Constipation and Back Pain: A Crappy Combination and How to Break Free
by JayDee Vykoukal, PT, DPT
Your digestive system affects your overall health in more ways than one. Many people don’t realize that if their bowels become blocked or sluggish, it can lead to a whole host of other problems, including back pain.
Back pain from constipation is your body saying, 'Hey, I'm not just going to sit here and take this crap!' Read on to find out more about the importance of staying regular.
In all seriousness, constipation is no fun. It can leave you feeling bloated, gassy, and uncomfortable in your own skin. In this post, we'll cover tips for back pain and constipation to help you get back on track to feeling your best.
- Can Constipation Cause Back Pain?
- How Can Constipation Cause Back Pain?
- Other Causes of Back Pain
- The Problem with Constipation
- Causes of Constipation
- Symptoms of Constipation
- How to Treat Back Pain Caused by Constipation
- How Physical Therapy Can Help
- More than Just a Pain in the Rear
Absolutely, yes. When the bowels get backed up, it can increase the pressure on the internal organs, local tissues, and nerves in your lower back, leading to fullness, aching, and discomfort in your trunk.
Again, too much fecal matter in the colon can put extra pressure on the areas around it. Since the lower intestine — specifically the colon — occupies a large area in your trunk adjacent to your lower back, it can affect this region's connective tissues and nerves.
If you're feeling sore, backed up, and bummed out don't fret, we'll cover some simple changes you can try below.
While constipation can certainly be the cause of back pain, there are other possible underlying causes. You may even be dealing with a combination of issues.
- Overuse injuries with hard labor from repetitive lifting, reaching, pushing, etc.
- Tissue strain due to overload from prolonged static positioning, such as sitting, driving, and sleeping
- Acute injury or trauma, such as a fall or motor vehicle accident
- Other health conditions, such as kidney stones and ovarian cysts or endometriosis in women
In terms of how frequently you should be pooping, there is a wide range of normalcy. By some medical definitions, you are considered constipated if you aren't pooping one to three times every 24 hours. However, if you're pooping only three times per week (and it's normal for you), that's okay too. Anything less than that, you're technically constipated.
Not only can constipation be an underlying cause of back pain, it can also have other negative effects on your health, with some research showing evidence of brain fog, mental health changes, and disruption of gut health that can affect your body's homeostasis (balance).
Constipation can also worsen existing conditions like sciatica, adding more fuel to the fire when you're already feeling like crap.
Constipation can occur acutely or chronically, depending on underlying causes and risk factors. If not managed, it can also lead to the onset of fecal impaction. Fecal impaction is a buildup of dry, hard stool that cannot be passed through the rectum, a serious and often painful condition that requires immediate medical attention.
The most common causes of constipation include:
- Low levels of dietary fiber
- Not drinking enough water (dehydration)
- Lack of physical activity
- Side effects from certain medications, such as iron supplements, narcotics, and antacids
- Overuse of laxatives
- Poor gut health or gut dysbiosis caused by the use of antibiotics, pesticide exposure, etc.
- Stress, anxiety, depression, or hormonal imbalances
- Undiagnosed food sensitivities
- A change in habits (exercise, diet, etc.)
- Poor toileting habits, such as ignoring the urge to go or having anxiety about pooping in public spaces
- Trauma to the pelvic floor or organ prolapse from child labor, postpartum complications, sexual abuse, etc.
- Weakness or hypertonicity (tight muscles that don't relax) of the pelvic floor, making it difficult to eliminate fecal matter
- Pregnancy due to hormonal changes and changes in the abdominal cavity
- Other underlying conditions include multiple sclerosis, Parkinson's, irritable bowel syndrome, tumors, etc.
The common symptoms of constipation include the following:
- Difficulty passing regular stools
- Infrequent bowel movements — this frequency is dependent on personal factors (three times per day to three times per week is normal)
- Hard, compacted stools
- Abdominal pain and cramping
- Bloating, gas, or a feeling of fullness
- Loss of appetite, nausea, or vomiting in extreme cases
- Feeling of incomplete evacuation after a bowel movement
- Pain in the lower back or pelvis
- Foul-smelling gas (we all know that smell, like something is rotting)
- Low energy or irritability (particularly in children)
Note: Seek medical care immediately if you experience severe pain (especially if it doesn't go away after defecation), bloody stools, or you haven't had a bowel movement in 7 days.
If you think your constipation may be causing or contributing to your back pain, it is important to address the root issue of constipation. We will review some tips below, but if your symptoms don't improve, become severe, or you feel unsure, always talk to your doctor first before trying anything new.
- Increase your fiber intake: by eating more fresh fruits, vegetables, and whole grains.
