Low back pain and diahrea

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit

"Diarrhea" is the correct spelling but sometimes people will type in diahrea when they're in a rush. A number of conditions can be associated with both low back pain and diarrhea. The interesting thing is that this combination, while possibly related to an arthritis condition, is usually due to problems outside of the musculoskeletal system.

Some of the more common causes are:

Inflammatory arthritis, including ankylosing spondylitis and related conditions. These disorders are called “spondyloarthropathies.” In these disorders, there is pain in the lower back, together with morning stiffness in the back, hips or both. There also can be pain and stiffness in the neck or chest or an extremely tired feeling. Other features may include psoriasis, eye pain and redness, or diarrhea, depending on the specific disorder causing back pain. This group of diseases is a relatively rare cause of back pain.

Inflammatory bowel disease which includes both Crohn’s disease and ulcerative colitis may be associated with low back pain, diarrhea, abdominal cramping, weight loss, fevers, and malaise. The low back pain is usually due to sacroileitis.

Endometriosis can cause mild to severe pain, probably from irritation of pain fibers on the peritoneal surface. In its early stages, endometriosis causes cyclic pain, which starts several days before menses and continues through the first few days. However, as the disorder becomes chronic, pain commonly occurs at variable times unrelated to menses.

It may be associated with low back pain and bowel disturbance such as diarrhea.

Primary dysmenorrhea, also known as menstrual pain, affects young women in their teens and early twenties. Pain usually begins a day or two before menstrual flow, and may continue through the first two days of menstruation. Discomfort tends to decrease over time and after pregnancy. Secondary dysmenorrhea is caused by underlying physical problems.

Symptoms and degree of pain vary, but may include the following.

• Abdominal cramping or dull ache that moves to lower back and legs
• Heavy menstrual flow
• Headache
• Nausea
• Constipation or diarrhea
• Frequent urination
• Vomiting (not common)




Pelvic inflammatory disease (PID) is an infection of the female reproductive organs. It usually occurs when sexually transmitted bacteria spread from your vagina to your uterus and upper genital tract. PID may also develop when bacteria travel up a contraceptive device or when they're introduced during gynecologic procedures, such as an abortion or insertion of an intrauterine device (IUD).

Signs and symptoms of pelvic inflammatory disease may include:

Pain in your lower abdomen and pelvis
Heavy vaginal discharge with an unpleasant odor
Irregular menstrual bleeding
Pain during intercourse
Low back pain
Fever, fatigue, diarrhea or vomiting
Painful or difficult urination




Irritable bowel syndrome (IBS), condition characterized by frequently alternating constipation and diarrhea in the absence of any disease process. It is usually accompanied by abdominal pain, especially in the lower left quadrant, bloating, and flatulence. Other symptoms, such as heartburn, lower back pain, and agitation, may be present concurrently. The cause of irritable bowel syndrome is unknown; on examination there are no physical abnormalities. The symptoms result from a disturbance of the normal peristaltic movements of the lower intestine. IBS is the most common gastrointestinal complaint in the United States. It affects twice as many women as it does men. In some individuals it is made worse by emotional stress, spicy foods, or excessive caffeine consumption. Symptoms can be minimized by a high-fiber diet and antispasmodic drugs. Acupuncture is helpful in many cases.

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