Can uterine fibroids cause lower back pain?

Jul 05, 2025 Source: Cainiu Health

Dr. Zhang Lu

Introduction

In general, if uterine fibroids are small, they typically do not cause lower back pain. However, larger uterine fibroids may lead to lower back pain. If discomfort occurs, it is recommended to seek timely treatment at a qualified hospital. Lower back pain is a non-specific symptom that can be caused by various factors, including muscle strain, skeletal issues, kidney diseases, and others.

Generally, if uterine fibroids are small, they usually do not cause back pain; however, larger fibroids may potentially lead to back pain. If discomfort occurs, it is recommended to seek timely treatment at a regular hospital. Detailed analysis is as follows:

When uterine fibroids are small, they typically do not cause back pain. This is because small fibroids are often located within the uterine muscle wall or subserosally, with insufficient volume to exert significant pressure on surrounding tissues, and they do not affect the normal shape of the uterus or the pelvic environment. Therefore, the lower back usually does not feel abnormal. At this stage, patients often have no obvious symptoms and may only discover the fibroids during a physical examination. Back pain is more likely related to other factors, such as lumbar muscle strain, lumbar spine diseases, or other gynecological inflammations, rather than being directly caused by small fibroids.

When uterine fibroids are large, they may cause back pain. If the fibroid is subserosal and large in size, it may press backward on pelvic nerves or connective tissues. Especially when the fibroid undergoes torsion of the pedicle or degeneration, ischemia and edema may stimulate pelvic nerves, causing persistent aching or severe pain in the lower back. If the fibroid is a large intramural fibroid, it may significantly enlarge the uterus, compressing the posterior sacrouterine ligaments or stretching pelvic tissues, thereby causing a feeling of heaviness or aching pain in the lower back. This pain may worsen as the fibroid increases in size.

Back pain is a non-specific symptom that may be caused by various factors, including muscle strain, skeletal problems, kidney disease, and others. If persistent back pain occurs, especially when accompanied by other symptoms, timely medical consultation is recommended for a comprehensive examination to determine the underlying cause and receive appropriate treatment. During the diagnostic process, doctors will consider the possibility of uterine fibroids but will also assess other potential health issues.

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