Back pain in the women is the commonest symptom.

Causes

• Gynecological conditions like endometriosis, menstrual cramps, fibroid tumors and pregnancy.
• Stress to the muscles, nerves or ligaments.
• Structural abnormalities like disc bulging, sciatica, arthritis.
• Osteoporosis.
• Cancer of spine.
• Maintaining poor posture while sitting, standing.
• Prolonged standing, sitting.
• Infection of spine.
• Overweight.
• Prolonged inactivity.

Risk factors

• Smoking.
• Obesity.
• Older age.
• Physically strenuous work.
• Sedentary work.
• Stressful job.
• Anxiety.
• Depression.

When to seek medical advice

• Most back pain gradually improves with home treatments and self-care. You need to see a doctor if
• The pain is constant or intense, severe, especially at night or when you lie down.
• Spreads down one or both legs, especially if the pain extends below the knee.
• If it causes weakness, numbness or tingling in one or both legs.
• Causes new bowel or bladder symptoms.
• Pain followed by a fall, injury or blow to the back.
• If it is accompanied with excess of weight loss.

Tests and diagnosis

• Medical history.
• Physical examination.
• Gynecological examination.
• X-rays.
• Magnetic resonance imaging (MRI).
• Computerized tomography (CT).
• Bone scan to detect osteoporosis.
• Nerve studies like electromyography (EMG).

Treatment

• Medications: Non steroidal anti inflammatory drugs like diclofenac, ibuprofen. Muscle relaxants. Narcotics.
• Anti-depressants.
• Physical therapy and exercises.
• Surgeries mainly for herniated disc.

Prevention

• Exercises: regular aerobic activities like walking, swimming.
• Building muscle strength and flexibility: Abdominal and back muscle strengthening exercises.
• Stop smoking.
• Maintaining healthy weight.
• Use of proper body mechanics while standing, sitting, lifting.

Alternative therapies

• Chiropractic care.
• Acupuncture.
• Massage.