Lower back pain before your period: Is it a pregnancy symptom?

Ovulation is over. You’re in the dreaded “two week wait”, impatiently waiting for testing time, when you start to notice a dull sort of pain in your lower back.

Could it be … an early pregnancy symptom? Or has your body just found another “interesting” way to let you know that your period is on its way once again?

We’re sorry: there’s no way to tell.

The good news?

Lower back pain can indeed be a very early pregnancy sign.

What causes lower back pain in very early pregnancy?

Backache is actually a relatively common early pregnancy symptom. Unfortunately, it’s also a relatively common symptom of PMS (pre-menstrual syndrome).

Whether you are pregnant or not, the cause is the same: hormones.

Menstrual cycle estrogen progesteroneIn the second half of any menstrual cycle, after ovulation, your body produces plenty of a hormone called progesterone.

One of its main functions is to ensure that your uterus builds up a nice, thick lining of blood and nutrients, ready to welcome a fertilized egg.

Progesterone also has relaxing properties. This is important, because it loosens the muscles in your fallopian tubes, facilitating the egg’s entry into your uterus. It also relaxes the uterus itself, preventing contractions which might disturb the implantation of the egg.

This relaxing effect also extends to muscles, ligaments and joints in the pelvic area, and this is why you might get lower back pain just before your period — or before you miss your period.

If you have conceived, your levels of progesterone will be higher than in non-conception cycles when the day of your expected period approaches. Unusual hormone-related symptoms—like backache—might therefore be a promising sign, but only a missed period and/or a positive pregnancy test can really give you the answer.

Other possible causes of lower back pain

Besides a spike in progesterone, whether you are pregnant or not, here are some other possible reasons why your lower back is aching.

If the pain is rather acute, a muscle or ligament strain is the most likely explanation. If you have lifted something heavy, made a sudden movement or twisted your back, it may have caused small stretches or tears.

Sciatica is another type of lower back pain which has nothing to do with pregnancy. It’s typically felt on one side only, and often radiates to your buttock or leg. Sitting or standing still makes it worse, while walking might provide some relief.

An ovarian cyst (a fluid-filled sac that grows on your ovary) can also cause discomfort in the lower back. Ovarian cysts are very common. They are mostly harmless, often symptom-free, and usually disappear by themselves. A large cyst, however, can cause persistent or intermittent pain in the pelvic area that may spread to the lower back and thighs.

If your back pain is sharp or stabbing, or if it persists after your period has started, consult your physician for proper diagnosis and treatment. Pregnancy will put a strain on your back in the best of cases, and you don’t want to head into it with an existing back condition if you can avoid it.

How to alleviate your lower back pain

If the pain turns out to be pregnancy-related, you’re probably more than happy to endure it. That doesn’t mean you can’t try to get some relief, however. Just make sure you don’t do anything which wouldn’t be safe, should it turn out that you are indeed pregnant.

If if hurts bad enough that you consider taking a painkiller, make sure to choose a drug that’s safe to use while you’re trying to conceive, such as acetaminophen (Tylenol).

This is important!

Certain painkillers known as nonsteroidal anti-inflammatory drugs (NSAIDs), including any drug containing ibuprofen, can make your uterine lining less favorable for implantation. You don’t want that to happen, back pain or not! (By the way, ibuprofen can also inhibit ovulation, so stay away from it altogether for as long as you’re trying for a baby.)

Read more: Which painkillers to choose when you are trying to conceive

Many women find that heat offers some comfort — try a warm bath, a heating blanket or a heating pad. The “cat stretch” yoga position, where you stand on your hands and knees and slowly arch you back, can also help ease the pain.

And even if you’re feeling sleepy and sluggish towards the end of your cycle (thank you very much, progesterone and your relaxing properties!), women who exercise regularly are less likely to experience period pains of all kinds.

If you already have a workout routine, just continue as usual. If not, this might not be the right time to start marathon training, but some easy walking, swimming or biking—whatever you most enjoy—might help you feel better.