Diagnosis and treatment of back pain in postmenopausal women

Back pain during menstruation bothers approximately 40% of women of reproductive age (from 16 to 45 years). It can be of moderate or high intensity, occur a few days before or during menstruation, and can also be localized, radiating or reflected. The main location of back pain that occurs during menstruation is the lumbosacral spine (lower back), consisting of five lumbar and five sacral vertebrae. In some cases, the cause of the pain syndrome is the physiological changes that occur in a woman’s body during menstruation, but sometimes such pain can indicate various diseases of the genitourinary and reproductive systems, as well as chronic pathologies of the spine, aggravated during menstruation under the influence of certain hormones.

Back pain during menstruation

Normal or pathological?

Menstruation is a cyclic bleeding from a woman’s vaginal tract, which is the initial phase of the menstrual (reproductive) cycle. Pain of varying intensity during menstruation bothers more than 70% of women, but it is localized mainly in the lower abdomen and is associated with intense contraction of the uterus.

Phases of the menstrual cycle

The uterus is a muscular organ, pear-shaped and lined from the inside with endometrium - a mucous (functional) membrane that produces hormones and is abundantly supplied with blood vessels and capillaries.

Structure of the uterine wall

During menstruation, the endometrium is torn away from the body of the uterus and is excreted in the form of menstrual fluid, which also contains enzymes, salts and secretions secreted by the endocrine glands of the vagina and cervix. In order for the endometrial tissue to be able to exit into the vaginal tract, the uterus actively contracts, which provokes a nagging pain in the lower abdomen, which usually occurs 1-2 days before the onset of discharge.

Back pain (mainly in the lower back) can conditionally be considered normal, since it can also appear under the influence of natural physiological changes in the female body.

If you want to learn in more detail how to treat aching lower back pain, and also consider the causes, diagnosis and alternative treatment methods, you can read an article about this on our portal.

Back pain may be normal

In cases where painful sensations cause severe discomfort, are of high intensity or are accompanied by other alarming symptoms (for example, fever or urinary dysfunction), you should consult a local gynecologist, since some chronic diseases of the musculoskeletal system are aggravated during menstruation in women with unstable hormonal levels.

If the pain causes severe discomfort, you should consult a gynecologist.

Normal causes of back pain during menstruation include:

• increased synthesis of prostaglandins (sex hormones that regulate the reproductive cycle of women), increasing susceptibility to the main mediators of pain - histamine and bradykinin;
• anatomical features of the structure of the uterus (for example, the location of the uterus closer to the spine or bending towards the spinal column);
• overstrain of the lumbar region caused by sedentary work or physical activity;
• swelling of the pelvic organs caused by natural fluid retention in the body during menstruation.

During menstruation, women are advised to maintain emotional peace, since any stress and nervous tension can provoke increased pain in both the lower abdomen and back. With chronic stress, women may experience all types of menstrual pain, including headaches.

Pain in the back, lower abdomen, headaches can be a consequence of stressful conditions

Increased salt intake is one of the reasons

Salt (sodium chloride) is vital for the normal functioning of the entire body. Salt components (in particular, chloride ions) are the main component of hydrochloric acid, produced by the parietal cells of the stomach and necessary for normal digestion of food. Salt also ensures the functioning of the nervous system by participating in the transmission of nerve impulses and helps improve the nutrition of muscle tissue.

Table salt should not be consumed in large quantities, as it causes fluid retention in the body.

During menstruation, fluid can accumulate in the subcutaneous fatty tissue of the pelvic organs, and increased consumption of salty, smoked and pickled foods can increase tissue swelling and cause acute or aching pain in the lumbar and tailbone areas.

Pathologies of the uterus and their connection with lumbar pain

Some anatomical features of the uterus can cause back pain during menstruation. As a rule, such pain is combined with intense pain in the lower abdomen and lasts until the cessation of menstruation.

Pathologies and abnormalities of the uterus that can cause back pain during menstruation

Note! Any diseases of the uterus (including infectious and inflammatory processes) can cause referred pain in the lumbar region. An alarming symptom is a combination of severe back pain with vaginal discharge that is not typical for the menstrual period (bad-smelling, purulent, interspersed with sediment): such discharge may be one of the signs of cervical cancer, so if it appears, you should immediately consult a doctor.

