When it comes to chronic pain, men and women are not created equal. Women are over-represented in the ranks of those dealing with chronic pain.

See Chronic Pain As a Disease: Why Does It Still Hurt?

Take a look at these 7 chronic pain conditions in the back, and see if the symptoms sound familiar.

• Coccydynia
• Compression fracture
• Degenerative spondylolisthesis
• Fibromyalgia
• Piriformis syndrome
• Sacroiliac joint dysfunction
• Spinal osteoarthritis

See Lower Back Pain Symptoms and Causes

Differences in pelvic structure, hormonal factors, and the impact of pregnancy are often cited to explain why women bear the brunt of chronic pain.

Coccydynia (tailbone pain) makes sitting painful

A relatively uncommon cause of chronic pain in women is coccydynia, or tailbone pain. Your pain can come on gradually or suddenly after an impact to the area at the end of your spine.

See Anatomy of the Coccyx (Tailbone)

The tailbone is often painful to the touch, so sitting, horseback riding, or anything that puts pressure on the area hurts. Constipation adds to the pain, but the pain is lessened after a bowel movement.

Women are 5 times more likely than men to develop coccydynia. Pregnancy-related injuries and the less-protected position of the tailbone in women are considered major reasons for the disparity.¹

During childbirth, the pressure of the baby’s head against the coccyx can injure the area. One research study of women with coccydynia found a connection between the condition and births that were described as difficult.²

See Tailbone Pain Causes

While coccydynia is most often caused by childbirth or a backward fall, doctors can’t always pinpoint the cause. The coccyx isn’t flexible enough to bend with pressure, resulting in injury to the coccyx, the nearby ligaments, or both.

See Diagnosis of Coccydynia (Tailbone Pain)

Coccydynia affects women of all ages, but age 40 is the average age of onset. It usually goes away in weeks or months, but it can become chronic and impact daily life, preventing you from driving or bending over without pain. Rarely, coccydynia may be due to a tumor or infection.

See Treatment for Coccydynia (Tailbone Pain)

When a bone in the spine breaks as a result of osteoporosis, or thinning of the bones, it’s called a compression fracture. The fracture usually happens in the front of the spine, where the front of the bone collapses. The back of the bone is usually not affected.

The fracture typically follows some sort of movement affecting the spine—from a sneeze to a fall. A compression fracture is most likely in the lower part of the upper back and can cause sudden, severe back pain, but some people don’t feel any pain. A compression fracture can also cause a rounded hump in the back and a loss of height.

Women are nearly twice as likely as men to have a compression fracture. This is because compression fractures are caused by osteoporosis, and women are much more likely to have osteoporosis.

If you’re a woman older than 45 and have sudden, intense back pain—especially if you’re at risk for osteoporosis—it’s best to get to the doctor quickly. Risk factors for osteoporosis include having a personal or family history of fractures or osteoporosis and having a small body frame.

Even if you aren’t in pain, it’s best to see a doctor as soon as possible after a spinal compression fracture since the injury can limit mobility.

Degenerative spondylolisthesis results in back and leg pain

Spondylolisthesis gets its unusual name from the Latin word for “slipped vertebral body.” When one of your lumbar (lower back) vertebrae moves forward over the one below it, you have a condition called degenerative spondylolisthesis. The movement of the vertebra can irritate the nearby spinal nerve root, causing pain in the lower back and legs.

Symptoms sometimes include aching or weakness in the legs with extended walking or standing. Sitting down often eases the pain. Spondylolisthesis pain can be severe enough to limit your daily activities.

The condition is much more common in women than men, with women over-represented by a 3-to-1 ratio. Hormonal factors, differences in pelvic structure, and lower bone density in women are among potential reasons for the gender imbalance. Osteoarthritis also often plays a role in the condition, and more women when than men have osteoarthritis.³

Degenerative spondylolisthesis is most likely to develop when you’re age 50 or older. Age-related weakness of joints and ligaments makes it more difficult for your spine to stay aligned, leading to the condition.

Fibromyalgia causes widespread pain and fatigue

Muscle pain, stiffness, and fatigue—often in areas known as tender points—are the hallmarks of fibromyalgia. Because the condition has an impact on the muscles, joints, and bones, fibromyalgia is classified as a rheumatic condition. If you have fibromyalgia, you may have pain in the upper and lower back, neck, and hips.

Symptoms may go away for a time, then reappear for no clear reason—sometimes in a new location. If you have fibromyalgia, you may have other conditions as well, with arthritis, depression, and irritable bowel syndrome three common coexisting conditions.

About 80% to 90% of those with fibromyalgia are women, generally between age 40 and 75. It is not clear why more women than men have fibromyalgia. Hormonal influences may play a role, since fibromyalgia is most common during the years leading up to menopause and beyond, when estrogen levels decline.

