Why endometriosis can cause back pain
Endometriosis is a condition where tissue similar to the lining of the uterus grows outside it. It most commonly affects the pelvic area, including the ovaries, the tissue behind the uterus, the bowel and the bladder. Because these structures sit close to the lower back, sacrum and pelvic floor, pain from endometriosis is often felt well beyond the pelvis itself.
Many people with endometriosis describe low back pain, particularly around the time of their period, during or after sex, or when their bladder or bowel is full. This is not usually a separate back problem. It is the same condition being felt in more than one place.
The pelvic pain picture
Endometriosis pain varies widely between people. It may be cyclical or constant, sharp or dull, and it may be accompanied by heavy or painful periods, pain during sex, painful bowel movements or bladder symptoms. The severity of pain does not reliably match how much endometriosis is present, which is why symptoms matter more than a scan result alone.
Pelvic floor muscle tension is also common in people with persistent pelvic pain. Muscles that have been guarding against pain for a long time become tight and sore in their own right, adding a second layer of pain on top of the original cause.
Where physiotherapy can help
Physiotherapy does not treat endometriosis itself. What it can do is address some of the consequences, particularly pelvic floor muscle tension, altered movement patterns and the loss of confidence in activity that tends to build up over years of pain.
A pelvic health physiotherapist can assess whether the pelvic floor muscles are overactive, whether breathing and posture are contributing, and whether there are bladder or bowel habits that are making symptoms worse. Where muscle tension is part of the picture, treatment can reduce it.
What physiotherapy may include
- Assessment of pelvic floor muscle tone and coordination
- Work on breathing patterns that help the pelvic floor relax rather than grip
- Manual therapy where appropriate and with consent
- Guidance on bladder and bowel habits that reduce pelvic load
- A graded plan for returning to movement and activity
- Education about how pain and muscle tension interact
Working alongside your medical team
Endometriosis is managed medically, and physiotherapy sits alongside that care rather than replacing it. The most effective approach usually involves your GP, a gynaecologist, and sometimes a pain specialist or a pelvic health physiotherapist working together.
This is why it is worth telling any physiotherapist about your existing care and diagnosis. It shapes what is appropriate and helps ensure everyone is working towards the same goal.
A note on what this page cannot do
A web page cannot diagnose endometriosis or tell you whether your back pain is related to it. If you have persistent pelvic or back pain, particularly with painful periods, pain during sex or bowel and bladder symptoms, that warrants proper medical assessment.
Seek urgent care for severe sudden pain, heavy bleeding with dizziness or fainting, fever, or pain that is rapidly worsening.
Getting assessed on the North Shore
If you are in the Lindfield or wider North Shore area and pelvic or back pain is part of your endometriosis picture, you can start an enquiry with the symptom pattern you want to discuss and your preferred timing. A qualified health professional confirms whether physiotherapy is appropriate and works with your existing care.
What to do next
- Back and pelvic pain alongside endometriosis is common, and the link is usually mechanical rather than a separate problem.
- Pelvic floor muscle tension often builds on top of endometriosis pain and can respond to physiotherapy.
- Physiotherapy supports medical care rather than replacing it, so tell your treating team about it.