Main causes of pain

The causes of pain can be different - they manifest themselves depending on the characteristics of the woman’s body. The main factors include:

1. Psychogenic – most often people with neurasthenic or labile-hysteroid characteristics suffer from pain. Such girls often experience mood swings and increased anxiety, which can lead to frustration and a decrease in the pain threshold. Therefore, even small manifestations are felt noticeably more acutely.
2. Physiological factors are closely related to psychogenic factors: asthenic body types are more susceptible to pain syndrome.
3. Organic: pathologies of the reproductive system (this can be diseases such as endometriosis or uterine hyperreflexia).
4. Individual – low pain threshold (manifests both during menstruation and in other situations).

Infectious pathologies of the pelvic organs

Pain syndrome that occurs in the lower segment of the spine may be a consequence of infectious diseases of the pelvic organs related to the excretory and reproductive systems, for example, cystitis or salpingoophoritis (referred pain). During menstruation, the most significant factor in the development of infectious and inflammatory pathologies of the pelvic organs is non-compliance with intimate hygiene, so women need to be especially careful about the cleanliness of the genital organs and anorectal space.

Back pain (referred) with infectious pathologies of the pelvis

The most important

Menstruation is a natural process that quite often causes lower back pain. This is caused by physiological changes in internal organs and muscles, as well as hormonal changes. In this case, the pain is moderate and disappears on its own after 1–2 days. But if severe pain appears suddenly and is accompanied by other suspicious symptoms (fever, weakness, copious, unusual discharge), then you should visit a gynecologist. The specialist will conduct a diagnosis, identify the nature of the pain and draw up a treatment plan. You should not regularly take antispasmodics, analgesics, NSAIDs or other drugs to relieve pain without the knowledge of your doctor, as this will only get rid of the symptom, but will not cure the disease (if it is present). If lumbar pain recurs regularly, then this is a good reason to consult a specialist.

How to relieve pain?

Regardless of the cause of pain, the main way to eliminate it is drugs from the group of non-narcotic analgesics, for example, drugs based on metamizole sodium (Baralgin, Analgin).

"Baralgin"

Metamizole sodium should be taken no more than 2-3 times a day in a single dosage of 500 mg. Despite the effectiveness of Analgin in the treatment of acute pain syndromes of various etiologies and localizations, this drug is used less and less in medical practice due to the high risk of side effects and negative consequences caused by the high toxicity of metamizole sodium.

"Analgin"

Experts consider drugs from the anilides group, for example, Paracetamol, to be the drugs of choice for reducing menstrual pain in the back and abdomen.

"Paracetamol"

It is necessary to take paracetamol and its analogues (Panadol, Efferalgan) 500-1000 mg up to 3-4 times a day. If paracetamol is ineffective, you can use drugs from the NSAID group: Ibuprofen, Diclofenac, Movalis, Ketorolac.

"Ketorolac"

The duration of taking non-steroidal anti-inflammatory drugs without consulting a doctor should not exceed 5 days.

To reduce muscle tone, relieve spasms and reduce the strength of uterine contractions, which can provoke pain in the lower back, the use of antispasmodics is indicated. The most effective and safe for women during menstruation are:

• drotaverine (“No-shpa”, “Spazmol”, “Spazmonet”) - 20-40 mg up to 4 times a day;

  
  "No-shpa"

• papaverine hydrochloride 1% (“Papaverine”, “Papazol”, “Andipal”) - 1 suppository 2-3 times a day after bowel cleansing or bowel movements.

  
  "Papaverine"

Further therapy is selected taking into account the results of diagnosis and medical examination. For infectious diseases of the pelvic organs or spine, antibiotics (Amoxicillin, Tetracycline, Hemomycin) and antimicrobial agents with antiprotozoal activity (Metronidazole) are prescribed.

Treatment of back pain without drugs

In cases where pain in the lumbosacral, coccygeal segment or in another part of the back is the result of natural physiological processes occurring in the body at the beginning of the menstrual cycle, it can be dealt with without the use of medications.

