Back pain affects up to 80% of adults at some point in their lives.
From strained muscles to degenerative conditions, back pain has many causes – one of which may surprise you. Diverticulitis, a common digestive condition, can manifest with lower left back pain as one of its primary symptoms.
Diverticulitis occurs when small pouches or sacs called diverticula become inflamed or infected along the wall of the colon. With over half of all people over age 60 developing diverticular disease, understanding its symptoms is key for timely diagnosis and treatment.
If you are experiencing back pain along with digestive issues, diverticulitis may be the culprit.
Can diverticulitis cause pain in the back?
Absolutely – back pain, usually lower left sided, is experienced by more than half of patients during an episode of acute diverticulitis.
The back pain stems from the common nerve supply between the inflamed sigmoid colon and the lower back. Diverticulitis should always be considered a potential cause of acute back pain in adults over 40.
What are the symptoms of diverticulitis back pain?
The classic symptom of diverticulitis is abdominal pain, usually in the lower left quadrant. This appears first, resulting from localized inflammation in the sigmoid colon where diverticula often form.
As inflammation spreads, it can radiate through tissue planes and irritate nerve fibers that supply the lower back. This manifests as lower back pain emerging after the initial abdominal pain.
Pain ranges from mild to severe, sometimes escalating to painful muscle spasms. Lower back pain from diverticulitis may radiate down into the left hip and buttock region as well.
What causes the back pain associated with diverticulitis?
Diverticulitis causes lower back pain due to the common nerve supply between the sigmoid colon and the lumbar spine and back muscles.
Diverticula predominantly forms in the sigmoid colon, which is located on the lower left side of the abdomen. As diverticula here becomes inflamed, it irritates the nerves supplying that section of the colon.
Through a phenomenon called referred pain, inflammation of the sigmoid colon is felt as pain signals in the lower back, even though the colon itself does not extend to the back.
These shared nerve pathways essentially transmit pain signals originating from the diverticula to the lower back. Just as a heart attack can cause left arm pain, diverticulitis can manifest as lower back pain due to overlapping nerve innervation.
Are there any warning signs that the back pain may be related to diverticulitis?
Lower back pain alone has numerous causes, from muscle strains to spinal conditions. However, certain accompanying symptoms increase suspicion that diverticulitis may be the culprit.
Diverticulitis back pain often arises after the initial onset of abdominal pain. Fever, chills, nausea, vomiting, and changes in bowel habits also point towards diverticulitis as the source of back pain.
Sudden, severe pain may indicate a diverticular abscess or perforation requiring emergency medical treatment. Thus, it is vital to monitor back pain in the context of related symptoms and seek prompt medical care for diverticulitis to prevent complications.
How can you distinguish back pain from diverticulitis vs. back pain from musculoskeletal issues?
The location, severity, and accompanying symptoms can help distinguish diverticulitis back pain from strains or spinal causes.
Diverticulitis pain predominantly manifests on the lower left side of the back near the sigmoid colon, whereas musculoskeletal back pain often affects the central lumbar spine. Spinal stenosis causes bilateral lower back pain, versus the unilateral left-sided pain of diverticulitis.
In terms of onset, diverticulitis back pain develops gradually over hours to days alongside abdominal pain. Musculoskeletal back pain comes on suddenly with injury and worsens with movement.
Spinal stenosis causes numbness and tingling, which are absent with diverticulitis.
Being aware of these distinguishing factors guides appropriate diagnosis and management.
| Feature | Diverticulitis | Musculoskeletal |
| Location | Lower left side | Central lumbar spine |
| Onset | Gradual, after abdominal pain | Sudden with injury |
| Pain with Movement | No worsening | Worsens with movement |
| Radiation | Into left hip/buttock | Stays localized |
| Other Symptoms | Fever, nausea, diarrhea | None |
| Numbness/Tingling | No | Possible with spinal issues |
| Risk Factors | Age over 40, colon disease | Injury, strain, poor posture |
When should you seek emergency medical care for back pain with diverticulitis?
Most cases of diverticulitis can be managed at home with rest, liquids, and oral antibiotics.
However, some severe signs and symptoms warrant immediate emergency care to treat serious complications. Seek prompt medical attention if you have:
- High fever over 101°F
- Inability to keep down fluids due to persistent vomiting
- Severe, sharp, constant abdominal pain or back pain
- Dizziness, weakness, or signs of shock such as rapid heart rate
- Change in bowel habits with bloody or tarry stools
These can indicate complications like perforation, abscess, or peritonitis – which require hospitalization and intravenous antibiotics. Early intervention prevents life-threatening sepsis, so always seek evaluation of severe symptoms.
How is diverticulitis back pain treated?
Uncomplicated diverticulitis is treated with bowel rest and oral antibiotics for 7-10 days. Hospitalization with intravenous antibiotics is needed for severe infection or complications. Pain medications like acetaminophen and narcotics can help manage both abdominal and back discomfort.
Muscle relaxants may be prescribed to alleviate painful back spasms from diverticulitis. Alternating hot and cold therapy can also relieve lower back pain and stiffness. Once acute symptoms resolve, a high fiber diet is recommended to prevent constipation and diverticulitis recurrence.
For chronic or recurrent diverticulitis with severe back pain, surgery may be indicated. This involves resecting the affected portion of colon and reconnecting the healthy ends. Diverticulitis surgery leads to improvement or resolution of related back pain in most patients.
Can diverticulitis cause back spasms?
Back spasms are a common manifestation of acute diverticulitis. The infected colon undergoes muscular spasms as part of the inflammatory process. These spasms can spread through tissue planes and trigger reflex spasms of the lower back muscles as well.
Sudden onset of painful lower back spasms, especially with concurrent abdominal pain, warrants medical evaluation for underlying diverticulitis. Spasms are a sign of actively spreading inflammation that needs antibiotic treatment.
Can diverticulitis cause upper back pain?
While rare, diverticulitis can sometimes cause upper back pain. The primary mechanism relates to splinting and guarding due to abdominal muscle spasms. Chronic guarding of abdominal muscles can lead to strain on the thoracic paraspinal muscles of the upper back.
Upper back pain from diverticulitis also results from prolonged posture changes to accommodate the abdominal discomfort. Lying in awkward positions stresses the upper back muscles. However, acute upper back pain is more likely attributable to unrelated musculoskeletal causes.
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