Women’s spine health is influenced by unique anatomical, hormonal, and lifestyle factors that can affect pain, mobility, and long-term function. Understanding these differences empowers women to take a more proactive approach to spine wellness. In this Q&A, Dr. de Vere shares insight into the conditions she commonly sees in women and the modern approaches helping patients stay active, strong, and moving well through every stage of life.
Why do women experience spine and pelvic pain differently than men?
Women experience spine and pelvic pain differently because our bodies are designed to accommodate pregnancy, childbirth, and hormonal changes—and those adaptations matter.
First, women generally have greater ligamentous flexibility, influenced by hormones like estrogen. While this flexibility is essential during pregnancy, it can also lead to joint instability, particularly in the pelvis and lower spine.
Second, women tend to carry and distribute load differently through their pelvis, hips, and core. The female pelvic anatomy, combined with differences in muscle activation and core support, places unique demands on the spine—especially during life stages like pregnancy, postpartum recovery, and menopause.
Finally, bone density changes affect women differently. Conditions like osteoporosis disproportionately impact women and can influence spinal alignment, posture, and pain over time.
When we put all of that together, it becomes clear why a “one‑size‑fits‑all” approach to back pain doesn’t work—especially for women.
What is the sacroiliac (SI) joint, and why is it such a common source of pain in women?
The sacroiliac (SI) joint is where the spine meets the pelvis. You have one SI joint on each side, connecting the sacrum at the base of the spine to the pelvic bones.
It’s a small joint, but it plays a huge role in transferring load between the upper body and the legs. In women, the SI joint is particularly vulnerable because of:
- Greater joint mobility
- Hormonal changes that affect ligament stability
- Pregnancy‑related widening and stress on the pelvis
- Repetitive asymmetrical movements (carrying kids, lifting, twisting)
SI joint pain is one of the most commonly overlooked sources of “low back pain” in women. Many patients are told they have a disc problem or generic back strain when the real issue is pelvic instability or SI joint dysfunction.
What symptoms may suggest SI joint dysfunction or pelvic instability rather than a traditional back problem? How do you diagnose it?
SI joint dysfunction often presents differently than classic spine issues. Common symptoms include:
- Pain localized to one side of the low back or buttock
- Pain that worsens with standing on one leg, climbing stairs, or rolling in bed
- Discomfort during transitions—like getting out of the car or off the couch
- Pain that worsens during pregnancy or postpartum
- Referred pain into the hip or upper thigh (but usually not below the knee)
Diagnosis is primarily clinical, meaning it comes from a careful history and physical exam. Imaging can help rule out other conditions, but they don’t always show SI dysfunction clearly. Recognizing SI joint pain early matters, because it changes the entire treatment approach—and leads to much better outcomes.
What treatment approaches are most effective for female spine and pelvic conditions?
For most women, the most effective care is conservative, targeted, and integrated. That typically includes:
- Stability‑focused physical therapy (not just stretching or strengthening, but retraining how the body moves)
- Core and pelvic floor rehabilitation
- Education on posture, lifting, and daily movement patterns
- Manual therapy when appropriate
- Image‑guided injections for diagnostic clarity or pain relief when needed
Surgery is rarely the first step, and for many pelvic‑driven conditions, it’s not needed at all. The goal is always to restore stability, movement confidence, and function—so women can stay active and independent in their daily lives.
As a physician—and as a woman and mother—how does your personal experience shape your approach to care?
As a woman and a mom, I understand how easy it is for women to push through pain, put everyone else first, and dismiss symptoms as “normal.” I’ve lived the physical demands of pregnancy, postpartum recovery, and balancing work, caregiving, and health. That perspective makes me especially attentive to listening—really listening—to what my patients are experiencing. It also reinforces my belief that pain is not something women should simply accept as part of life, motherhood, or aging.
My goal is to help women feel informed, heard, and confident in their care—and to intervene early, before pain becomes chronic or limiting.
Women deserve care that recognizes their physiology, respects their lived experience, and supports long‑term wellness—not just symptom management.
SCHEDULE AN APPOINTMENT
Dr. Stephanie de Vere is currently accepting new patients at our Overland Park and Lee’s Summit offices.
