Yes, fibroids can cause lower back pain. ACOG lists "pain in the abdomen or lower back (often dull, heavy and aching, but may be sharp)" among fibroid symptoms. Leg pain from fibroids is much less common. It has been reported when a large fibroid presses on a nerve in the pelvis, or when pressure on pelvic veins contributes to a blood clot. Most back and leg pain has other causes, though, so fibroids should be confirmed, not assumed.
How fibroids can cause back pain
Back pain from fibroids is usually a "bulk" symptom. It comes from the size and position of the fibroids, not from bleeding. A 2017 American Family Physician review groups low back pain with pelvic pressure, bowel problems and urinary frequency as bulk symptoms. It notes that symptoms depend on "the size, number, and location" of the fibroids. A 2020 review in the International Journal of Gynecology & Obstetrics also lists back pain among the symptoms seen in women with more severe fibroid disease.
Position matters because the uterus sits between the bladder in front and the rectum behind. Fibroids pushing forward tend to cause frequent urination. Fibroids on the back wall of the uterus push toward the rectum and the lower spine. ACOG lists constipation, rectal pain and difficult bowel movements as fibroid symptoms, and these often travel with a deep, dull ache low in the back.
Sudden, sharper pain is different. ACOG notes that fibroids that grow rapidly or start breaking down may cause pain. A fibroid on a stalk can twist, which can cause pain, nausea or fever. Read more about degenerating fibroids.
Can fibroids cause leg pain?
Occasionally. There are three main routes, and they need very different care.
- Nerve pressure (rare). In a 1999 case report from a New York hospital, a 55-year-old woman had buttock and leg pain with foot numbness. She was treated for a pinched spinal nerve without improvement, and a spine MRI showed no disc herniation. A pelvic MRI then showed a large fibroid pressing on the sciatic nerve where it leaves the pelvis. Her leg pain resolved after surgery. The authors called it the first reported case of its kind. This is a rare cause, but it shows why pelvic imaging can matter when spine imaging does not explain leg symptoms.
- Vein problems. A 2009 review of acute fibroid complications lists deep vein thrombosis (a blood clot in a deep vein), "usually due to pelvic venous compression." A large fibroid uterus can press on the veins that drain the legs. Separately, vein reflux in the pelvis or legs can cause aching, heaviness and swelling that has nothing to do with fibroids.
- Artery problems. Leg pain that comes on with walking and eases with rest can be a sign of peripheral artery disease (PAD), which narrows the arteries to the legs.
Telling leg pain causes apart
| Pattern | Possible cause | Next step |
|---|---|---|
| Swelling, pain or tenderness, warmth, and redness or discoloration, usually in one leg | Deep vein thrombosis (CDC signs) | See a doctor as soon as possible. Seek emergency care if you also have trouble breathing or chest pain. |
| Dull ache, heaviness or cramping that is worse when standing and better with legs raised; swelling; varicose veins | Venous insufficiency (MedlinePlus) | Vein evaluation |
| Positional low back, pelvic and upper thigh pain that worsens through the day; varicose veins on the back of the thigh or buttock | Pelvic venous disorder, sometimes called pelvic congestion | Evaluation by a vein specialist |
| Pain, aching, heaviness or cramping in the calf, thigh or buttock that comes with walking and eases with rest | Peripheral artery disease (NHLBI) | Artery evaluation |
| Pain shooting from the buttock down the leg, numbness or tingling | Usually a spine problem; rarely a pelvic mass pressing on the nerve | Spine evaluation; pelvic imaging if that does not explain it |
The pelvic vein pattern above comes from a 2013 review by Durham and Machan. Because its symptoms overlap with fibroid pressure, we compare the two in fibroids or pelvic congestion. If vein symptoms sound familiar, see our page on vein treatment for women. If walking brings on the pain, read about PAD in women. The NHLBI notes that more than half of people with PAD have symptoms that do not fit the textbook pattern.
Questions about your treatment options? Dr. Fox can help.
Book a ConsultationThis article is part of our Fibroid Treatment Guide.
Other causes of back pain to rule out
Back pain is very common, and fibroids are a minority cause. MedlinePlus explains that sudden low back pain is most often caused by an injury to the muscles and ligaments that support the back. Other causes include:
- Herniated disks, sciatica and spinal stenosis
- Spinal fractures
- Kidney stones or kidney infection
- Pregnancy
- Rarely, a leaking abdominal aortic aneurysm, a weakened and bulging section of the body's main artery
The CDC also lists abdominal or back pain, together with bloating, pelvic pressure and urinary changes, among possible signs of ovarian cancer. It advises seeing a doctor if any of these signs last 2 weeks or longer and are not normal for you. Ovarian cancer is far less likely than the other causes listed here, but persistent new symptoms deserve an exam.
