If you have ever wondered, “Can constipation cause back pain?”, the answer is that it can, and vice versa. Constipation and back pain may go hand in hand. Can constipation cause lower back pain? According to some healthcare professionals, it also can.1 It is first important to understand what constipation is. The term refers to a situation in which bowel movements happen less often or are difficult. Most of the time it is not serious, and the span between normal bowel movements can vary from “three times a day” to “only once or twice a week”. However, going longer than three days between bowel movements is not generally healthy, and the longer time between eliminations can lead to the stool becoming harder to pass. Symptoms of constipation include hard stools, small stools, straining, few bowel movements, a feeling “that everything didn’t come out”, vomiting, abdominal pain, or swollen abdomen. Common causes of this disorder include dietary and activity changes, antacids, dairy, irritable bowel syndrome, eating disorders, colon cancer, multiple sclerosis, Parkinson’s disease, dehydration, lack of fiber, inactivity, laxative overuse, pregnancy, some medications, stress, or hypothyroidism. Some patients may have “problems with the nerves and muscles in the digestive system”, while others might have hemorrhoids which lead them to resist having bowel movements. So how can constipation cause back pain?
How Can Constipation Cause Back Pain?
The constipation lower back pain is caused by the obstruction in the intestines. When there is a blockage, “defecation is painful or halted”. The “traffic jam” becomes worsened, creating more pressure on the lumbar region, and increasing pain as the impaction continues. The opposite relationship between constipation and back pain is also true. A patient with back pain can develop constipation as a result of the lower back muscles spasms. These spasms “interfere with the autonomic nerves responsible for the intestinal action that cause bowel movements”. Pain that is experienced when patients attempt to alleviate their bowels might also be a deterrent, continuing the cycle of constipation. Furthermore, using medications to treat back pain can also cause problems. Many of the prescription medications for pain relief, including antidepressants and opioids, “can cause constipation”.3 A slipped disc can lead to “chronic lower back pain”, which is irritated by sitting and bending. Straining on the toilet “with a bent seated position…creates the maximum pressure on the intervertebral discs”. This leads to nerve irritation and more back pain. Reaching for pain medication worsens the situation, and “can cause pressure on the pelvic nerves”.4
Self-Treatment for Constipation
Lifestyle changes could help patients eliminate constipation. One option is to take in more water. Dehydration makes this disorder worse. Fiber, such as from vegetables and fruits, can also help with digestive problems. Patients should not be sedentary, as motion keeps things moving. Some may consider chiropractic adjustments, massage, acupuncture, or colon irrigation, but laxatives should be avoided. Another option is trying a “body cleanse” to eliminate toxins.5 Caffeine is dehydrating, and dairy products may be causing an issue, especially in those who experience constipation from their lactose intolerance. It is crucial to “go to the bathroom when you feel the urge” and to drink up to two quarts of water a day. For some patients, eating bran cereal or prunes may help, and warm liquids could also be beneficial. Fiber can also be found in legumes and whole-grain bread. Doctors may recommend a stool softener, but laxatives are not recommended for long periods of time since they can worsen the condition. If a patient has “sudden constipation with abdominal pain or cramping” and cannot pass any stool or even gas, it is important to call a doctor. If constipation is a new problem or has lasted over two weeks, if there is blood in the stool, if a patient has unexpected weight loss, if the bowel movements lead to severe pain, or if the stools are “pencil-thin”, then it is time to call a doctor.6
Chiropractic and Massage
A misalignment in the sacrum can initiate constipation, pressing on the nerves and triggering pain in the lower back. A spinal adjustment from a chiropractor can help with this situation. Often a chiropractor will recommend lifestyle and nutritional changes to prevent a recurrence.7 Self-massage of the abdomen could provide relief from constipation. What is useful about massage is that it relieves stress and stimulates organs and muscles. This type of massage is performed below the sternum. One hand moves down the abdomen, followed by the other, and each hand cycles over the other “in a backwards bike-pedaling motion”. In another massage movement, the fingertips are used to “massage in small circular motions” starting from the sides of the abdomen and moving “inward and downward…progressively deeper”. Self-massage should be gentle and comfortable. Before any massage, a patient should increase water intake because toxins become dislodged and need to be flushed out. If engaging in self-massage while lying down, the patients should alternate moving the knees to the left and right sides. Being consistent matters: “two twenty minute sessions every day” is suggested. With regular massage, patients should notice improvements within a week or two.8