Diverticulitis and back pain at first blush may seem unconnected. Diverticulitis is a condition stemming from the lower intestine. Back pain, of course, may have any number of origins – muscle strain, tissue injury, or nerve damage. But, can diverticulitis cause back pain?

Diverticulitis (as part of a category of diverticular disease) is a condition that develops form diverticulosis. This early condition is characterized by the formation of intestinal polyps (diverticula) on the outside of the colon. High pressure in the colon pushes against the weaker spots in the colon where nourishing blood vessels flow through the muscle layer of the bowel wall, supplying blood to the inner wall. Diverticulitis develops when one of these normally benign polyps become inflamed; bacteria from the processed fecal matter in the colon may infect the outside of the polyp. The danger is these bacteria may infect tissues near the outside of the colon; if the infection spreads to the abdominal cavity an illness called peritonitis can develop.  This is often fatal if untreated.  Inflamed diverticula can also cause bowel obstructions leading to chronic constipation. Sometimes, an infected polyp may adhere to a nearby organ in the pelvic cavity, such as the bladder, or it may enmesh with other tissues.

Diverticular disorders most often affect the middle-aged and the elderly. There are few symptoms, and many patients experience none. In that the disease rarely expresses any. Usual indicators, if present, are abdominal pain and rectal bleeding (from a diverticulum that might erode a blood vessel). Other symptoms may include abdominal tenderness, loose bowel movements, and fever. Another symptom, surprisingly, is back pain – the pain from an inflamed diverticulum may radiate outward and express itself in the lower back.

Confirmation of diverticulitis is done in a clinical setting with a barium-enema X-ray examination. A blood test can also confirm the condition is present as the infection will elevate the white blood cell counts.

Treatment for many patients may involve nothing more than switching to a high-fiber diet. This aids in removing bowel material more effectively and completely, and it reduces pressure on existing diverticula. Acute attacks are normally responsive to antibiotic treatment to eliminate infection. Anti-spasmodic drugs (to relieve the muscular spasms in the area of the diverticula) are effective in stopping abdominal pain at its source. More severe cases, as in a blood vessel eroded or ruptured by an inflamed diverticulum, require surgery to correct if severe bleeding is present. In cases of recurrent acute attacks (and in instances where peritonitis appears) surgery is also probably the best solution.

All back pains cannot be associated with diverticulitis, of course. However there is a link between diverticulitis and back pain, especially if the back pain is clearly associated with other common symptoms of diverticulitis.