What Is The Connection Between Hemorrhoids And Back Pain?

Dealing with hemorrhoids can be stressful, and if other body parts are affected, they may halt your body's normal function, requiring more than over-the-counter medication. Hemorrhoids are itchy, uncomfortable, and painful due to increased pressure in the blood vessels around or in your anal canal.

There is no scientific research to link hemorrhoids and backache. However, one possible theory would be changed in your sitting mechanics due to hemorrhoid pain or discomfort, leading to straining your lower back muscles. Understanding what hemorrhoids are and how they interact with the body is essential to determine their connection to back pain.

What are hemorrhoids?

Hemorrhoids, or piles, are swollen hemorrhoidal tissue in and around your anus. Hemorrhoidal tissue is within the perianal area and anal canal, consisting of small muscles, connective tissue, and blood vessels. When the hemorrhoidal tissue suffers from increased pressure, it becomes enlarged, causing discomfort and pain.

There are two types of hemorrhoids. Firstly, there are internal hemorrhoids, which exist inside the rectum. They are not visible and hardly cause pain, but straining during bowel movements can engorge them, resulting in painless bleeding. 

In some instances, internal hemorrhoids can become prolapsed — bulged veins outside the anus or swelling of the lower rectum. A prolapsed hemorrhoid can be gently pushed back in or go back into the rectum on its own.

External hemorrhoids appear beneath the anus, often irritating and itchy, and cause discomfort and pain. With external hemorrhoids, the severity increases as they can progress from small smears of blood to large puddles of blood.

Can hemorrhoids cause back pain?

From a scientific point of view, there is no link between hemorrhoids and back pain. If anything, there may be an association, not a correlation. Another speculation about the possible connection between hemorrhoids and backache is the location. People with hemorrhoids can complain of pain near the tailbone (coccyx). Such rare pain may be due to the mass effect from engorged hemorrhoids on the susceptible nerves around the area or may be referred pain.

Symptoms of hemorrhoids

If you have internal hemorrhoids, the only symptom you can expect to experience is the presence of blood in your stool, in the toilet, or on tissue paper, as well as perianal pain/discomfort. 

For external hemorrhoids, the symptoms may include one or all of the following:

• Lumps around your anus that feel spongy

• An itchy anus

• Pain around your anus

• Bright red blood after a bowel movement

• Feeling like you still need to pass a stool after going to the toilet

• Mucus on your toilet paper after wiping your anus or in your underwear

You may experience both internal and external hemorrhoids at the same time, a condition known as mixed hemorrhoids. 

Back pain and hemorrhoids

There is no scientific evidence to directly connect lower back pain and hemorrhoids. Back pain, especially low back pain (LBP), is the leading cause of global musculoskeletal problems. Some conditions linked to back pain include:

• Ruptured or bulging disks from an injury or a single excessive strain

• Ligament or muscle strain due to repeated heavy lifting

• Osteoarthritis in a condition known as spinal stenosis 

• Osteoporosis due to brittle and porous bones in the spine's vertebrae 

Anyone can develop back pain, but the chances of it increase with the following risk factors:

• Age 

• Obesity

• Sedentary lifestyle, including smoking

• Poor lifting of heavy materials

• Physiological conditions such as depression and anxiety

Before making a conclusive decision on the cause of your back pain, you should visit your physician for a proper diagnosis. 

Hemorrhoid treatment and pain relief

Piles may halt your life, inconveniencing your daily activities. For instant pain and itch relief, soak your anal area in warm water with Epsom salt, preferably in a sitz bath, for ten minutes, three times a day. 

Other hemorrhoid treatment options include using lidocaine 2% jelly. The medication is prescribed to hemorrhoid patients to relieve pain during and after bowel movements and reduce rectal irritation.

Ointments such as diltiazem 2%, nitroglycerin 0.2 % to 0.3%, and nifedipine 0.03% are used to treat external thrombosed hemorrhoids, promote wound healing, and help heal anal fissures. Most of these medications need to be combined into an ointment prepared by a pharmacy. 

You can also use natural treatments like witch hazel, aloe vera, tree oil, coconut oil, or cold compresses for fast relief. 

Other risk factors for hemorrhoids

Lifestyle factors that can directly or indirectly increase your risk of suffering from hemorrhoids include:

1. Consuming a low-fiber diet

Food rich in fiber is essential to digestive health. Conversely, low-fiber diets (less than 25 to 30 grams of fiber per day) can increase your risk of constipation. Research shows that certain foods can increase your risk of constipation, including:

• Snack foods and frozen foods

• Ice cream

• Fast food

• Cheese

• Chips

• Red meat

Increasing the intake of insoluble fiber may help restore normal bowel function as it helps speed the passage of food through the stomach and intestine.

2. Sedentary lifestyle

Although data linking hemorrhoids and exercise is disputed, a sedentary lifestyle is a risk factor for hemorrhoids. Regular exercise may also help prevent the development of hemorrhoids by mitigating constipation.

Medical risk factors for hemorrhoids include pregnancy, childbirth, obesity, inflammatory bowel diseases (IBD), such as ulcerative colitis and Crohn's disease, chronic constipation/diarrhea, space-occupying pelvic lesion or ascites, and the accumulation of fluid in the abdominal cavity.

The lowdown

No direct scientific research connects hemorrhoids to back pain. If you suspect that your back is being affected by hemorrhoids, visit a doctor as soon as possible for proper medical attention and to find fast relief. 

Frequently asked questions

Can hemorrhoids cause stomach and back pain?

No. Hemorrhoids can be worsened by stomach issues such as diarrhea or constipation, but they cannot cause stomach or back pain.

How do I check myself for hemorrhoids?

Internal hemorrhoids can't be self-diagnosed unless they prolapse (bulge out of the anus). So if you notice blood on your stool, tissue paper, or toilet, go to your physician for a proper check-up. Your anus may feel itchy, uncomfortable, or painful from external hemorrhoids. In addition, your anus may become swollen with light bleeding.

How common are hemorrhoids?

Hemorrhoids, or piles, are common in men and women, affecting one in about 20 adults¹ in the US, and over half of the population of adults above 50 years have hemorrhoids.