Why Diverticulitis Can Cause Aggravating Low Back Pain

Medically reviewed by Dr. Brian Paris, D.C on Nov. 6, 2018.

Diverticulitis is a serious condition that can cause irritating pelvic and lower back pain.

To understand why diverticulitis can cause pelvic and low back pain, you have to know what diverticulitis actually is — and how it’s different from diverticulosis.

Diverticulosis is when the colon bulges out into “pouches” along weak spots in the colon wall, usually in the sigmoid colon that runs along the left side of the abdomen.

(RELATED: Why your abdomen is hurting from lower back pain)

These balloon-like pouches are called diverticula.

Many people have diverticulosis without knowing they have it. It’s estimated that half of people in the U.S. over the age of 60 and most over 80 have had some form of diverticula [i].

When the diverticula become infected or inflamed, the condition is escalated to diverticulitis.

When it advances to full-blown diverticulosis, serious complications can arise.

5 complications of diverticulitis

• Abscesses — when pus collects in the “pouches”
• Perforations — tiny tears in the bowel walls that may eventually grow larger and allow bowel contents to leak into the abdominal cavity
• Intestinal blockages from scarring — this prevents waste from passing through the intestines; a full blockage is a medical emergency that requires surgery. (This is much more serious than typical constipation, which can also cause back pain.)
• Fistula — an abnormal pathway between two organs. In diverticulitis, a fistula typically connects the colon with either the bladder, the small intestine, or the vagina.
• Peritonitis — inflammation and infection of the abdominal cavity caused by perforations in the bowel walls; this is a medical emergency that requires surgery. Peritonitis presents with serious stomach pain that shouldn’t be ignored.

Symptoms of Diverticulitis

Diverticulosis often doesn’t show any symptoms.

But when it progresses to diverticulitis, it can result in severe abdominal pain and tenderness, nausea, vomiting, change in bowel habits or cramping.

It can also result in back pain.

Since there are so many possible causes of lower back pain, it’s easy for a physician to overlook diverticulitis as a potential culprit.

Sometimes the pain can even spread to the scrotum, buttocks, hips, thighs, legs, and even shoulder and neck. Obviously, this complicates diagnosis even further.

Cases where diverticulitis causes back pain are more common among women and the elderly, or people whose immune systems are compromised.

When diverticulitis progresses to the point of back pain, it’s usually much more dangerous and harder to treat.

Unfortunately, that sort of back pain can also arise from things like kidney stones or gallbladder problems, among many other things that aren’t related to the muscle strains and imbalances or orthopedic problems that usually cause back pain.

It can make for a scenario where the pain is extremely difficult to accurately diagnose and treat.

Common treatment options

Your physician will probably start by ruling out the obvious (strenuous activity or the wrong mattress), then work their way to the less obvious.

The good news (if you can call it good news) is that diverticulitis will most likely present other symptoms other than just back pain (i.e. nausea, abdominal pain, vomiting, irritable bowel and others we discussed earlier).

And remember that before it advances to diverticulitis, diverticulosis often goes for years without showing any symptoms whatsoever.

It’s an unusual case of diverticulitis (or diverticulosis) that only causes back pain without any other problems.

If your back pain is coupled with other symptoms that would point toward diverticulitis, consider getting a reference for a gastroenterologist from your MD.

The gastroenterologist will probably want to do a colonoscopy and run additional tests to narrow down the causes and try to discover any problems with diverticulitis, diverticulosis or other bowel disorders.

Other treatment options

Diet plays a crucial role in the management of diverticular disease. After an acute attack, it’s usually recommended that you stick to clear liquids for a few days, then slowly add low-fiber foods to your diet.

One other important thing you can do is take a proteolytic enzyme supplement.

Proteolytic enzymes aid in digestion and reduce inflammation in the colon. You can learn more about them here.

Final thoughts

Diverticulitis can be a serious condition that requires immediate treatment.

If you’ve experienced these symptoms and complications for an extended period of time, seek a diagnosis from a qualified medical professional.

Aside from your doctor’s suggested treatment options, you can improve the health of your digestive system by cleaning up your diet, and adding in supplements like psyilium husk, which has numerous health benefits, as well as proteolytic enzymes, which reduce inflammation throughout your body.

Editor’s note: This article has been reviewed by a member of our medical advisory board. The content provided is for informational purposes only and should not be construed as medical advice. Please consult with your physician if you have any questions about your health.