Is Constipation Causing Your Back Pain?

When two symptoms occur at the same time, it makes sense to suspect they’re connected. Could one be causing the other? Could both be symptoms of a separate condition?

When it comes to constipation and back pain, the answers are yes. “Constipation may cause back pain,” says nurse practitioner Bryn DeSantis, CNP. “But more often, chronic conditions are the source of both symptoms.”

DeSantis explains the complex relationship between constipation and back pain and shares how to find relief.

Back pain and digestive health

Individually, back pain and constipation are common conditions affecting millions of people every year. Having them at the same time could easily be a coincidence. But there may be more to the story.

Back pain caused by constipation

A large amount of poop (stool) in your colon can put pressure on nerves in your lower spine. “If this happens, you might feel a dull, achy pressure in your lower back,” shares DeSantis.

A more severe form of constipation called fecal impaction can sometimes cause back pain. Fecal impaction is when a dry, hard lump of stool gets stuck in your rectum. This often occurs as a result of decreased mobility, neurological disorders or as a side effect of certain medications. Symptoms of fecal impaction include:

• Abdominal pain, bloating and cramping.
• Diarrhea caused by watery stool that passes around the fecal impaction.
• Urinary changes like frequent urination.
• Rectal bleeding.
• Fever.
• Dizziness or confusion.

If you have these symptoms, contact a healthcare provider right away. Fecal impaction requires immediate treatment.

Conditions that cause both back pain and constipation

Most of the time, constipation doesn’t directly cause back pain. When you have back pain and constipation together, the more likely scenario is that both are caused by different but often related conditions.

Irritable bowel syndrome

Irritable bowel syndrome (IBS) is a type of central sensitization syndrome. Central sensitization causes an increase in nerve signaling to your brain that heightens pain sensations. It’s like your nerves are being extra chatty with your brain, says DeSantis.

In IBS, the nerves in your gut are hypersensitive, causing constipation, diarrhea or both. Although not typical, IBS can sometimes cause lower back pain.

“The source of back pain in IBS isn’t clear,” notes DeSantis. It may be referred pain that starts in your gut, but you feel it in your back. More commonly, people with IBS may also have other chronic pain conditions, including:

• Fibromyalgia, which causes pain throughout your body and fatigue.
• Interstitial cystitis (IC), which causes on-and-off pain in your bladder, lower abdomen and lower back.

Neurologic conditions

Neurologic diseases like Parkinson’s disease and multiple sclerosis affect your nerves and muscles. This means they can affect the nerves in your gut that directly impact the speed and flow of your body’s waste, as well as the nerves in your back and spinal cord. Among other symptoms, people with these conditions may experience:

• Muscle pain, cramps and tightness in the back and hips.
• Slow movement of food through the digestive system that can lead to constipation.

Tumors

Spinal tumors can press on nerves, causing pain or slowed digestion. A similar situation can occur with large tumors in your lower abdomen as a result of:

• Colorectal cancer.
• Ovarian cancer.
• Uterine cancer.

Medication-related constipation

The medications used to treat back pain-related diseases can also affect bowel function.

“Constipation is a very common side effect of pain relievers and muscle relaxants,” states DeSantis. “Medications for Parkinson’s disease can also trigger or worsen constipation.”

Exercise and constipation

Back pain may affect your ability to exercise, says DeSantis. And a lack of exercise can contribute to constipation.

How to know if back pain is due to constipation

To determine if your back pain is due to constipation or another reason, a provider will review your symptoms and medical history. They typically want to know if you:

• Are taking any medications that may cause constipation.
• Have a known related condition, such as IBS or Parkinson’s disease.
• Have other symptoms, such as gas, bloating or diarrhea.
• Experience back pain that gets worse when you move (which could be a pulled muscle, herniated disk or other back issue).
• Have back pain that improves after bowel movements.
• Tried other back pain treatments, such as physical therapy.

How to relieve lower back pain from constipation

If constipation is causing your back pain, try some constipation-relief home remedies like:

• Eating high-fiber foods.
• Getting more exercise.
• Going to the bathroom when the urge strikes (holding in stool can cause constipation).
• Making sure you’re drinking enough water.
• Taking a fiber supplement, stool softener or laxative.
• Try a cup of warm caffeinated coffee to stimulate the muscles in your digestive tract, followed by five minutes on the toilet.

Your provider may also suggest more intensive treatments, such as:

• A bowel cleanse, like what you’d do for colonoscopy prep.
• An enema, which involves flushing your rectum, usually with a saline solution.

For pain relief, DeSantis warns against using over-the-counter pain relievers, which can sometimes make gastrointestinal symptoms worse. Instead, try these home remedies for back pain:

• Topical pain relievers.
• Heat or ice.
• Yoga, meditation and deep breathing.
• Gentle exercise and avoiding prolonged bed rest.

When to talk to a provider

If you have back pain and constipation that last longer than a few weeks, call a healthcare provider who can take a closer look at what’s happening with your body. Other signs that you should seek immediate medical care include:

• Loss of sensation in your legs.
• Rectal bleeding.
• Severe back or lower abdominal pain.
• Unexplained weight loss.
• Urinary or fecal accidents (incontinence).

Back pain and constipation aren’t fun — and having them together can be even more challenging. When these problems interfere with your life, it’s time to get help. Your provider can determine what’s going on and recommend ways to get you and your bowels moving again.