What Causes Period Cramps So Bad You Can’t Move?

You're not alone if you experience intense, debilitating cramps before, during, or after your menstrual cycle (period). More than half of those who menstruate have mild to moderate pain for a couple of days. 

Though it's typical to have some discomfort with your period, it should be a low-level annoyance instead of excruciating pain. Underlying medical conditions, like fibroids or pelvic inflammatory disease (PID), can cause period cramps so bad you can't move.

Severe period cramps might:

• Affect movement 
• Keep you home from school or work
• Prevent you from sleeping
• Lead you to the emergency room
  

This article reviews the characteristics of severe period cramps, their causes, how long cramps should last, diagnosis, relief, and treatment. 

What Qualifies as Severe Period Cramps?

Severe period cramping is intense lower abdominal (belly) pain. It’s typically constant and may feel like a dull ache or a throbbing pain (like muscle contractions). 

It’s challenging to find relief from severe cramps, which can be debilitating. They can make it hard to get out of bed or do anything other than focus on the pain.

If period cramps are severe and hinder your ability to go about daily life, there may be an underlying issue that needs attention. A few causes of severe period cramps include:

• Primary dysmenorrhea (painful periods)
• Endometriosis
• Adenomyosis
• Pelvic inflammatory disease (PID)
  

'Normal' vs. Unbearable Period Pain

Some mild to moderate cramps for a couple of days with your period are typical. You can find relief with "normal" period pain through natural remedies or over-the-counter pain medications. 

Normal period cramps should be an annoyance but not excruciating. Unbearable period pain is so intense it affects your ability to move around or participate in regular activities. 

Experiencing intense, debilitating cramps is not "normal" and involves: 

• Pain that interferes with daily life, school, and work
• Pain not relieved with over-the-counter (OTC) medication
• Pain that lasts more than a few days
• Pain that feels different than usual
• Cramping that makes it difficult to get out of bed or walk

You may also have the following symptoms: 

• Back, hip, or leg pain 
• Intense headaches or migraines
• Flu-like symptoms (aches, fatigue, chills, lightheadedness)
• Nausea, vomiting, diarrhea

Causes of Horrible Period Cramps

Primary and secondary dysmenorrhea (period pain) are the leading causes of horrible cramps. However, several underlying medical conditions can contribute to secondary dysmenorrhea.

Primary Dysmenorrhea

Primary dysmenorrhea (PD) occurs without any underlying medical condition, typically due to high levels of the hormone prostaglandin, which causes the uterus to contract.

Secondary Dysmenorrhea 

Secondary dysmenorrhea (SD) is due to an underlying medical condition of reproductive organs, including those listed in this section. 

Secondary dysmenorrhea pain characteristics involve:

• Pain that gets worse over time 
• Long-lasting menstrual cramps 
• Painful periods in females over 24 
• Pain with sex

Endometriosis

Endometriosis affects 5–10 million reproductive-aged women in the United States. It occurs when tissue similar to the endometrium (uterine lining) grows outside the uterus, usually in the pelvis (between the hips) or reproductive organs. Endometrial-like tissue or lesions bleed but don’t have a way to leave the body, causing pain. 

Fibroids

Uterine fibroids are non-cancerous growths that develop in the uterine wall and may also involve: 

• Heavy bleeding and clotting
• Backaches
• Long-lasting cramps

Pelvic Inflammatory Disease (PID)

Pelvic inflammatory disease (PID), an infection of the reproductive organs, occurs in over 1 million women annually in the United States. 

Sexually transmitted infections (STIs) such as chlamydia and gonorrhea are the most common cause. But other non-STI vaginal infections, such as bacterial vaginosis (unbalanced vaginal flora), can also cause PID. Left untreated, PID can lead to infertility and may involve: 

• Fever 
• Unusual vaginal discharge
• Irregular periods
• Urination pain 
• Pain with sex

Adenomyosis

Adenomyosis is similar to endometriosis, but the endometrial-like tissue doesn’t leave the uterus. It spreads to the myometrium (uterus muscles) and causes pain in your abdomen, hips, or lower back.

Intrauterine Device (IUD)

A healthcare provider inserts an intrauterine device (IUD) into the uterus for pregnancy prevention. Many women note that hormonal IUDs help relieve cramping. However, hormonal and copper IUDs can also cause irregular periods and worsen cramping. 

