Brown discharge and lower back pain: causes, when to worry

Brown discharge is old blood that has taken a while to leave the body. Together with lower back pain, it most often has to do with your period: at the start or end of a period it's very common to have both. But if you are or might be pregnant, if the pain is severe or if you have a fever, contact your doctor or gynaecologist without waiting. We're a chiropractic clinic: we treat mechanical back pain, not the cause of the discharge, and this article doesn't replace a medical assessment.

Common, usually harmless causes

Start or end of your period: brown discharge is older blood, and lower back pain is common during a period because of uterine contractions.
Ovulation: some women have light spotting and pain mid-cycle, sometimes on one side.
Hormonal contraception: spotting between periods, especially in the first months or after switching method.
Perimenopause: cycles become irregular and spotting appears.

If you are or might be pregnant

Early in pregnancy there can be light implantation spotting.
Even so, any bleeding in pregnancy should be checked with your midwife or gynaecologist the same day.
Go to A&E if the bleeding comes with severe pain, especially on one side of the abdomen, dizziness or fainting, shoulder-tip pain, or if the bleeding increases. It can point to an ectopic pregnancy or a threatened miscarriage.
If you don't know whether you're pregnant and it's possible, a pregnancy test is a good first step.

Causes that need a medical assessment

Infection: smelly discharge, pelvic pain, fever or pain during sex (possibly pelvic inflammatory disease).
Endometriosis: very painful periods, lower back or pelvic pain that worsens with your period, pain during sex.
Fibroids or polyps: heavy periods or bleeding between periods.
Urinary or kidney infection: pain on one side of the lower back, fever, burning when passing urine or blood in your urine (which isn't the same as vaginal discharge).
Bleeding after the menopause: always get it checked.

And the back pain itself

Lower back pain is very common and almost always mechanical: it changes with posture and movement, improves when you move and gets worse after staying in one position for a long time. If it only appears with your period, it most likely comes from the uterus. If it comes on its own, or carries on once the discharge has stopped, it may be mechanical low back pain. See low back pain.

What to do

Note where you are in your cycle: does it match the start or end of a period, or ovulation?
If you might be pregnant, take a test and call your midwife or gynaecologist.
Gentle heat on the lower back or lower abdomen and gentle movement usually ease period pain.
Keep a note of whether it repeats, how long it lasts and any other symptoms, to tell your doctor.

When to go to A&E

Bleeding with severe abdominal or pelvic pain.
Dizziness, fainting or feeling you might faint.
High fever with lower back or pelvic pain.
Heavy bleeding (soaking a pad every hour for several hours).
Any bleeding with pain in pregnancy.

How we treat it at the clinic

Only the mechanical back pain, and always after your doctor or gynaecologist has assessed the discharge if there was reason to. If you're pregnant, we use techniques adapted to each trimester; we explain them in sciatica in pregnancy.

Frequently asked questions

Is it normal to have brown discharge and back pain before my period? Yes, it's very common in the days before or at the start of a period.

Can brown discharge with lower back pain mean pregnancy? It can be implantation spotting, but it can also be other things. If you might be pregnant, take a test and get advice.

When should I worry? If there's severe pain, fever, dizziness, heavy bleeding, if you're pregnant, or if it happens after the menopause.

Could it be my kidneys? If the pain is on one side of your back, or there's fever or discomfort passing urine, it may be a urinary or kidney infection. See your doctor.

Can a chiropractor treat this? Only mechanical back pain. Your doctor or gynaecologist assesses the cause of the discharge.