Lower Back and Groin Pain in Women: Causes, Symptoms, and Treatments

Medically reviewed by Stuart Hershman, MD

In women, lower back and groin pain that radiates to the front pelvic area can have a wide range of causes. The pain can feel dull, sharp, or burning. Lower back pain can also radiate to the front pelvic area in females.

Although it may sound like two different types of pain—pain in the lower back and pain in the groin—healthcare providers group them as one. If you feel pain in one area, then you're extremely likely to feel the other.

The main causes of lower back and groin pain in women fall into two categories.

• Musculoskeletal and nervous system: Related causes of pain affect how your muscles, nerves, ligaments, joints, and bones move. Examples include sciatica, arthritis, and injury.

• Other organ system-based: Causes may stem from the kidneys (such as stones), reproductive system (such as the ovaries), or gastrointestinal system (such as inguinal hernias or appendix). Causes can also be related to acute/chronic conditions or infections.

This article discusses the possible causes of women's lower back and groin pain. It also details the diagnostic process, treatment options, and how to prevent lower back and pelvic pain.

Musculoskeletal and Nervous System Causes

Musculoskeletal and nervous system-related causes of lower back/groin pain in women may be obvious to you (e.g., a fall) or less-so (e.g., poor posture).

Overuse Injuries and Trauma

Frequent use and repetitive movement patterns can lead to overuse injuries to muscles, ligaments, and joints. They could include:

• Exercises and physical activities, such as tennis or golf, that require repetitive twisting and bending in the same direction.

• Frequently lifting heavy objects or any movements that are repeated regularly.

Trauma can also lead to lower back and groin pain. Trauma could result from car accidents, falls, or sports accidents. Such trauma can inflict acute and chronic bodily injuries, like strained muscles or broken bones. Depending on the type of trauma, the healing time and treatment needed can vary.

Both overuse and trauma injuries to the lower back or groin area can lead to weakness in the legs, tingling, numbness, pain, stiffness, or popping sensations.

Poor Mobility

Decreased range of motion and mobility in muscles and joints over time can cause discomfort and pain. Causes for this include:

• Long periods of time spent in the same position

• Sitting for extended periods

This type of pain often feels dull, achy, and stiff. It can also lead to muscle spasms characterized by short episodes of sharp, intense pain.

Related:What Causes Groin Pain When Walking?

Posture

Your posture while sitting, standing, and walking affects your range of motion. It also can affect the nerves and blood supply to your back and groin area.

Prolonged bad posture can contribute to lower back pain and strain muscles. Posture-related discomfort can feel achy and stiff and lead to short episodes of more severe pain.

Sciatica and Pinched Nerves

Sciatica and pinched nerves are most commonly caused by a bulging or herniating vertebral disc. These feel like a sharp, burning, or radiating pain along the nerve pathway.

Arthritis

Arthritis is inflammation that leads to swelling, stiffness, pain, and the breakdown of cartilage that cushions the joints. Hip arthritis causes groin pain and, occasionally, back pain that becomes more intense when standing or walking for long periods.

Thoracic or lumbar spine arthritis or degenerative disc disease are other common causes of back pain.

Sacroiliac Joint Dysfunction

The sacroiliac joints connect your lower spine and pelvis. When these joints move too much or too little, it may cause sacroiliac joint pain, leading to a burning sensation in the lower back and groin area.

Renal/Urinary Causes

Kidney Stones

Kidney stones are formed by the build-up of minerals and salts, which form a hard, stone-like ball in your kidneys. When the kidney stone begins to move from your kidney to the bladder, it typically becomes painful. It triggers severe back and side pain and radiating pain to the groin, as well as symptoms such as a change in urine color, pain when urinating, nausea, and vomiting.

Kidney Infection and Urinary Tract Infections

Urinary tract infections and infections of the kidneys are other causes of lower back and groin pain in women. They cause fever, a frequent urge to urinate, and painful urination.

Gynecological Causes

Pelvic Inflammatory Disease

Infections in the female reproductive organs, known as pelvic inflammatory disease, typically occur when sexually transmitted bacteria spread through the vagina, womb, fallopian tubes, or ovaries.

Symptoms include:

• Pain in the lower abdomen or groin

• Fever

• Pain during sex

• Bleeding between periods

• Vaginal discharge

Ovarian Cysts

An ovarian cyst is a solid or fluid-filled sac on the surface of or within an ovary. Small ovarian cysts are unlikely to cause pain.

Large ovarian cysts or those that rupture can cause pain that ranges from mild discomfort to severe pain. This pain can occur during the menstrual cycle or intercourse or acutely in the back, pelvis, or lower abdomen.

Back pain and discomfort in the groin area are common during pregnancy. As your body adjusts to the pregnancy, the bones and round ligaments in your pelvis move and stretch, which can make you uncomfortable.

While these symptoms are usually normal, it's important to mention them to your healthcare provider during your check-ups. Pain in the lower back and groin during pregnancy can be a sign of miscarriage or labor (including preterm labor).

Contact your healthcare provider right away if your pain is severe or doesn't go away, or if it is accompanied by bleeding, cramps, or vaginal discharge.

Sexually Transmitted Infection

Some sexually transmitted infections, such as chlamydia or gonorrhea, can cause pain in the lower back and groin area. Other symptoms could include painful urination, vaginal discharge, pain during intercourse, and bleeding between periods.

Yeast Infection

A yeast infection is the overgrowth of the fungus candidiasis. It is a common vaginal infection whose symptoms include itching, swelling, irritation, and pain in the pelvis.

Related:Sexual Positions That Cause Back Pain and What to Do About Them

Other Causes

Appendicitis

Appendicitis occurs when your appendix becomes blocked and infected. In most people, a major symptom is pain that starts near the belly button. But for some, it can start in the lower back and radiate to the right side of the pelvic area.