Piriformis syndrome can mimic sciatica pain

Your piriformis muscle stabilizes your hip joint and makes walking and other movements possible by enabling rotation of the thigh. The condition known as piriformis syndrome occurs when the piriformis muscle deep in the buttocks spasms and pushes against or aggravates the sciatic nerve. The pressure on the sciatic nerve can trigger pain, numbness, and tingling all the way down your leg and into your feet, as happens with sciatica.

Other common symptoms include a dull ache in your buttocks, pain when climbing stairs or walking up a hill, and worsening pain—usually on one side of the body—the longer you sit. Symptoms usually get better when you lie on your back.

Piriformis syndrome is most prevalent in women age 40 to 60. Women are 6 times more likely than men to have piriformis syndrome.⁴

Doctors aren’t certain why more women have the condition, but differences in anatomy between men and women, especially in the pelvis, are often cited. The tendency for the pelvis to be wider in women results in a sharper inward angle of the thigh bone. Hormonal changes, especially those affecting the pelvic muscles during pregnancy, may often contribute. Pelvic changes during pregnancy can also stress the area, leading to piriformis syndrome.

Overuse or an injury can cause piriformis syndrome, but in most cases the cause is not clear.

If you do a lot of running or other repetitive movements, you could be putting pressure on the muscle and causing it to tighten. Professional drivers, skiers, tennis players, and long-distance bicyclists are at an extra risk for piriformis syndrome.

Stiffness, Pain Common in Spinal Osteoarthritis

When you think of osteoarthritis, you may think of aching knees or hips, but your back is not exempt from this most common kind of arthritis.

Spinal osteoarthritis is a degenerative joint disease that causes a breakdown of the fibrous cartilage in the facet joints connecting your vertebrae. Without the cushioning provided by the cartilage, your bones rub together, leading to changes in the bones’ shape. In the spine, bone spurs can develop on the vertebrae.

Joint degeneration can occur in many parts of the body, so spinal osteoarthritis pain may be felt in your upper or lower back, neck, shoulders, groin, buttocks, or even the back of your thighs. Symptoms vary, but often include back stiffness and pain in the morning after getting out of bed and a dull ache, with occasional flares of severe pain.

Spinal osteoarthritis develops gradually as the years go by, and you may at first mistake it for muscle aches. Osteoarthritis affects all ages. It is more common in men until age 45, but after age 45 it is more common in women. Overall, 26 percent of women have arthritis, compared with 18 percent of men.

Stretches, water therapy, and physical therapy are usually favored over surgery for osteoarthritis.

Sacroiliac joint dysfunction

Your sacroiliac joint, also called the SI joint, plays a crucial role as a shock absorber between your upper body and your pelvis. When something goes wrong, triggering pain, you have a condition known as sacroiliac joint dysfunction, or SI joint pain.

Low back and leg pain, similar to that experienced with sciatica, are common. Other symptoms include pain on one side of your buttocks or low back that radiates down the leg, ending either just before the knee or continuing into the ankle or foot. Pain is usually worse after you stand for an extended time, bend, or climb stairs.

Doctors aren’t certain what prompts sacroiliac joint dysfunction, but a change in the pattern of movement in the joint is generally suspected.

Sacroiliac joint dysfunction is more likely to occur in young and middle-aged women. While more women than men have SI joint dysfunction, estimates of the extent of the disparity vary widely.

The impact of pregnancy is one reason women are more likely to have sacroiliac joint pain. During pregnancy, the body releases a chemical that relaxes the ligaments and joints, allowing more space for the baby during childbirth. The pressure and weight of the baby can also stress the pelvis. SI joint pain can occur during pregnancy and the effects on the ligaments may linger after birth. An accident, such as a fall, may also harm the ligaments.

Chronic pain is not only more common in women than men, the symptoms are often more severe. Awareness of a chronic condition is the first step toward early treatment to ease your pain and help keep the problem from getting worse.

Finding just the right gift for someone with chronic pain is often a challenge for friends and loved ones. Try sharing this list to help gift-givers know what you’d like.

A gift card for a massage could be a beneficial gift option for someone with chronic pain.

Inexpensive gift options for people with chronic pain

A gift doesn’t need to be expensive to be useful. Several items that can help a person in pain be more independent or comfortable include:

• Extension shoe horn to avoid painful bending
• Long-handled brushes or combs
• Padded lap desk
• Reachers, also called grabbers, to pick up items that have fallen or are too high up to reach otherwise
• Fluffy seat belt covers for people with pain in the upper body
• Microwaveable heat wraps
• Swivel seat for getting out of a car seat without painful twisting
• Relaxation CDs and DVDs
• Ergonomic keyboard or mouse
• Folding cane

Some of these items can be found at your local drugstore, a medical supply store, or automotive products retailer, as well as online. If it’s important for the fabric on a product to be soft, it may be best to shop in a store, rather than go online, to be sure the product won’t irritate the skin.

Gifts for shower and bath comfort

A long, hot bath or shower can make everyone feel better. These products are likely to enhance the experience:

• A hand-held attachment for the shower, allowing the person to sit
• A cushioned bath pillow or cushioned shower seat for long soaks
• A sturdy grab bar or two
• Bath soaks, such as eucalyptus and Epsom salts, but check about scent sensitivities first. Scented items sometimes trigger symptoms for people with migraine headaches or fibromyalgia.

