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The Back Story of Back Pain: The Solution May be In Your Pelvis!

January 5, 2018

We are gynos, and we do pelvic exams, and in fact we find out that as often as not, the real back story to back pain is a treatable pelvic condition. If you are going to massages, PT therapy, or using ice, have you thought about checking back in with your gyno as well? You should! Uterine fibroids, ovarian cysts and pelvic floor problems like prolapse are some of the common causes of lower back pain that have nothing specifically to do with the back.

 

 

 

Back pain is either acute: under a month, or chronic: over 3 months. There are some conditions called subacute that are in that 2 month range, but most causes are acute or chronic! Something new: just hang in for 4 weeks, it might just resolve, as long as there is nothing lie fever or something that you suspect is clearly a red flag alert to speak to a provider about.

 

Tell your gyno:

  1. Rate your pain

  2. Does it interfere with life enjoyment

  3. Does this pain interfere with activity

If the answers to the above questions are yes here’s what to do:

  1. STAY ACTIVE!

  2. Read about the Back pain initiative from the ABIM; http://www.choosingwisely.org/patient-resources/imaging-tests-for-back-pain/

  3. Get a pelvic exam: prolaspse can only be diagnosed on exam! And non-hormonal solutions can be discussed.

  4. Try some active self-therapy: this would include massage, roller foam, heat, ice, stretching, yoga

  5. Acupuncture or other alternative therapy can be very successful

  6. If you can safely use try an NSAID

  7. Try topical medications, may want to do this with your PCP primary care provider’s advice

  8. For more advanced medication, get a consultation

 Back pain can be a big topic to discuss, but here are a few other hints:

 

Other considerations for women who commonly have back pain, note it is often more pronounced in pregnancy. Hot showers, and heating pads, maternity girdles, and rest, have been the main options for most women and all are safe in pregnancy. When that fails prescription pain medications have been used.. 

 

It is possible for some pelvic pain to be caused by back pain. Walking in the tall pointy high heels will exaggerate your lower back curvature forward causing strains that can lead to lower back pain and pelvic pain. It is not always possible to pinpoint the cause of some of these nagging back or pelvic pains, because some physical signs are subtle. That vague pain that hurts a bunch more if you start to do sit-ups or the elliptical, this  might be a sign of something else. If you have a history of crooked spine (scoliosis) or back or muscle problems you are more likely to be suffering from muscular derived pain than inner abdominal or pelvic organ problems, but the pelvic exam should help you figure that out.

 

If your stretching and exercising hurts a bunch more than ever before, then you are more likely to have a muscle or fascia problems. If you contract your abdominal wall and you feel a bit better, again, it might be myofascial pain. Radiating pain from back to groin or thigh is more likely muscular. Remember it could be both muscular and organ in nature. And your gyno can sort, so don't go it alone is your pain is persistent!

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