Back Pain Treatment For Women

14 Sep Back Pain Treatment For Women

Back pain is a common problem faced by humans. The female body is unique as it goes through a lot of bodily and hormonal changes throughout their lifetime, namely, starting of monthly periods, pregnancy, delivery and menopause along with normal ageing. These factors make the female body more susceptible to back pain. We discuss the common and somewhat unique issues faced by women during their lifetime.

Back pain before menopause:–

The most common causes of back pain in women comprising 70% of spine surgeon visits before menopause are related to following factors,

1. Weight gain due to menstrual cycle issues PCOD/PCOS, thyroid and other hormonal issues ( or sometimes genetics and bad food choices common for both sexes).
2. Lack of exercises and vitamins ( vitamin D3 and B-12 importantly).
3. Continuous sitting for work.  

Less common but critical causes which shall be discussed elsewhere are a slipped disc issue, spondylolisthesis (meaning slippage of vertebral bone) and spinal infection (most common being tuberculosis of the spine- Yes you read it right – spine is the most common human part affected after chest or lung tuberculosis in India)

Either one or all of the above causes significant back pain in women of this group. 

Following are typical examples seen in spine surgeon office practise:-

A middle aged housewife with slow weight gain over the years wakes up in the morning with back pain and stiffness. The stiffness starts getting little better with activity and although she manages household work, the back pain forces her to take short periods of rest in between. She remains tired most of the times with relief only at rest. 

Another young female who recently joined a deskjob with with a sedentary lifestyle due to the erratic work schedule complains of back pain. She exercises on weekends and knows that she feels  better with exercises but is unable to manage the time for same. She may or maynot have  gained weight recently .

Short term treatment– So the treatment is to try and pay attention to the most common causes of back pain in women and work on them. Now it doesn’t happen soon. So meet your local spine surgeon, get checked to rule out serious causes, preliminary advice to manage the pain in the short term with tablets, physical therapy modalities and adequate rest. A common error seen is to start exercises when u experience pain in the hope of making it better. It actually makes the problem worse in most cases. So give it rest, limit your activities which cause pain, take help of tablets for a short duration, some physio modalities (like IFT/TENS/Local ultrasound) to manage pain.

Long term Treatment- Once the pain settles (which generally takes in few days to 2 weeks),  in few weeks start planning towards reducing weight the scientific way, getting checked and treated for calcium and other vitamin deficiencies if any, and planning for safer exercises for your problem. Like all good things in life, being consistent and progressing slowly gives you results. Read below for exercises for women suffering from back pain.

Back pain after menopause:-

Amongst common causes of back pain in this category are age related lumbar spondylosis.  In this age category one very important factor  is osteoporosis in women.  

Lumbar spondylosis is wear and tear of the spine due to ageing. It needs treatment on similar lines as discussed in above section ( short term and long term treatment)

In osteoporosis there is weakness of the bony architecture  after menopause in particular.(even with Normal calcium and vitamin D). {One can imagine it to be more like weakening of pillars in a building leading to major collapse with minor external changes.} This condition can literally break bones (spinal or vertebral bone, hips and wrist bones in particular) in the long term without a major fall. This pathology needs aggressive treatment once it sets in but even better shall be to prevent it from getting worse.  Read here about osteoporosis in detail. Being aware about getting a bone density scan assessment  after menopause and then every three yearly helps us treat you better. 

Management of osteoporosis depends on its severity and is a combination of following:-

1. a) Special medicines for osteoporosis [either a once weekly tablet or daily self administered injection (exactly like insulin injection)  or a 6 monthly injection.] 
2. b)  Calcium, Vitamin D supplements.

          AND 

1. c)  Resistance exercises.

These 3 things should be started ALL TOGETHER. Most people incorrectly feel that taking calcium and vitamin D supplement shall save them from osteoporosis after menopause. 

Once there is a fracture either of spine or wrist or hip then its a long road to recovery. So preventing a fracture after menopause in females is very critical with proper investigations and treatment. Patient participation in their own health is a critical aspect as the medical doctor can advice exercises and medicines but it has to be done by the patient. 

So in conclusion, women need to be treated early, adequately and for a longer time to prevent or delay the age related and hormone related factors that affect them.

Exercises for Women

The broad principles remain the same for both sexes with back pain, irrespective of age. The  exercise load and frequency per week change as one gets older. Diet, protein intake and sleep are other important things to consider.

The exercises for back pain are a mixture of stamina building and strength training.

Safer stamina building exercises are either walking (if not overweight), stationery cycling or swimming 3 times a week for 30-40 minutes with rest breaks if required in between for someone who is just starting out .

The strength training exercises to develop general strength of upper body, lower body and back which are useful to improve function in daily life. These too should be done with aim of progressively improving the strength, although not daily ( 3-4 times a week is safe for most people). The commonly taught back exercises like the pelvic bridge/ back extensions/ superman pose/dead bug exercise/leg raises are a decent start. They should be gradually  replaced by some resistance training involving either the body weight or some resistance bands or proper weights in gym. Potentially harmful back exercises are sit ups, twisting turning movements of the back or legs and any sudden forward bending movements. it is prudent to avoid them.

More importantly people need to know which exercises to avoid if they have back pain. Impact related exercises like running or skipping rope, jumping jacks which have a pounding effect on the lower back and knee joints are discouraged by us for its obvious hazards. So is doing lots of stretching exercises or yoga postures if you are having back pain. Yoga asanas can be added as a flexibility exercise later once you have recovered from pain and have developed some strength of the supportive muscles around your painful area, in this case the back. Yogic deep breathing and meditation can be useful for overall wellbeing and not particularly for your back pain.

There isn’t one exercise or tip that’ll be useful for back pain. Most often it is a mixture of lifestyle changes  like eating right, sitting less, adequate rest and REGULAR ( doesn’t have to mean daily) exercises throughout your life.