Constipation and Back Pain: What’s the Link?
Back pain is typically caused by musculoskeletal issues, but constipation can also contribute to back pain, says gastroenterologist Sameer Berry, MD, a clinical assistant professor of medicine at the NYU Grossman School of Medicine in New York City and the chief medical officer of Oshi Health, which provides multidisciplinary gastrointestinal (GI) healthcare.
Because pain signals from the colon enter the spinal cord alongside signals from the lower back and flank, the brain may misinterpret where the discomfort is coming from, says Simon Mathews, MD, a Baltimore-based gastroenterologist and spokesperson for the American Gastroenterological Association, where he chairs the Committee for GI Innovation and Technology.
As stool builds up in the colon, Dr. Mathews says that the stool stretching the walls of the colon can trigger visceral (internal) pain. “The brain sometimes misreads a poorly labeled colon signal as coming from the back. A distended colon can be felt as a dull ache across the low back,” he says.
It’s a vicious cycle, says Joe Betz, a doctor of chiropractic and the president of the International Chiropractors Association, who is based in Boise, Idaho. “Pain can reduce movement, and reduced activity may worsen both spinal stiffness and bowel motility,” he says.
Dr. Betz says that muscle strain, joint irritation, pelvic dysfunction, and prolonged sitting can also cause lower back, flank or pelvic pain that’s often interpreted as related to the digestive system. “Straining during a bowel movement may aggravate an existing back condition without being its original cause,” he says.
Mathews says that people can often point to the specific location of musculoskeletal back pain with one finger. But internal organ pain, also called visceral pain, is associated with a vaguer sense of location. “And it is more likely to be associated with GI symptoms like bloating, fullness, gas, and a sense of incomplete emptying,” he says.
If you’re unsure if your back pain is caused by constipation, or if what you’re doing to manage it is causing constipation, speak to your doctor, Berry says.
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