Lower Back and Abdominal Pain

Stomach bloating and lower back pain that occurs simultaneously can be both frustrating and frightening. In most cases, the cause of lower back and abdominal pain is a relatively harmless underlying health issue. However, it is important to monitor the duration and severity of these symptoms as it may become necessary to speak with a health care professional such as a physical therapist if the pain persists.

Common Causes of Lower Back and Abdominal Pain

Lower back pain, bloating, and abdominal issues are frequently reported complaints that can have numerous causes. If the pain is not intense or accompanied by more serious symptoms (e.g., vomiting, chest pain), then it is generally safe to wait and see if the discomfort will resolve on its own. The most common causes of lower back and abdominal pain include: 

• Stress
• Pregnancy
• Back injuries
• Hormonal changes
• Kidney and urinary tract infections
• Gastrointestinal problems and flatulence

Pain that is persistent, gradually begins to intensify, or occurs along with other troubling issues warrants a consultation with a health care provider. Prompt treatment can help target serious or life-threatening conditions.

Stress

Stress-induced lower back pain is referred to by some as tension myositis syndrome or TMS. It involves undesirable changes in the nervous system due to prolonged emotional tension that gradually increases. The problematic changes include elevated cortisol (stress hormone) levels, blood vessel constriction, and reduced blood flow to ligaments, nerves, tendons, muscles, and soft tissues.

Poor blood circulation subsequently decreases the transfer of oxygen, which causes biochemical waste to accumulate in the muscles. This in turn can lead to muscle tension, spasms, and lower back pain.

Some people may even experience stomach issues that include abdominal pain and bloating. The combination of consistent stress and certain conditions such as irritable bowel syndrome (IBS) can increase the incidence of cramping, bloating, and upper stomach pain.

Pregnancy

Pregnancy is associated with bloating and gas due to the increase in progesterone. This particular hormone prepares the uterus for the baby by initiating the thickening of the uterine lining.

However, elevated progesterone levels also relax smooth muscle in the gastrointestinal tract. When gastrointestinal muscles relax, the speed at which food moves through the intestines slows down. Slower digestion causes gas to build up and this is typically followed by burping, stomach bloating, and flatulence.

Additionally, pregnancy may cause abdominal discomfort, upper stomach issues, or even pain due to constipation, especially during late pregnancy when the uterus begins to compress different organs.

Furthermore, weight gain along with the additional weight of the growing baby can put a strain on the hips and back, thereby causing lower back pain. For most pregnant women, symptoms such as abdominal discomfort, bloating, and back pain are harmless and usually resolve on their own after the baby is born. 

Symptoms that gradually worsen or become debilitating during pregnancy should be discussed with a health care professional. Some women can even benefit from physical therapy during or after the pregnancy, particularly those who experience ongoing back pain.

Back Injuries 

Various types of back injuries that range from minor muscle strains and sprains to serious injuries such as disc compression, sprained ligaments, or herniated discs may cause lower back pain. However, the pain that develops from a herniated disc, for example, may also radiate to other parts of the body such as the abdomen. This can subsequently lead to bloating, abdominal discomfort, and additional digestive issues. These types of abdominal problems generally become more prevalent as the injury or condition progresses.

Individuals who experience chronic lower back pain that is accompanied by persistent abdominal issues may benefit from physical therapy. In terms of back pain management, physical therapy is described as one of the most successful treatment approaches.

This non-surgical form of treatment is generally recommended for a specific period of time, such as 4 to 6 weeks, to determine whether this approach can effectively target the back issue or if more invasive treatments, including surgery, may be required.

The primary goal of physical therapy is to reduce back pain, increase range of motion, improve mobility, and restore function of the muscles or bones in the back. By targeting the back pain, most abdominal issues that are linked to the back injury may also resolve.

In addition, physical therapy regimens are customized for each individual to help ensure progress and to teach maintenance strategies that can be applied at home or work to lower the risk of recurring back problems.