More expensive gifts

Gift-givers with a bigger budget may want to consider one of these items:

• Rolling walker with a built-in seat and backrest allows the person to stop and take a rest if needed. Having the option to sit down allows the person to be venture out more. Some walkers have a basket and/or bag for carrying extra items. Walker covers in everything from leopard prints to camouflage styles can be purchased separately to customize the walker.
• Blackout curtains for people who are sensitive to light can help ease symptoms and allow people to sleep more soundly.
• A padded portable power seat, also called a seat assist, makes getting out of a chair more comfortable. These seats may be easiest to find online or at a specialty store.
• Gift cards for a massage, manicure/pedicure, housecleaning, or a restaurant (especially one that delivers) are often welcome options.

Sometimes a personal IOU or homemade gift card is the best present of all. A gift card for dog-walking, snow-shoveling, a couple hours of babysitting, or running some errands can be just what a person needs.

If you have chronic back pain or are recovering from back surgery, you may be wondering how you’re going to manage the holidays.

The family togetherness is great, but all the events and obligations can make the season exhausting—and painful. Try the following strategies for a less hurried, more comfortable time.

1. Save your energy for what’s important

Before the holidays are in full swing, think about what you really enjoy about this time of year. If a longtime tradition has become more of a chore than a celebration, cross it off your list.

It may be helpful to make a few tweaks in holiday festivities that require a lot of standing or twisting. If you love to bake cookies, for instance, see if a friend or relative would like to stop by and help so you aren’t bending over a hot oven yourself.

2. Pace yourself

It’s easy to get wrapped up in the holiday spirit and end up paying for it later.

To avoid pushing yourself too hard, start thinking now about what can be done ahead of time. That could mean cooking a one-dish favorite, such as lasagna, and freezing it to serve when company arrives. Getting out the holiday decorations and checking to see if any lights need to be replaced now could save time later. If clothes need to be ironed or sent to the cleaners for a big holiday event, take care of that soon too.

Avoid a last-minute scramble to clean up household clutter by tackling a small area every couple of days. Put together a countdown schedule of what should be done three weeks in advance, two weeks in advance, and so on, to stay on track.

When the holidays arrive, pay attention to your pain. Take a nap or sit in the recliner with a heating pad and a movie. Make a good night’s sleep a priority; if you have company, don’t rush to get out of bed in the morning and make everyone breakfast. Set out cereal and bowls so they can help themselves instead.

3. Let others help

You’ve probably had people ask you to let them know “if there’s anything I can do.” This is the time to have a ready answer, whether it’s picking up the ingredients for a pumpkin pie, shoveling the sidewalk, or bringing in the Christmas tree.

Any kind of exertion that could add to your pain or jeopardize your recovery should be delegated to someone else. If you can’t avoid hosting duties, draw up a detailed list of duties well in advance—and leave yourself off the list. Distribute the list to everyone early on.

4. Keep moving—safely

Climbing a ladder to put up a string of lights should be avoided, but don’t abandon your exercise routine. Stretches and gentle aerobic exercises, such as walking, can help improve your outlook by producing endorphins, the body’s natural pain reliever.

Exercise can help counteract depression, which commonly develops alongside chronic pain.^1,2Swimming or doing water exercises in a warm pool can be a soothing, healthy break from the holiday rush. (If you’re recovering from surgery, your doctor has probably outlined the safest moves.)

5. Plan ahead for gift-buying

Standing in long lines at crowded stores is likely to be uncomfortable at best, excruciating at worst.

If you usually exchange gifts, tell family members you need gift ideas right away. Then try to buy everything at one store, or deputize a friend or relative to do the shopping for you.

Ordering some or all gifts online or from a catalog can also give make your life easier. If someone on your list doesn’t give you an early suggestion, don’t let it derail your plan. Buy the person some colorful socks, a scarf, or a gift card and call it a day.

6. Get some meals delivered

A growing number of restaurants and retailers offer delivery. Call your favorite restaurant or check its website to learn about delivery or carry-out options. Some restaurants and grocery stores offer economical dinner packages for a group. Avoiding the bending, lifting, and twisting involved in shopping and cooking for a large group is probably worth the cost of the meal.

7. Consider hiring help

Are the dust bunnies in the corner driving you crazy? A housecleaner may be a good investment to avoid painful positions as you scrub and vacuum.

Ask friends and neighbors who have cleaning help to recommend someone, or check on Angie’s List or Care.com. You may also contact your local middle school or high school to see if there are students who need to volunteer to earn community service hours.

If you already have occasional cleaning assistance, it may be worthwhile to have the housecleaner come more often until the holidays are over.

Setting priorities and doing less can difficult, especially if you’re someone who usually takes care of everyone else. By planning ahead and delegating duties, and making a real commitment to honor your own needs, you’re less likely to push yourself too far and make your pain worse.