back.

2. Prostaglandins increase inflammation and cramping

Right before your period starts, your body releases prostaglandins, hormone-like chemicals that trigger the uterus to contract and shed its lining. However, prostaglandins also promote inflammation, which can:

• Cause the muscles around your lower back and pelvis to spasm.
• Increase sensitivity to pain, making discomfort feel more intense.
• Lead to bloating and water retention, putting extra pressure on your lower back.

If your prostaglandin levels are particularly high, you may experience more intense cramps and back pain.

3. Pelvic and back muscles are closely connected

Your lower back, pelvis and abdominal muscles all work together to support movement and stability. When your uterus contracts or becomes inflamed before your period, it can trigger referred pain in the lower back.

If you already have poor posture, weak core muscles or existing back pain, this additional strain may make the discomfort worse.

4. Water retention and bloating can increase pressure

Many people experience fluid retention before their period, which can lead to:

• Swelling around the lower back and abdomen.
• Added pressure on nerves and muscles, making the back feel stiff or sore.
• A feeling of heaviness or tightness in the lower back.

5. Existing conditions may flare up

If you already have chronic back pain, sciatica or a musculoskeletal condition, hormonal changes before your period can increase pain sensitivity. Conditions such as endometriosis or pelvic inflammatory disease (PID) can also cause significant lower back discomfort that worsens before menstruation.

How to manage back pain before your period

The good news is that there are ways to relieve back pain and reduce discomfort before your period. Here is what can help:

1. Apply heat therapy

• Use a heating pad or hot water bottle on your lower back to relax muscles and improve blood flow.
• Take a warm bath with Epsom salts to ease tension and reduce inflammation.

2. Gentle movement and stretching

• Avoid prolonged sitting—stand up and move every 30 to 60 minutes.
• Do gentle stretching for your lower back, hips and hamstrings to release tension.
• Low-impact exercises like walking, yoga or swimming can improve circulation and reduce stiffness.

3. Support your core and posture

• Strengthening your core muscles can help stabilise your lower back and reduce pain over time.
• Be mindful of posture, especially if you work at a desk—use a chair with lumbar support and avoid slouching.

4. Stay hydrated and reduce bloating

• Drink plenty of water to help reduce fluid retention.
• Reduce salty and processed foods, which can contribute to bloating and inflammation.

5. Try over-the-counter pain relief if needed

• Anti-inflammatory medications (NSAIDs) like ibuprofen can help reduce inflammation and prostaglandin-related pain.
• Magnesium supplements may help relax muscles and reduce cramping.

6. Manage stress and prioritise sleep

• Stress can worsen pain perception, so relaxation techniques like deep breathing, meditation or gentle yoga can be helpful.
• Prioritise good sleep habits, as poor sleep can make pain feel worse.

When to see a doctor

If your back pain before your period is severe, lasts longer than a few days or interferes with daily activities, it may be worth discussing with a doctor. Conditions like endometriosis, fibroids or other pelvic issues can contribute to intense back pain and may require further evaluation.

Final thoughts

Back pain before your period is a common experience, often caused by hormonal changes, inflammation and muscle tension. While it can be uncomfortable, simple strategies like heat therapy, gentle movement, hydration and posture support can help ease discomfort.

By understanding why it happens and taking proactive steps, you can reduce the impact of pre-period back pain and feel more in control of your body.

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