There are many diseases and health conditions that can lead to lower abdominal and back pain. Problems in the back, pelvis, or lower abdomen can cause referred pain to any of the other areas. Causes vary from simple constipation to serious abdominal aortic aneurysm. Because this pain can be so difficult to diagnose, it is important to have your healthcare provider evaluate and treat any lower back or abdominal pain that lasts for longer than a few days without a known cause.

Causes of Lower Back and Abdominal Pain

There are many causes of lower back and abdominal pain. Listed below are those causes that may require medical treatment.

1. Ectopic pregnancy

An ectopic pregnancy is a pregnancy in which the fertilized egg is implanted outside the uterus – usually in a fallopian tube. These pregnancies are not viable and will not progress to delivery of a child. Instead, these ectopic pregnancies can cause vaginal bleeding, excruciating lower abdominal and back pain from the blood in the abdomen, and dizziness from pain and loss of blood.

2. Pelvic inflammatory disease

Pelvic Inflammatory Disease (PID) is an infection of the female reproductive organs that occurs in sexually active women due to infection with a sexually transmitted disease (STD). When the infection moves further up into the pelvis, lower abdominal and back pain can develop. In addition to pain, a woman with PID may have irregular menses, foul-smelling vaginal discharge, nausea, vomiting, diarrhea and pain during sexual intercourse.

3. Endometriosis

Endometriosis is often confused with PID. This disease is an inflammation of the endometrium. A woman with endometriosis will complain of abdominal and pelvic pain that tends to increase during the menstrual period and radiates to the back. Other symptoms of endometriosis include pain during sexual intercourse, pain during urination, excessive bleeding during the menstrual period and between periods, and infertility.

4. Abdominal aortic aneurysm

An Abdominal Aortic Aneurysm (AAA) is caused by a weakness in the abdominal aorta – the main artery in the abdomen. When this area of the artery begins to leak, internal bleeding results. Because the blood is outside of a vessel, it can cause tremendous irritation and resulting abdominal and back pain. If the vessel ruptures, death is likely unless you are in a hospital with immediate access to surgical intervention. A major symptom of a AAA includes a pulsing mass in the middle of the abdomen near the navel. It can cause pain in the back and abdomen because of pressure on surrounding tissues. Other symptoms, including pain in legs are late and usually occur only after the AAA ruptures. Those at highest risk include men with a history of hypertension, hardening of the arteries, tobacco use, and age over 60 years old.

5. Constipation

Constipation is defined as lack of bowel movement for three days. This problem is one of the most common causes of abdominal pain. Often relieved with no healthcare intervention, constipation can cause nausea, vomiting and a swollen abdomen. If constipation lasts more than a few days, it may be a symptom of a more specific problem.

6. Pancreatitis

Pancreatitis is an inflammation of the pancreas resulting in severe upper abdominal pain. This pain that gets worse after eating may radiate to your upper back or shoulders and can cause oily stools, nausea, and vomiting. Often, the pain will be somewhat relieved when you lean forward.

7. Kidney stones

Kidney stones are hard calcifications that form in your urinary bladder. Symptoms occur when the stone starts moving down the small tubes out of the bladder. When this happens, you will feel excruciating pain in the lower back and abdomen radiating into the groin. You may notice blood in your urine or cloudy urine. Often, someone with a kidney stone will have nausea and vomiting. If the stones result in an infection, you may develop fever and chills. Although some people are more prone to kidney stones than others, you can reduce your risk if you drink plenty of water, avoid foods rich in calcium oxalate (spinach, beets, chocolate, soy products, and nuts), reduce your salt and animal protein intake, and use calcium supplements sparingly.

When to See a Doctor

• You should see your healthcare provider if your abdominal and low back pain is caused by a traumatic injury or if it is associated with chest pain.
• If the pain is very severe or accompanied by bloody stools or excessive vaginal bleeding, you should be evaluated by a physician.
• Seek help if the pain is accompanied by nausea or vomiting or if there is swelling or a pulsating mass in your abdomen.
• If the back pain radiates down your legs or if you have any numbness in your extremities, see your doctor.
• If the pain lasts more than a few days, be sure to make an appointment to see your healthcare provider.

For minor cases

• Use over-the-counter pain medications for one or two days for persistent pain.
• Try applying heat or cold to the painful areas – use the rule “20 minutes on then 20 minutes off”. Experiment to determine if one works better than the other.
• Bed rest may be helpful, but if the pain forces you to be in bed for more than a day, it is time to see your doctor.