Hormonal Changes

Hormones function like chemical messengers that help regulate various bodily processes. As hormone levels change, it can alter the body’s reactions and responses.

Furthermore, both men and women are susceptible to hormonal changes. For instance, a number of women experience cramping, stomach bloating, and lower back pain before or during their menstrual cycles. This is caused by hormones called prostaglandins that are released during menstruation. They stimulate uterine contractions that lead to the shedding of the uterine lining. 

Elevated levels of prostaglandins may cause strong, painful uterine contractions that can affect muscles in the lower back. Contractions that are particularly heavy can radiate through the back and abdomen, thereby causing lower back and abdominal pain. Accordingly, if the symptoms recur in a predictable pattern for women without causing serious complications, then they generally resolve on their own.

Similarly, andropause, which is a male form of menopause, may cause age-related changes in the production of male hormones. The most problematic change is a drop in testosterone, one of the main hormones that helps regulate sex drive, mental and physical energy, bone density, and muscle mass, among other functions.

Although andropause does not occur in all men, for some it may be linked to another health issue known as prostatitis or the inflammation of the prostate. Prostatitis is associated with pain in the abdomen, lower back, the pelvis, prostate, testicles, and even the rectum.

Furthermore, some people who undergo hormone replacement therapy for menopause, low testosterone levels, prostate cancer, or other reasons may experience bloating as well as abdominal or lower back pain due to the administration of progesterone and estrogen, estrogen alone, or testosterone.

Kidney and Urinary Tract Infections

Urinary tract infections (UTIs) develop due to the overgrowth of bacteria in the bladder or urethra. They typically cause symptoms such as painful urination, cloudy urine with a strong scent, and pain in the groin, but the symptoms can expand to other parts of the body if the infection spreads to the kidneys.

More specifically, as the kidneys are located in the lower region of the back, lower back pain may develop if the kidneys become inflamed. As the infection continues to spread, it may lead to painful contractions of the abdominal or pelvic muscles. Additional symptoms that indicate the infection is becoming severe include: 

• Fever
• Chills
• Nausea
• Bloating
• Vomiting
• Diarrhea
• Abdominal pain

If symptoms of a UTI or kidney infection are experienced, it is important to seek medical treatment.

Gastrointestinal Problems and Flatulence

A common gastrointestinal problem is gas or flatulence. In the majority of cases, gas is simply a minor annoyance that quickly goes away. However, excess gas may lead to intense pain that is accompanied by bloating, belching, flatulence, tenderness, and a feeling of fullness. The pain can also extend to the back, causing lower back pain.

Excess gas in the upper stomach region may be the result of swallowing more air than usual, overeating, or chewing gum. Gas that develops in the lower abdomen is often linked to eating gassy foods, the improper digestion of certain foods, or an imbalance of healthy bacteria in the gut or colon. The following foods may lead to excess gas for some people: 

• Bran
• Lentils and beans
• Carbonated drinks (e.g., soda, beer)
• Dairy foods that contain lactose (e.g., milk, cheese)
• Vegetables such as broccoli, cabbage, cauliflower, Brussels sprouts, bok choy

Another common issue that may cause these symptoms is gastritis, which is characterized by inflammation of stomach lining. More specifically, this condition occurs when foreign invaders or certain substances weaken the protective mucosal lining of the stomach, thereby allowing digestive juices to damage the lining. It is most often caused by Helicobacter pylori bacteria, but is also linked to other factors such as alcohol use or taking nonsteroidal anti-inflammatory drugs (NSAIDs) frequently.

The inflammation that may develop due to gastritis is associated with a burning sensation or sharp, stabbing pain in the upper stomach or the left side of the upper abdomen. The pain may also radiate through the back. Additional symptoms include nausea, bloating, burping, and feelings of fullness, particularly after eating a meal.

In some cases, the symptoms may be acute, meaning they arise and resolve quickly. In other cases, the symptoms may develop more slowly and initially go unnoticed until they become a chronic problem.