When back or leg pain needs urgent care
MedlinePlus advises contacting a provider right away for back pain with any of the following:
- Loss of control over urine or stool
- Weakness or numbness in the buttocks, thigh, leg or pelvis
- Unexplained fever
- Pain after a severe blow or fall
- Pain that runs down the leg below the knee
Seek emergency help for sudden trouble breathing, chest pain that worsens with a deep breath, or coughing up blood. The CDC lists these as signs of a blood clot in the lungs. Severe new pelvic pain with fever or vomiting also needs same-day care.
How doctors check whether fibroids are the cause
A 2025 American Family Physician evidence review recommends starting a fibroid evaluation with a full history and an abdominal and pelvic exam. Pelvic ultrasound, done through the abdomen and the vagina, is the first imaging test. MRI with contrast can show the size and position of each fibroid more precisely. The key question is whether the fibroids are large enough, and positioned in a way, that could explain your pain. If they are not, the search should continue elsewhere.
Treatment when fibroids are to blame
If imaging shows fibroids are a likely cause, the options are the same ones used for other bulk symptoms. The 2025 review notes that procedures, not medicines, are what reduce bulk symptoms. Those include myomectomy, hysterectomy, uterine artery embolization, radiofrequency ablation and focused ultrasound. CIRSE, the European interventional radiology society, lists "pain, pressure" among the complaints embolization is used to treat. Be aware that studies usually measure overall pain and pressure scores, and good data on back pain alone are limited. Results also take time, because fibroids shrink gradually over months. Read more on our uterine fibroid embolization (UFE) page, or compare surgery, medicines and embolization in our fibroid treatment guide.
Dr. David Fox is a board-certified vascular surgeon. When back or leg symptoms could come from fibroids, veins or arteries, it helps to see a specialist who can look at all three before you settle on a cause.
Frequently Asked Questions
Can fibroids cause lower back pain?
Yes. ACOG lists lower back pain, often dull, heavy and aching, among fibroid symptoms. It is usually a pressure symptom from the size and position of the fibroids.
Can fibroids cause sciatica or leg pain?
Rarely. Case reports describe large fibroids pressing on the sciatic nerve inside the pelvis. Most sciatica comes from the spine, so the spine is usually checked first, with pelvic imaging if that does not explain the symptoms.
Can fibroids cause leg swelling?
A large fibroid uterus can press on pelvic veins, and a 2009 review lists deep vein thrombosis from pelvic venous compression as a rare complication. New swelling, pain, warmth or redness in one leg should be checked by a doctor as soon as possible.
How do I know if my back pain is from fibroids?
A pelvic exam and ultrasound, sometimes followed by MRI, show whether you have fibroids large enough or positioned to explain the pain. If they do not, other causes such as muscle strain, disks or kidney problems need to be looked at.
Will treating fibroids help back pain?
If fibroids are the cause, procedures that remove or shrink them can ease pressure symptoms. Studies usually measure overall pain and pressure rather than back pain alone, so ask your doctor how likely relief is in your case.
Keep Reading
- Uterine Fibroid Embolization (UFE) in New York City
- Fibroids or Pelvic Congestion Syndrome? How to Tell Them Apart
- Fibroids and Frequent Urination: When Fibroids Press on the Bladder
- Degenerating Fibroid: Symptoms and When to Go to the ER
- Fibroid Symptoms: 9 Signs to Know
- Fibroid Diagnosis: Ultrasound vs MRI
- Fibroid Treatment Guide: every option, compared
Sources
- ACOG patient FAQ — Uterine fibroids (reviewed December 2025)
- De la Cruz & Buchanan, Am Fam Physician, 2017 — Uterine fibroids: diagnosis and treatment
- Giuliani et al., Int J Gynaecol Obstet, 2020 — Epidemiology and management of uterine fibroids
- Keating et al., Am Fam Physician, 2025 — Uterine fibroids: rapid evidence review
- Bodack et al., Am J Phys Med Rehabil, 1999 — Sciatic neuropathy secondary to a uterine fibroid (case report)
- Gupta & Manyonda, Best Pract Res Clin Obstet Gynaecol, 2009 — Acute complications of fibroids
- CDC — About venous thromboembolism (updated March 2025)
- MedlinePlus — Venous insufficiency (reviewed June 2026)
- Durham & Machan, Semin Intervent Radiol, 2013 — Pelvic congestion syndrome
- NHLBI — Peripheral artery disease: symptoms
- MedlinePlus — Low back pain, acute (reviewed June 2026)
- CDC — Symptoms of ovarian cancer (updated February 2025)
- van Overhagen & Reekers, Cardiovasc Intervent Radiol, 2015 — CIRSE standards of practice for uterine artery embolization
Medically reviewed by David Fox, MD, FACS, RPVI. This article is general information, not a substitute for a medical evaluation.
Living with heavy periods, pelvic pressure or other fibroid symptoms? Schedule a consultation with Dr. David Fox at Fox Vein & Vascular in Manhattan to find out whether uterine fibroid embolization is right for you. Call (212) 362-3470 or request a UFE consultation online.