- Aim for 25-30 grams of fiber per day for adults: preferably from food. If you aren't getting anywhere near this amount, gradually increase your intake to avoid stomach and intestine upset.
- Drink enough water: to keep your urine clear to light yellow throughout the day (coffee does not count). Keep a water bottle near you at all times, and slowly sip all day. If you're increasing your fiber intake, you will find you will need to increase your water intake for adequate absorption too.
- Reduce your intake: of processed, high-sugar, and low-fiber foods.
- Exercise regularly: to help promote movement in the intestines and digestive system. Great options include walking, running, swimming, and yoga. There's nothing like a good run, or twisted yoga poses to induce a sudden urge to go to the bathroom.
- Address your pelvic floor health: Talk to a physical therapist specializing in pelvic floor health for the best results. Avoid straining during a bowel movement, as this can exacerbate any underlying dysfunction.
- Stay away: from stimulant laxatives and over-the-counter medications (unless your doctor recommends it).
- Make lifestyle changes: that promote optimal health, including stress management, getting enough sleep, and staying active.
- Use the restroom when you feel the urge to go: instead of ignoring it. If you're in public and feeling anxious, try your best to remember — everyone poops!
- Start a daily habit: If you don't already have a regular poop habit, take time to train your body to go at the same time every day. Your body will thank you! If you need tips, talk to any dad that devotes hours to their toilet sanctuary in the name of "pooping."
- Manage other conditions: If constipation is due to an underlying condition, such as multiple sclerosis or Parkinson’s disease, speak to your doctor about options for treating the underlying disorder.
Once you have "gotten rid" of the problem, literally, you should notice immediate relief from back pain.
Talking to your CityPT physical therapist may not be the first option that comes to mind when dealing with constipation, but it should be. Constipation and back pain are both conditions that require careful attention to underlying factors, particularly the core and pelvic floor.
Although physical therapy treatments are associated with massage and exercise, they're much more that. A CityPT physical therapist that specializes in pelvic floor health (often referred to as women's health, but men are welcome too) can help with your concerns about constipation, low back pain, and beyond.
Here are just some of the ways your physical therapist can help:
- Offer extensive education: about pain management tools, posture, movements, and other lifestyle factors that are impacting your constipation and back pain
- Evaluate the health of your pelvic floor: (for both men and women) and give personalized recommendations for optimizing your ability to poop effectively and comfortably.
- Determine other potential causes of your back pain: if there is more than one cause or constipation doesn't seem to be the real issue.
- Design a personalized treatment program: to promote optimal tissue health, including daily movement, specific exercise prescription, biomechanical training, posture assessment, and more.
- Offer ergonomic advice: for the best way to poop (yes, there's a reason squatty potties are a thing).
Check out some of the most commonly asked questions below:
Frequently Asked Questions
What helps constipation and back pain?
The most obvious answer is fixing the issue with the above-mentioned tips. Other practical tips include talking to a pelvic floor physical therapist, drinking a warm beverage, getting a light massage, placing a heating pad on the back or abdomen, or squatting to try and get things moving.
Can constipation cause crippling back pain?
Typically, back pain related to constipation is not "crippling," but it can be quite uncomfortable in the lower back and abdomen. If your pain is more than a dull ache, it's time to get medical help.
Why does a bowel movement relieve back pain?
A bowel movement instantly removes uncomfortable pressure from the hard stool that was within the colon, offering immediate relief that is almost guaranteed to leave a smile.
What are the signs of a blocked bowel?
A blocked bowel often presents itself with constipation, stomach pain or discomfort, nausea, abdominal bloating, gas, and loss of appetite. Worsening symptoms without being able to pass stool warrants a prompt visit to your doctor.
Can you be constipated and still poop?
Yes. It's possible to experience constipation and still have bowel movements. This is common with chronic constipation, where you could pass stool, but it was not complete or difficult to pass.
What position should you sleep in when constipated?
Due to the position of the intestines, some experts recommend sleeping on your left side to promote the movement of stool into the colon for expelling.
Don't be afraid to talk to your physical therapist about your concerns about constipation or other bodily functions. It's actually quite important for them to know to treat your pain.
Constipation can be an uncomfortable and embarrassing issue, but it doesn't have to remain that way. Following these tips and talking to a medical professional can make all the difference in finding sustainable relief.
No matter how bad you think it is, physical therapy can help you get the situation in check and put the pain in your back where it belongs—in the past.
Ready to say goodbye to constipation and back pain sustainably? Book an appointment.
Before you go, please read our disclaimer. This blog is intended for informational purposes only. We are not providing legal or medical advice and this blog does not create a provider-patient relationship. Do not rely on our blog (or any blog) for medical information. Always seek the help of a qualified medical professional who has assessed you and understands your condition.