Back pain in women
A few months ago, we encountered new diagnostic and therapeutic information on Premenstrual Syndrome (PMS) discovered and applied by Dr. Jorge Lolas. We have been reanalyzing the concepts of lumbago, cervicalgia, and women’s back pain as a whole. Of course, we do not ignore the traditional concepts and our accumulated experience throughout the years. This allows us to diagnose and treat spinal conditions whenever there is a treatable pathology. However, how many women go to see a doctor for lower back pain, dorsalgia, and chronic cervicalgia without an evident pathological substrate in the diagnostic tests? How many women are diagnosed with fibromyalgia when experiencing different types of pain? Why is fibromyalgia mainly manifested in women? Why are so many women hypersensitive to touch, to the extent of a sweet hug’s touch? There are also men in the same situation, but it is most common in women. It might be due to lesser muscle development, or higher sensitivity and tendency for women to suffer from stress due to family or work-related problems… but we are likely not considering other pathological processes, mainly because they are still unknown.
One of the most puzzling symptoms of PMS is low back pain. It is undoubtedly a type of dysmenorrhea that, instead of manifesting at the pelvis, is felt at the renal sinus. Patients visit their gynecologist because they associate it with premenstrual symptoms, at least initially. However, when the gynecologist does not find any problems (as usually happens), patients are directed to see a spine specialist, who may not find any issues, except by chance. An unsolved case…
Another common symptom is chronic cervicalgia due to muscle spasm, which is non-responsive to treatment on many occasions. Pain at the light touch of the skin is prevalent in severe cases. In these extreme instances, it is evident that other problems exist besides the muscle condition. It could be interpreted as a decrease in the pain threshold, indicating a pathological increase in the response of the skin and myofascial pain and tension receptors.
Why does the pain threshold decrease? There are numerous reasons. The psychogenic factor is among them and is currently the most significant. However, there are many inflammatory mediators that modify this parameter. When considering women and Dr. Lolas’ theory, the causal factor for pain hypersensitivity, never previously taken into account, is the increase in circulating prostaglandins. Where does this excess prostaglandin originate? A swollen cervix acts as a remarkable prostaglandin factory, generating an inflammatory and hyperalgesic state throughout the body, among other changes, including neuropsychological ones. It is intriguing that treatments for inflammatory processes exist in various body parts. Why has cervicitis been the only body inflammation that doctors have overlooked?
Definitely, cervical inflammation might cause back pain (and other symptoms). Fortunately, there is a treatment.
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