can ectopic symptoms start as early as TWW?

Lindsey • IVF miracle born 12/11/2018, surprise baby #2 due August 2021!
Can you have symptoms of an ectopic pregnancy before you've even gotten a BFP?  I've had pain in my lower back, hips, and abdomen waking me up in the middle of the night for a week now. I think I'm about 8 dpo. I've also been unusually tired. Should I worry about this discomfort or am I being overly paranoid?