If you’ve ever found yourself wondering, “Why do I get lower back pain before my period?” you’re not alone. Lower back pain before a period is one of the most common premenstrual complaints. For some women, it’s a dull ache that fades in and out. For others, it can be a more persistent throb that makes it tough to get through work, exercise, or even a normal day at home.
Dealing with recurring pain right before your period can feel frustrating and poorly timed, like your body is working against you. The good news? These aches usually have an understandable cause and, often, some straightforward relief strategies.
This article unpacks what’s typical when it comes to lower back pain before your period, what might signal a bigger issue, and the practical steps you can take to feel better.
Why lower back pain flares before a period
What’s happening in the body
Lower back pain before a period often ties back to natural hormonal changes. Right before menstruation, prostaglandins — hormone-like chemicals — increase in the body. They trigger uterine contractions that help the uterus shed its lining. Those contractions don’t always stay local; they can radiate through nerves and cause pain in the back and hips.
Typical vs. warning signs
Some discomfort is common. But if you’re experiencing severe lower back pain before period after period, that’s worth paying attention to, especially if the pain disrupts sleep, work, or mobility, or if it suddenly worsens compared to your past cycles.
What it feels like
Timing in the week before bleeding
Most people report lower back pain starting three to five days before bleeding begins. Some feel it earlier, around ovulation, while others only notice it hours before their period starts.
Pain pattern in the low back, hips, and legs
For some, it’s a localized ache in the lumbar area. Others feel radiating soreness through the hips and down the legs. The source is in the uterus, but the discomfort can spread outward.
Other PMS symptoms that often appear together
Bloating, breast tenderness, mood changes, fatigue, and headaches frequently team up with lower back pain before a period. This cluster of symptoms is what makes PMS feel like a whole-body experience rather than just cramps.
Why it happens
Prostaglandins and uterine contractions
The biggest culprit is prostaglandins. Higher levels often mean stronger uterine contractions. That cramping can radiate into the lower back and create soreness that feels hard to shake.
Uterine size and pressure
During this phase, the uterus temporarily changes in size. That swelling can press on surrounding tissues, creating discomfort in the back and pelvis.
Muscle tension, sleep disruption, and stress
Add in muscle tension from stress or a few nights of poor sleep, and the pain intensifies. When the body is already run down, discomfort tends to feel worse.
When pain points to a condition
Endometriosis signs
If you’re asking, “Why do I get lower back pain before my period every single month, and it’s severe?” Endometriosis might be worth exploring. With this condition, tissue similar to the uterine lining grows outside the uterus, leading to significant pain and sometimes fertility challenges.
Uterine fibroids and adenomyosis
These non-cancerous growths can create pressure and amplify cramps. Pain is often worse and more persistent than typical PMS.
Pelvic inflammatory disease and infections
Infections in the pelvic region can mimic period-related back pain but usually come with fever, unusual discharge, or pain outside of cycle timing.
Spine and back injuries
An existing back issue, like a herniated disc, can flare up premenstrually, when inflammation is already heightened.
Pregnancy-related causes
Sometimes, early pregnancy can mimic PMS. If your cycle is late and you’re experiencing lower back pain before your period, it’s worth testing.
Self-care that helps today
Heat therapy and gentle movement
Applying heat, whether a heating pad at your desk or a warm bath at night, can relax muscles and improve blood flow. Pairing that with short walks can ease stiffness.
Stretching, yoga, and relaxation
Gentle yoga poses, like child’s pose or cat-cow, can relieve muscle tightness. Breathing exercises help manage both stress and discomfort.
Sleep, hydration, and nutrients
Magnesium, B vitamins, and adequate hydration all play roles in muscle relaxation and hormone regulation. Prioritizing quality sleep gives your body the bandwidth to handle discomfort.
What to avoid
Caffeine, alcohol, and excessively salty foods can worsen bloating and cramps, making back pain feel worse.
Medicines and clinical options
NSAIDs and timing
Nonsteroidal anti-inflammatory drugs (like ibuprofen) work best when taken before pain peaks, often a day before your period begins.
Hormonal options
For those with severe lower back pain before their period regularly, hormonal birth control may help reduce prostaglandin production and lighten periods.
Imaging, exams, and procedures
If pain is persistent and severe, your provider may recommend an ultrasound, MRI, or even minimally invasive procedures to rule out underlying conditions.
Drug-free relief tools
Smart neurostimulation
Livia is the first scientifically proven, wearable solution for menstrual pain relief. It uses SmartWave™ pain-blocking technology to tap into your body’s natural pain defense system. This adaptive neurostimulation interrupts pain signals - giving you fast, effective relief without side effects, tolerance buildup, or drugs.
Heat, massage, and posture support
Ergonomic chairs, supportive mattresses, and massage can help prevent muscles from tightening up in the days before bleeding.
Severe lower back pain before a period
Red flags that need urgent care
If pain is sharp, one-sided, accompanied by fever, sudden heavy bleeding, or prevents normal activity, it’s time for medical attention.
Patterns suggesting secondary dysmenorrhea
If back pain becomes progressively worse instead of following a consistent monthly pattern, it may indicate conditions such as endometriosis or fibroids, rather than typical menstrual cramps (dysmenorrhea) or PMS.
Prevention and cycle planning
Tracking symptoms
Using a period app or even a paper calendar helps spot when pain flares. Knowing the pattern lets you plan relief strategies ahead of time.
Training load, nutrition, and recovery
Athletes often adjust training intensity in the luteal phase, the week or two before menstruation, to prevent overtraining when discomfort is likely.
Building a monthly plan
If you know day 26 is always rough, schedule lighter tasks or rest days, and build in more recovery rituals like baths, stretching, or meditation.