Gender Differences in Low Backache

Low back pain (LBP) is one of the most common causes of disability worldwide, and it varies significantly between men and women in terms of frequency, severity, and chronic progression. Women consistently report a higher burden of low back pain, especially during midlife and after menopause. These differences are influenced by a combination of hormonal changes and musculoskeletal characteristics that affect spinal stability, tissue integrity, and pain perception. Fluctuations in estrogen, progesterone, and relaxin during a woman’s reproductive years lead to increased ligament laxity and joint mobility, which can predispose them to mechanical back pain. After menopause, the decline in estrogen levels accelerates bone loss and intervertebral disc degeneration, raising the risk of vertebral fractures and persistent pain. In contrast, men typically have greater muscle mass and spinal support due to higher testosterone levels. However, as they age and experience hormonal declines, their susceptibility to osteoporosis increases. Several musculoskeletal conditions, including osteoarthritis, rheumatoid arthritis, osteoporosis, fibromyalgia, and disc degeneration, are more common and more severe in women. These conditions can contribute to increased pain sensitivity and chronic pain. This review highlights the key hormonal and structural factors that explain gender differences in low back pain and emphasizes their clinical importance.