Endometriosis is a common cause of lower back pain during menstruation. Lower back pain is one of the symptoms of dysmenorrhea, a term given to particularly painful periods. ⁽¹⁾ 
 
Menstrual pain is caused by a substance called prostaglandin – made by cells in the inner lining of the uterus.⁽²⁾ Prostaglandin makes uterine muscles contract in order to help shed the lining built up during the menstrual cycle. Too much prostaglandin causes painful menstruation. 
Fortunately, there are several ways to reduce back pain.  

These may include: 

-Heat. ⁽³⁾ Using heating pads or hot water bottles can soothe the pain. Hot showers and baths can have the same effect. 
-Exercise. Studies have shown ^(4,5) that regular exercise can significantly reduce the intensity and frequency of menstrual cramps and lower back pain. Regular exercise helps to increase blood flow and circulation, which can alleviate cramping and reduce pain. It also releases endorphins, which are natural painkillers that can help combat menstrual discomfort. Aim for a minimum of 150 minutes of moderate-intensity exercise per week on a regular basis. It can be a brisk walk, swim, or a pilates class, whatever you enjoy the most! During your period avoid overexertion or excessive exercise especially vigorous abdominal strengthening exercises that may worsen menstrual cramps or lower back pain. Try a gentle walk, breathing exercises a yoga practice instead.  
 
-TENS machine- ideal for the treatment of painful menstruation. ⁽⁶⁾ TENS stands for Transcutaneous Electrical Nerve Stimulation. It is a non-invasive device that works by sending electrical signals into our nervous system reducing its ability to send painful signals to our brain. No signals, no pain. Clever, right? 

If you struggle with painful periods, seeking assistance from a specialized pelvic floor physiotherapist and a doctor is highly recommended. 

 
REFERENCES: 

1. Harada T. Dysmenorrhea and endometriosis in young women. Yonago Acta Med. 2013 Dec;56(4):81-4. Epub 2013 Nov 28. PMID: 24574576; PMCID: PMC3935015. 

2. Rosenwaks Z, Seegar-Jones G. Menstrual pain: its origin and pathogenesis. J Reprod Med. 1980 Oct;25(4 Suppl):207-12. PMID: 7001019. 

3. Armour M, Sinclair J, Chalmers KJ, Smith CA. Self-management strategies amongst Australian women with endometriosis: a national online survey. BMC Complement Altern Med. 2019 Jan 15;19(1):17. doi: 10.1186/s12906-019-2431-x. PMID: 30646891; PMCID: PMC6332532. 

4. Armour M, Ee CC, Naidoo D, Ayati Z, Chalmers KJ, Steel KA, de Manincor MJ, Delshad E. Exercise for dysmenorrhoea. Cochrane Database Syst Rev. 2019 Sep 20;9(9):CD004142. doi: 10.1002/14651858.CD004142.pub4. PMID: 31538328; PMCID: PMC6753056. 

5. Jaleel G, Shaphe MA, Khan AR, Malhotra D, Khan H, Parveen S, Qasheesh M, Beg RA, Chahal A, Ahmad F, Ahmad MF. Effect of Exercises on Central and Endocrine System for Pain Modulation in Primary Dysmenorrhea. J Lifestyle Med. 2022 Jan 31;12(1):15-25. doi: 10.15280/jlm.2022.12.1.15. PMID: 35300040; PMCID: PMC8918380. 

6. Li L, Lou K, Chu A, O’Brien E, Molina A, Riley K. Complementary therapy for endometriosis related pelvic pain. Journal of Endometriosis and Pelvic Pain Disorders. 2023;15(1):34-43. doi:10.1177/22840265231159704