Can Constipation Cause Back Pain?

It is commonly known that constipation is related to difficulty in passing stools and having hard or painful stools. But can constipation be related to back pain? Sounds strange; isn’t it? Although it might sound different, there are chances of back pain being caused due to constipation.

While some severe cases of constipation can cause back pain, sometimes even minor cases can be related to back pain and discomfort.⁽¹⁾ Constipation is known to affect the bowels, but sometimes it can also affect your back.

Constipation can be determined by changes in regular bowel movements, is mostly accompanied with discomfort and difficulty in passing stools. While it is normal for some people to pass stools 2-3 times in a day, some may pass 2-3 days in a week.⁽²⁾

Constipation is a very common condition in which a person may have difficulty in emptying bowels or passing motions. The stools may be hard, painful and difficult to evacuate. Sometimes, severe constipation can cause bloating and cramping pain in lower abdomen.

Many factors like certain foods, inadequate intake of water, fluids or fibrous foods, certain medications and inactive lifestyle can contribute to constipation. Some medical conditions like gastrointestinal disorders, irritable bowel syndrome, thyroid problems or hormonal changes for e.g. during pregnancy too sometime lead to constipation. In some cases, the exact cause may not be known.

Constipation is related to difficulty in passing stools and much straining is required to be able to evacuate the stools. As the stools are not passed regularly, the fecal matter may get built-up in the body. Hard stools can add to the discomfort, which may cause more strain on the body, requiring additional effort during excretion. The body needs to force the fecal matter while passing stools, which can ultimately cause strain on the back muscles.

Back is an important part of the body that enables various movements and is easily subjected to pain and discomfort. Back pain can result from various conditions ranging from poor posture, pregnancy, muscle strain, injuries to bone and soft tissues, inter-vertebral disc problems and various medical conditions. Excessive strain on back muscles due to constipation can also cause pain in back.

When a person experiences constipation for long, it can have adverse effects on the body. Chronic constipation is a condition in which the fecal matter, which has not been expelled for long, builds-up in the body and is known as fecal impaction. This occurs due to long standing constipation over a period of time and the resulting hard or dry stools get impacted.

Dietary factors, medical conditions, inactivity, certain drugs, etc. contribute to chronic constipation. While the causes are those that lead to constipation, the duration of complaints is longer, which lead to impacted feces. In addition to hard and painful stools, the symptoms may also include bloated abdomen and abdominal pain, alternate diarrhea, feeling of sickness and sometimes sweating, changes in heart rate or blood pressure.

• In chronic constipation, the impacted fecal matter causes blocking of the rectum. The excess accumulated matter can exert more pressure on the internal parts. The blocked rectum and impacted feces can exert pressure on the back and cause back pain. The fecal impaction can also press on the sacral nerves of the back. When these nerves get irritated a pain response may be felt in the back.
• Additionally, the force exerted while trying to pass stools and straining can hurt the back muscles. If the back muscles are already weak or injured, the discomfort and back pain may be more. Prolonged constipation and straining too can eventually weaken the back muscles and cause pain. After a painful straining toilet activity, pain and discomfort may be felt in the back, around hips and legs.

Presence of constipation can worsen the pre-existing back related problems or back pain and cause more pain. Similarly, reliving constipation can have a great impact on relief in back pain.

Back pain due to any cause should be treated appropriately. However, if constipation is present in persons experiencing back pain, management of constipation can help to a great extent. Most of the times, it is observed that other causes of back pain like previous injuries, muscle strain, inter-vertebral disc problems, etc. may be present along with constipation. Hence, treating constipation in addition to other problems is advisable.

Constipation can be treated with medications in certain cases. Treating the underlying causes of constipation is equally important. It is advisable to seek medical opinion and follow the advice.

• Preventing and managing constipation needs slight modifications in the lifestyle. Some tips includes
• Drink plenty of water and fluids; at least 8 to 10 glasses of water is ideal. Special attention to fluid intake must be given during summer season and during play, workout or sports activities.
• Add enough roughage to your diet. Include whole grain foods for breakfast and meals. Include enough amounts of fruits and vegetables in your diet. Identify foods that cause constipation or gastric upset.
• Maintain a healthy schedule and toilet routine. Attend to toilet needs without ignoring or suppressing the urge.
• Exercise regularly and remain active during the day. Light exercises, yoga or walking can be easily taken up. Seek medical advice if required.

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