Can Pernicious Anemia Lead to Back Pain?

Pernicious anemia is a condition where your body can’t absorb vitamin B12, an important nutrient that helps make red blood cells and keeps your nerves healthy. Without enough B12, you may feel tired, weak, and in some cases, experience back pain. Not everyone with pernicious anemia will have back pain, but there is a clear connection. Since B12 is essential for nerve and muscle health, a deficiency can lead to discomfort. Knowing how these issues are linked can help you manage symptoms more effectively and improve your overall well-being.

How Pernicious Anemia Affects the Body

Pernicious anemia happens when your body doesn’t make enough of a special protein needed to absorb vitamin B12 from food. Without enough B12, your body can’t produce healthy red blood cells, which means less oxygen reaches your muscles and organs. When your muscles don’t get enough oxygen, they become weak and tired, which can lead to pain—especially in your back.

The link between pernicious anemia and back pain isn’t always obvious, but it’s real. Since vitamin B12 is crucial for nerve health, a deficiency can cause nerve damage, leading to pain, tingling, or numbness, including in the lower back. The nerves around the spine are particularly sensitive, so when they’re affected, back pain can become a bigger issue, especially if left untreated.

B12 deficiency can also weaken the muscles that support your spine. These muscles need oxygen to stay strong, and without it, they lose endurance, leading to poor posture and increased back pain. Weak muscles also make injuries and strain more likely, which can make the pain even worse over time.

The Connection Between Pernicious Anemia and Back Pain

The connection between pernicious anemia and back pain isn’t always obvious, but it exists. Vitamin B12 is essential for keeping nerves healthy, and when your body lacks it, nerve damage can occur, leading to pain all over—including in your back. This is especially true for the spine, where nerves are highly sensitive. If the nerves in your lower back are affected, you might experience pain, tingling, or numbness, which can get worse over time if untreated.  

A B12 deficiency can also weaken the muscles that support your spine. These muscles need oxygen to stay strong, and without enough B12, they become weaker, leading to poor posture and a higher chance of back pain. Weakened muscles also make injuries and strain more likely, which can make the pain even worse.

How Vitamin B12 Deficiency Contributes to Back Pain

Pernicious anemia can affect the spine in more ways than one. A lack of vitamin B12 doesn’t just impact your blood—it can also cause degenerative changes in the spine. One serious issue is myelopathy, a condition where the spinal cord stops working properly due to nerve damage. As these nerve fibers deteriorate, back pain can develop, and moving around may become harder or more painful.  

There’s also evidence that vitamin B12 deficiency might increase the risk of osteoporosis, a condition that weakens bones and makes them more likely to break. When osteoporosis affects the spine, it can lead to painful compression fractures. If you have pernicious anemia and osteoporosis, your back pain may be even worse, especially if you’ve had previous spinal problems.

Managing Back Pain in Pernicious Anemia

Managing back pain caused by pernicious anemia starts with fixing the root issue—a lack of vitamin B12. Once B12 levels are back to normal, usually through injections or high-dose supplements, many people notice better nerve function and less pain. But treatment doesn’t end there. A combination of physical therapy, lifestyle adjustments, and pain management techniques can help keep back pain under control.  

Physical therapy plays a key role in relief. Strengthening the muscles around your spine can take pressure off your back, while stretching exercises improve flexibility and reduce stiffness. Activities like yoga may also help by promoting better posture and spinal health.  

For some, pain medications like NSAIDs can provide temporary relief, but they should be used cautiously. Instead, focusing on posture, core strength, and movement can be a better long-term solution for managing pain.  

A well-balanced diet is also important for preventing future B12 deficiencies. Foods like eggs, meat, dairy, and fortified cereals can help, but if absorption is an issue, regular B12 injections may be necessary to keep symptoms in check.