How Long Should Period Cramps Last?

Cramps typically begin before or when bleeding starts and last for around two to three days. Signs your cramping is going on for longer than "normal" include:

• Cramps that start several days before your period
• Cramps that don't go away until after your period ends 

How Are Bad Period Cramps Diagnosed?

Your healthcare provider will diagnose dysmenorrhea with a medical history, abdominal and pelvic exam, and diagnostic tests, including:

• Sexually transmitted infection (STI) tests
• Pregnancy test
• Urinalysis (urine test)
• Transvaginal ultrasound
• Magnetic resonance imaging (MRI)
• Laparoscopy (rare)

Relief for Period Cramps When You Can’t Move 

You can try the following remedies for bad cramps. Ask your provider before taking a new medication, homeopathic treatment, or heat (or cold) therapy. 

If the pain persists, seek emergency care.

• Change positions: Changing positions may take pressure off a nerve. 
• Over-the-counter (OTC) pain reliever: This includes non-steroidal anti-inflammatory drugs (NSAIDs) such as Tylenol (acetaminophen), Advil and Motrin (ibuprofen), or Aleve (naproxen). 
• Heat: Heat therapy relaxes tissues and stimulates blood flow. You can use a heating pad, hot water bottle, or disposable heat patch. Try a warm bath when you can move more freely.
• Topical medications: Place topical (on the skin) patches, gels, or creams over sore areas in the lower back. This includes Aspercreme (trolamine salicylate) and Icy Hot (methyl salicylate-menthol).
• Arnica: Arnica is a homeopathic treatment for inflammation and pain. It comes in teas and pellets. Try taking it in addition to your pain medications. 
• TENS machine: Transcutaneous electrical nerve stimulation (TENS) machines use electrodes to deliver mild electrical impulses to relieve pain. Some are available over the counter. 

Medical Treatment for Bad Period Cramps 

Unbearable cramps are not a “normal” part of menstruation, and it’s best to talk to a healthcare provider about relief options. If they disregard your symptoms, consider talking to them again or seeking another opinion.

In addition to the treatments mentioned above, medical treatment may involve:

• Hormones (common and includes hormonal birth control)
• Prescription pain relievers
• Physical therapy
• Surgery (in extreme cases)
• Acupuncture or acupressure

Lifestyle Changes

Lifestyle changes that minimize cramping include: 

• Hydration: Dehydration can worsen cramping, headaches, and fatigue. Drink plenty of water and avoid dehydrating drinks like alcohol and caffeine. 
• A healthy diet: Highly processed foods can lead to inflammation and cramping. Try including more fresh fruits and vegetables.
• Stop smoking: Cigarettes cause blood vessel constriction, which reduces blood flow to the uterus and worsens cramps.
• Exercise: Movement improves blood circulation, reduces inflammation, and stimulates serotonin and endorphins (natural mood-elevating chemicals and pain relievers). 

How to Prepare for Painful Menstrual Cycles 

The following are a few things that can help you prevent and manage painful periods. 

Keep Supplies Handy

Keep medications, tampons, pads, and disposable heat wraps nearby. If you feel your period sneaking up on you or it begins, take pain medications and place the heat wrap as soon as possible. Supplies can also include extra water, snacks, or arnica pellets.

Schedule Pain Medicine

Scheduling pain medicine can help prevent severe pain. Try taking NSAIDs (OTC or prescription) the day before your period is due or as soon as you start cramping or bleeding. If your healthcare provider OKs it, try taking them on a schedule during your period, regardless of your pain level. 

Massage

A massage can help relax your muscles and reduce stress. The stress hormone cortisol causes inflammation and muscle tension. Some find it helpful to give themselves a gentle tummy massage before and during their period.

Pamper Yourself

Pamper yourself with a warm bath or a soft blanket and heating pad. Add your favorite bath salts, aromatherapy, book, or movie. This helps release muscle tension and stress. Remember to drink plenty of water (plain or infused) or non-caffeinated herbal or arnica tea.

Summary

Mild to moderate period cramps that last a couple of days are typical. You should find relief with natural remedies or over-the-counter pain medications. Excruciating period pain affects your ability to move around or participate in regular activities and is not “normal.” If you have severe period pain, speak with your healthcare provider about treatment options or schedule an exam or tests to check for underlying health conditions.