Wool belt

A belt made from dog or goat hair is the safest and most effective way to combat back pain. More aggressive thermal effects (for example, heat applications, baths, saunas) are prohibited during menstruation, and the belt can be used with virtually no restrictions. It should be worn throughout the day, and in case of severe pain, the product should be left overnight (at least 8 hours).

Dog hair belt

Note! Some people advise rubbing your lower back with vodka or alcohol before putting on the belt. Experts do not advise doing this, since ethanol easily penetrates the skin (especially under the influence of heat, when the pores open more), which can cause intoxication in women with weakened immune systems.

Badger fat ointment

Badger fat is a very effective analgesic and anti-inflammatory agent that is used in folk and traditional medicine to treat coughs. Badger fat also stimulates blood flow to the application site, which has a positive effect on blood circulation and nutrition of the cartilage tissue that makes up the intervertebral discs. You need to apply the ointment 2-3 times a day (it is better to immediately wrap your lower back with a down scarf after this).

Badger fat

Advice! For chronic pelvic pain, which intensifies during menstruation, you can mix badger fat with natural honey (1 teaspoon each), heat the resulting mixture and apply a thick layer to the lumbar and tailbone area. Cover the top with a warm scarf and leave for 1-2 hours. After the procedure, rinse the skin thoroughly. To improve your well-being, it is enough to do 4-5 procedures.

Badger fat with honey

Gymnastics (exercise with a roller)

Heavy and intense physical activity during menstruation is contraindicated, but if a woman is bothered by back pain, it is recommended to perform this exercise daily (see picture below). It will not only relieve pain and discomfort, but also improve blood flow to the pelvic organs, and also increase the flexibility and elasticity of the spine.

Exercise to relieve back pain

If you don’t have a special gymnastic roller at home, you can make one from a terry towel. You should remain in this position for about 1 minute, gradually increasing the time to 2-3 minutes. If you perform this exercise daily, after a month you can forget about pain in the lumbar region.

Useful tips for lower back pain before menstruation

If lumbar pain before menstruation is caused by physiological processes, then to reduce it you can use antispasmodics (Baralgin, Spazmalgon, No-shpa) or analgesics (Paracetamol, Sedalgin-neo, Analgin). Doctors advise taking these medications only as a last resort.

Special exercises will help reduce lower back pain

And you can also perform exercises that will help relieve pain:

• Lie on the floor, bend your knees, place your hands under your lower back, and then tilt your legs alternately to the sides, trying to reach the floor with your knees. Then place your hands under your buttocks, inhale deeply, trying to breathe from your stomach.
• Roll over onto your stomach, lean on your fists and forehead, and bring your legs together. Then, while inhaling, raise your lower limbs, hold for 30 seconds, breathing deeply, and then slowly lower your legs.
• Roll over onto your back, put your hands on your stomach, smoothly raise your legs, as in the “birch tree” exercise, then slowly lower them. Breathe from your stomach while doing the exercise.
• Do not change your position, smoothly do the “scissors” exercise according to this pattern: 3 swings of your legs, and then tuck your knees to your chest.

These exercises will help strengthen your abdominal muscles and relieve soreness.

To relieve pain in the lower back, you can perform self-massage. To do this, lie on your back, with your right hand feel the point on your stomach under your navel (at a distance of four fingers). Then move 2 fingers to the right and left to find points that feel slight pain when pressed. Massage the above points for 3-5 minutes.

Reference. During menstruation, massage should be abandoned, and gymnastics can continue to be performed. At the same time, it is recommended to perform exercises 5-6 times before menstruation, and 2-3 times during it.

If you have a sedentary job, and the pain intensifies in this position, then place a special pad on the chair, which is used for hemorrhoids or diseases of the tailbone. This device will help relieve stress from the lower back, prevent pinching of blood vessels, and relieve pain.

In addition, for lumbar pain, it is recommended to drink more warm liquids (tea, compote, fruit juice) and apply dry heat to the sore spot, and observe bed rest. As prescribed by the doctor, a woman can take vitamins and sedatives.