In addition, vomiting occurs for some people. If gastritis causes an individual to vomit, it may be clear, yellow, or green, and may even contain blood, depending on the severity of the inflammation or damage. Yellow or green vomit is a sign of biliary reflux, the backup of bile into the stomach. If this condition becomes chronic and it is left untreated, serious complications such as severe stomach pain, bowel movements with a foul smell, chest pain, and even shortness of breath may occur. These types of symptoms warrant medical attention.

Furthermore, excessive upper and lower abdominal gas that cause flatulence or belching throughout the day for extended periods of time may be due to a digestive disorder. Such disorders include:

• Peptic ulcer
• Gastroparesis
• Celiac disease
• Crohn's disease
• Ulcerative colitis
• Chronic constipation
• Functional dyspepsia
• Irritable bowel syndrome
• Inflammatory bowel disease (IBD)
• Gastroesophageal reflux disease (GERD)

There are additional conditions that may produce lower back and abdominal pain, flatulence, bloating, and belching, but it is important to speak with a healthcare professional to determine the exact cause. Proper treatment can improve the health outcomes.

Less Common Reasons for Lower back Pain and Abdominal Issues

The following conditions are also associated with stomach bloating and upper stomach problems (e.g., abdominal pain), but they are less common:

• Pancreatic cancer
• Bowel obstruction
• Liver disorders or failure
• Spinal injuries or disorders
• Peritonitis (inflammation of the abdominal lining)
• Abdominal aortic aneurysm (enlargement of the abdominal aorta)

Although these conditions are rare, they require prompt medical treatment. In general, any form of severe persistent pain should be medically evaluated to potentially rule out the presence of life-threatening health problems. If a serious issue is present, immediate treatment is vital.

Treatment for Lower Back and Abdominal Pain

Treatment for lower back pain, bloating, and abdominal discomfort typically depends on the underlying cause. For example, reducing pain that is linked to stress involves finding positive ways to cope with stressful situations.

If the pain is due to an infection, antibiotics may be necessary. Stomach bloating and back pain that develops due to a back injury can be effectively addressed with physical therapy for most people.

The following strategies may also be beneficial for minor discomfort, pain that is linked to a known cause (e.g., menstruation, andropause), or mild gastrointestinal issues:

• Drink plenty of fluids to help avoid dehydration-induced cramping or muscle spasms.
• Make sure to maintain good posture while sitting, lifting, or exercising.
• Avoid the use of antacids unless advised by a doctor to take them.
• Refrain from lifting heavy objects that may strain the back.
• Avoid food that causes bloating and gas (e.g., legumes).
• Take frequent breaks, stand up, and move around to avoid prolonged sitting.
• Alternate warm and cold compresses for about 10-20 minutes throughout the day.
• Use over-the-counter pain relievers for short periods of time.

However, speak with a doctor if the lower back and abdominal pain are accompanied by other symptoms such as chest pain, difficulty breathing, chills, blood in the stool, or any other concerning issues.

Summary

Lower back and abdominal pain are fairly common symptoms that may develop due to a harmless underlying issue. Accordingly, the discomfort generally resolves on its own. Most people experience rapid improvement by implementing common home remedies such as resting, lowering stress, applying hot and cold pads, or taking pain relievers.

In some cases, the health problem that is causing the discomfort may require ongoing management through approaches that include physical therapy. Furthermore, if the symptoms persist for several days or intensify, it may signal a serious or life-threatening health problem that warrants medical treatment. Certain conditions (e.g., organ failure, kidney infections) may be difficult to treat, but early intervention and receiving timely medical care increase the chances of positive outcomes.

FYZICAL offers a wide variety of physical therapy services by qualified providers across the U.S. To find a FYZICAL Therapy & Balance Center near you, visit our website at FYZICAL.com. Our highly skilled therapy providers are 100% focused on your optimal health so you can Love Your Life®!

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