An ovarian cyst is a common, fluid-filled sac that develops on or within an ovary. While many cysts are small and cause no symptoms, their size and location can cause discomfort, including pain that radiates away from the pelvis. Yes, an ovarian cyst can cause back pain, but this typically occurs only under specific circumstances. This article explains the connection between ovarian cysts and lower back pain, details associated symptoms, and outlines urgent signs requiring medical attention.
How Ovarian Cysts Cause Back Pain
The primary way an ovarian cyst causes lower back pain is through a mechanism called mass effect, where the cyst physically presses on nearby structures. The ovaries are located deep within the pelvic cavity, near the nerves and supporting structures of the lower back and sacrum. When a cyst grows large, it occupies space, creating pressure on these sensitive areas.
This mechanical pressure is often felt as a dull, persistent ache in the lower back, sometimes described as a heavy sensation. Cysts that grow to a diameter of five to ten centimeters or more are more likely to exert this significant pressure. The pain is frequently unilateral, meaning it is felt on the same side of the body as the affected ovary.
The resulting back discomfort is often a type of referred pain, originating in the pelvis but perceived in the lumbar or sacral region due to shared nerve pathways. If the cyst is positioned low in the pelvis, it may press directly on nerves that run down the back and into the legs. This back pain is generally chronic and steadily worsens as the cyst increases in size.
Other Indicators of an Ovarian Cyst
While back pain can occur, most ovarian cysts manifest with discomfort centered in the pelvic region. The most common indicator is pelvic pain or pressure, which may be a dull ache or a sharp, sporadic sensation, usually felt on the side where the cyst is located.
Many people also report abdominal fullness, bloating, or swelling in the lower abdomen. Due to their size and location, some cysts can press on the bladder or bowel, leading to a frequent or urgent need to urinate or difficulty emptying the bowels. Pain during sexual intercourse (dyspareunia) is another common symptom.
Changes in the menstrual cycle can also signal the presence of a cyst, including periods that are heavier or lighter than usual. Certain types of cysts, such as endometriomas associated with endometriosis, can cause intense, cyclical pelvic and abdominal pain.
Recognizing Urgent Complications
In rare instances, an ovarian cyst can lead to acute complications requiring immediate medical intervention, usually signaled by a sudden, severe increase in pain. One emergency is ovarian torsion, which occurs when a large cyst causes the entire ovary to twist on its supporting ligaments. This twisting cuts off the blood supply, leading to sudden, stabbing pain often accompanied by nausea and vomiting.
A second acute complication is a cyst rupture, where the fluid-filled sac bursts open. This typically causes sudden, sharp pain in the lower abdomen or back. If a large cyst ruptures, it can cause significant internal bleeding or infection, requiring emergency surgery.
Signs of an acute complication include debilitating pain, or pain accompanied by fever, dizziness, or a rapid heart rate. These symptoms suggest internal bleeding or severe irritation and necessitate an immediate trip to the emergency room.
Confirming a Diagnosis and Treatment Options
A healthcare provider typically begins the diagnostic process with a physical examination, often including a pelvic exam to check for tenderness or masses. The primary tool for confirming a cyst is a pelvic ultrasound, which uses sound waves to create images of the pelvic organs. This imaging allows the provider to determine the cyst’s size, exact location, and whether it is purely fluid-filled or contains solid components.
The treatment strategy is determined by the cyst’s type, size, symptoms, and the patient’s age. For small, asymptomatic cysts, particularly functional cysts, the standard approach is watchful waiting. This involves monitoring the cyst with follow-up ultrasounds to see if it resolves on its own.
Medications, such as hormonal contraceptives, may be prescribed to prevent the formation of new cysts by stopping ovulation. If a cyst is large, persistent, causes significant pain, or appears suspicious, surgical removal may be necessary. This procedure is often performed laparoscopically through small incisions, allowing the surgeon to remove the cyst while preserving the ovary.