Research suggests 60 to 80% of people experience low back pain during their lifetime with its prevalence being slightly more common in females than males across all age groups. Back pain in women increases significantly with age. Additionally, a middle-aged subject research comparison reported an increased incidence of low back pain in females versus males post menopause age.
Here are some possible causes for back pain in women.
Menopause and Hormonal Issues:
Research suggests that chronic low back pain (LBP) is one of the most common musculoskeletal challenges women face during menopause. Around 70% of perimenopausal women will experience symptoms tied to estrogen deficiency, with musculoskeletal pain reported in over half of women in perimenopause. Most studies demonstrate that increasing menopausal symptoms correlates to chronic back pain symptoms.
Menstruation or Uterine Dysfunction:
Dysmenorrhea, a uterine dysfunction which is the origin of frequent and severe cramping for women during menstruation, also predisposes back pain in women. The condition is classified as either primary or secondary, and with both types, low back pain is a common symptom.
Primary dysmenorrhea begins when a woman starts her period and perpetuates throughout her life. Its harsh and atypical uterine contractions can result in recurrent and severe menstrual cramping.
Secondary dysmenorrhea usually begins later in life, and it’s caused by another condition such as endometriosis or pelvic inflammatory disease.
Endometriosis:
Endometriosis is a chronic condition that can also be a cause of back pain in females. The condition occurs when tissue that behaves like endometrial tissue grows outside of the uterus, in the pelvic cavity or other areas. The displaced tissue responds to the body's hormonal changes and can cause swelling, pain, spotting between periods, and bleeding. Because the endometriosis growths bleed monthly like the uterine lining, without having a place for the blood to go, the excess fluid irritates and makes the surrounding tissue swell. Consequently, the condition can result in heavy periods, chronic pain, and scar tissue build up. Endometriosis symptoms may present at any menstrual cycle stage. Pelvic pain that radiates down the legs is common, and some females encounter gnawing and throbbing pain that can present from mild to very severe.
Back Problems That May Affect Women More Often
A woman’s reproductive anatomy can sometimes contribute to her back pain, as we’ve seen. On the flipside, however, women can also be susceptible to degenerative conditions that affect the structure of the spine. Back pain is quite common and the average patient experiences one to two episodes of low back pain per year. Low back pain can start in your 20s and can become a recurring problem which can be triggered by various events in life.
Most back pain resolves by six weeks and is considered acute low back pain. When the pain lingers more than 12 weeks it is considered chronic low back pain.
Postmenopausal Compression Fractures:
Research studies suggest that in the United States, about 25% of women will experience vertebral compression fractures (VCFs) of the middle to lower spine throughout their lifetime. The condition occurs more frequently with age, reaching 40% at age 80. These small cracks in vertebrae can cause substantial disability and limit in function. Postmenopausal women have an increased risk of osteoporosis due to hormonal changes that decrease bone mineral density, predisposing bones to fracture. Osteoporosis is estimated to occur in 44 million Americans and low bone mass is present in an additional 34 million Americans.
Spondylolisthesis:
Spondylolisthesis occurs when one vertebral body, the thick oval bone segment in front of the vertebra, slips against an adjacent vertebral body resulting in pain or mechanical symptoms. The pain can radiate through the spine to the hip, back, and into the legs. The condition can be present from birth, attributed to an unknown cause, or acquired. Some research suggests that childbirth and hysterectomies can put women at risk for spondylolisthesis.
Spondylolisthesis is most common in the lower lumbar spine, lower back, though it can also present in the cervical spine. It rarely occurs, except in trauma cases, in the thoracic spine. The thoracic spine is the longest section, and is located between the cervical and lumbar regions.
Piriformis Syndrome:
Sometimes back pain isn’t really back pain, it’s piriformis syndrome. Piriformis syndrome occurs when the piriformis muscle, a small muscle that extends from the lower spine to the top of the femur, involuntarily contracts and compresses or irritates the sciatic nerve. The piriformis muscle aids in helping to rotate and turn the leg and foot outward. It presents with symptoms consistent with sciatica although it’s not spinal in origin.
Piriformis syndrome typically presents with buttock/gluteal pain that shoots, aches, or burns along the leg’s back side, thigh, calf, and Also common is tingling in the sciatic nerve area and buttocks’ numbness. That’s why it’s so commonly mistaken for sciatica.
SI Joint Dysfunction:
Like piriformis syndrome, sacroiliac joint dysfunction can be challenging to diagnose, as it can be mistaken for other low back pain causes.
SI joint dysfunction causes:
Pregnancy: During pregnancy, the increased weight and altered movement can cause additional stress and wear on joints.
Joint Infection: In rare situations, the SI joints can be subject to infection.
Arthritis: Sacroiliac joints can experience arthritis from normal wear and tear, also known as osteoarthritis.
Traumatic Injury: The sacroiliac joints can be injured from sudden impacts like a fall or car accident.
Reports say that despite the array of lower back pain in women, many of the cases don’t end up needing medication or surgery. Most often the pain will resolve on its own without requirements for medication or treatment. It is only such warning signs as pain that lasts more than six weeks, back pain associated with neurologic symptoms down the legs, or a bowel or bladder dysfunction should they be concerned about. If these symptoms or conditions occur, seek medical attention immediately.
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