Pain associated with appendicitis may worsen over time, or when you're coughing, moving or taking deep breaths.

Other symptoms of appendicitis include upset stomach, nausea or vomiting, loss of appetite, fever or chills, or abnormal bowel movements (including constipation and/or diarrhea).

Related:Is My Pain From an Ovarian Cyst or Appendicitis?

Inguinal Hernia

A hernia in the groin area is referred to as an inguinal hernia. It involves soft tissue, often part of the intestine, pushing through weak groin muscles. It causes pain in the abdomen, lower back, or pelvis, especially when bending or lifting heavy objects.

Pancreatitis

Pancreatitis is inflammation in the pancreas. One of its symptoms is abdominal pain that radiates to the back. It can be caused by bile stones, alcohol, or infection.

The pain with pancreatitis is worse during and after eating. Other symptoms of pancreatitis include nausea, vomiting, and fever.

Enlarged Lymph Nodes

There are lymph nodes that lie both in the internal and external regions of the iliac artery in the pelvis. These can become enlarged for many reasons, including infection, injury, and, in rare cases, cancer. Symptoms of enlarged lymph nodes include pain, swelling, redness and skin irritation, and fever.

Enlarged Spleen

The spleen is a small organ, located behind the left side of your rib cage. It filters the blood and helps create new blood cells. Like the lymph nodes, infections and diseases can cause your spleen to become enlarged.

Pain related to an enlarged spleen (a condition called splenomegaly) is usually in the upper left part of the belly, and sometimes the left shoulder and upper back. However, some people with an enlarged spleen experience abdominal symptoms like not being able to eat large meals without discomfort.

When to See a Healthcare Provider

If your pain is caused by a muscle strain, minor joint sprain, or overuse, the pain should begin to resolve with rest and improve without medical help.

If you are experiencing chronic or unusual lower back and groin pain, your primary care healthcare provider or OB/GYN can help you determine the cause of your pain or refer you to a specialist. Lower back and groin pain in women is a symptom that may have many possible causes, so be sure to see your healthcare provider for a proper diagnosis.

Seek immediate medical attention at an emergency room or urgent care center if your pain is severe, sudden, or you have any of these symptoms:

• Dizziness

• Fever

• Nausea and vomiting

• Rapid breathing or heart rate

• Weakness

Diagnosis

Depending on the cause of your pain, a healthcare provider may be able to diagnose it with a physical exam and by asking questions about your condition. Other tests may be needed to find the cause, particularly blood work and imaging (X-ray or magnetic resonance imaging).

Treatment

Treating your pain will depend on its cause. Once a diagnosis is made, your treatment plan will be created. An effective treatment plan will likely contain a combination of the following tactics:

Lifestyle Management

For injuries caused by muscle strains, joint sprains, overuse, and smaller traumas, the pain will often begin to resolve with rest, icing, and over-the-counter pain relievers such as acetaminophen or ibuprofen. Braces or compression wraps can help support your body and alleviate pain while healing.

Exercises to improve posture, paying attention to your form when lifting objects, and stretching can help ease the pain.

Medication

Medicine can be used in a variety of ways to help in the treatment of your lower back and groin pain. If your pain is caused by an infection, medications will be prescribed to clear the infection and resolve the symptoms of the condition. These include:

• Antibiotics

• Antifungals

• Antivirals
  

Medications may also be prescribed by your healthcare provider to help manage your pain. These may include:

• Medicine to reduce nerve pain

• Muscle relaxants

• Pain medications

• Steroids

Physical Therapy

Working with a physical therapist helps to correct problems with:

• Decreased mobility

• Posture

• Strength

• Walking gait
  

Depending on your condition, physical therapy can reduce or resolve your pain by helping to correct problems or improve your situation. A physical therapist will provide exercises to help increase and maintain your strength, range of motion, and flexibility.

Pelvic Floor Therapy

Pelvic floor therapy is a type of physical therapy that focuses on the muscles, ligaments, and connective tissues in the pelvis. It helps with pain, weakness, and dysfunction in the pelvic floor area.

A physical therapist will decide on a treatment plan for your pelvic floor therapy to help with strength and range of motion in your pelvic muscles.

Chiropractic Care

Chiropractors offer spinal and hip adjustments to realign the joints of the spine. Adjustments by a trained chiropractor have been shown to help reduce back and hip pain.

Surgery

Some conditions are more severe and may require surgery. Ovarian cysts, hernias, and other infections sometimes require emergency surgery to remove infected or unhealthy tissue (such as ruptured ovarian cysts or appendicitis).

Also, essential surgeries that are non-emergent are sometimes recommended by healthcare providers, such as:

• A hernia repair

• A hip replacement to resolve arthritis pain
  

• Gall bladder removal to prevent recurring pancreatitis

Prevention

Not all conditions and diseases causing lower back and groin pain in women can be prevented. For some conditions, however, the risk for pain can be reduced by adopting lifestyle changes. To help prevent lower back and groin pain, consider:

• Using proper bending and lifting techniques

• Eating healthy foods

• Engaging in some form of physical activity, like walking, swimming, yoga, cycling, or strength training (with proper form), every day

• Maintaining a healthy weight

• Staying hydrated

If you have any questions about the symptoms you're experiencing, turn to your healthcare provider. Addressing matters early on is always the best way to deal with pain.

Summary

Lower back and groin pain in women can have a wide range of causes. Like your healthcare provider, you may wish to group the possible causes into categories, which may include musculoskeletal or nervous system issues, renal/urinary causes, gynecological influences, and a few conditions you might call "other" triggers.

Identifying the cause is the first step in devising a treatment plan, which might include lifestyle improvements, medication, physical therapy, or chiropractic care.