LOWER BACK PAIN (main causes)

Back pain in women can be a result of improper bending or lifting, excessive exercise, chronic diseases or pregnancy. Women are more likely than men to experience lower back pain due to hormonal influences on the bones as well as physical changes during pregnancy. Common causes of low back pain (lumbar backache) include lumbar strain, nerve irritation, lumbar radiculopathy, bony encroachment, and conditions of the bone and joints.

Many causes of back pain affect both women and men equally and produce the same symptoms. However, there are some back pain conditions that are unique to women. It is important that women understand how back pain can be related to their individual situations in life.

Lower Back Pain Causes

Lumbar strain	Lumbar strain is a stretch injury to the ligaments, tendons, and/or muscles of the low back. The stretching incident results in microscopic tears of varying degrees in these tissues. Lumbar strain is considered one of the most common causes of low back pain. The injury can occur because of overuse, improper use, or trauma. Soft-tissue injury is commonly classified as "acute" if it has been present for days to weeks. If the strain lasts longer than three months, it is referred to as "chronic."
Menstrual Cycle	Menstrual Cycle can cause minor muscular back pain. It is common for women to experience lower back pain during certain times in their menstrual cycles. It is also common for these symptoms to change monthly. Dealing with back pain during their period can be a real problem for some unlucky women. Premenstrual syndrome (PMS)and menstrual cramps may cause lower back aches and pain in women during the days right before and during their periods.
Large breasts	Large Breasts can provoke back pain – it can be a lifelong affliction for some women. The constant stress that large breasts put on the spine can cause postural and skeletal changes, as well as serious pain. Special bra styles can be useful - back pain relief bras can help to support large breasts, reducing the symptoms of breast related back pain.
Pregnancy	Pregnancy can cause lower back pain in women due to added weight and the change in center of gravity of the body. Pregnancy commonly leads to low back pain by mechanically stressing the lumbar spine (changing the normal lumbar curvature) and by the positioning of the baby inside of the abdomen. Additionally, the effects of the female hormone estrogen and the ligament-loosening hormone relaxin may contribute to loosening of the ligaments and structures of the back. Pelvic-tilt exercises and stretches are often recommended for relieving this pain. Women are also recommended to maintain physical conditioning during pregnancy according to their doctors' advice. Pregnancy back pain is a normal part of many births. The stress caused by physical changes during pregnancy can cause her body some real pain. Luckily, most cases of pregnancy back pain end with the birth of the precious child.
Osteoporosis	Women are much more likely to develop osteoporosis than men. They are also generally at risk earlier in life and live longer. Women do not usually partake in skeletal loading resistance training. Women’s bones are naturally thinner and lighter. Osteoporosis might be genetically transferred more easily in women than in men. All these reasons make osteoporosis a real problem for women. Osteoporosis can cause fractures of the spine which result in pain in the lower back. It is common among women after menopause.
Ovarian cysts, fibroids and endometriosis	Ovarian cysts, uterine fibroids, and endometriosis not infrequently cause low back pain. Precise diagnosis can require gynecologic examination and testing. In general pain in reproductive organs very often irradiated to back pain.

Kidney problems	Kidney infections, stones, and traumatic bleeding of the kidney (hematoma) are frequently associated with low back pain. Diagnosis can involve urine analysis, sound-wave tests (ultrasound), or other imaging studies of the abdomen. Urinary Tract Infections (UTI) also can be a cause for unpleasant low back pain. In most cases this pain disappears after UTI treatment.
Pelvic Infections	Infection of the pelvis is infrequent but can be a complication of conditions such as diverticulosis, Crohn's disease, ulcerative colitis, pelvic inflammatory disease (PID) with infection of the Fallopian tubes or uterus, and even appendicitis. Pelvic infection is a serious complication of these conditions and is often associated with fever, lowering of blood pressure, and a life-threatening state.
Bleeding in the pelvis	Bleeding in the pelvis is rare without significant trauma and is usually seen in patients who are taking blood-thinning medications, such as warfarin (Coumadin). In these patients, a rapid-onset sciatica pain can be a sign of bleeding in the back of the pelvis and abdomen that is compressing the spinal nerves as they exit to the lower extremities.
Nerve irritation	The nerves of the lumbar spine can be irritated by mechanical pressure (impingement) by bone or other tissues, or from disease, anywhere along their paths - from their roots at the spinal cord to the skin surface. These conditions include lumbar disc disease (radiculopathy), bony encroachment, and inflammation of the nerves caused by a viral infection (shingles).
Lumbar radiculopathy	Lumbar radiculopathy is nerve irritation that is caused by damage to the discs between the vertebrae. Damage to the disc occurs because of degeneration ("wear and tear") of the outer ring of the disc, traumatic injury, or both. As a result, the central softer portion of the disc can rupture (herniate) through the outer ring of the disc and abut the spinal cord or its nerves as they exit the bony spinal column. This rupture is what causes the commonly recognized "sciatica" pain of a herniated disc that shoots from the low back and buttock down the leg. Sciatica can be preceded by a history of localized low-back aching or it can follow a "popping" sensation and be accompanied by numbness and tingling. The pain commonly increases with movements at the waist and can increase with coughing or sneezing. In more severe instances, sciatica can be accompanied by incontinence of the bladder and/or bowels. The sciatica of lumbar radiculopathy typically affects only one side of the body, such as the left side or right side, and not both.
Arthritis	Arthritis commonly affects the joints of the spine and can lead to lower back pain in women. In general the arthritis in the spine affects women and men. However, due to their naturally lighter skeletal frames, women often suffer worse effects than men. This is especially true when the patient has both osteoporosis and osteoarthritis together.

IMPORTANT TO KNOW

Acute and intense low back pain often results from unspecific sprains and strains. Acute low back pain from lumbar strains and sprains can be accompanied by sciatica, a term used to describe pain extending down into the buttock and leg from the irritation of a larger nerve exiting the lumbar spine called the sciatic nerve.

Bony encroachment	Any condition that results in movement or growth of the vertebrae of the lumbar spine can limit the space (encroachment) for the adjacent spinal cord and nerves. Causes of bony encroachment of the spinal nerves include foraminal narrowing (narrowing of the portal through which the spinal nerve passes from the spinal column, out of the spinal canal to the body, commonly as a result of arthritis), spondylolisthesis (slippage of one vertebra relative to another), and spinal stenosis (compression of the nerve roots or spinal cord by bony spurs or other soft tissues in the spinal canal). Spinal-nerve compression in these conditions can lead to sciatica pain that radiates down the lower extremities. Spinal stenosis can cause lower-extremity pains that worsen with walking and are relieved by resting (mimicking the pains of poor circulation).
Fibromyalgia	Fibromyalgia is far more common in women than in men. This is one of the reasons why many doctors speculate that this is a hormonally based illness. Regardless of the true cause, fibromyalgia can make life hell for the millions affected with this mysterious disease.
Breast Cancer	Breast Cancer back pain can be a direct result of the disease or a side effect of the treatments.
Tumors	Low back pain can be caused by tumors, either benign or malignant, that originate in the bone of the spine or pelvis and spinal cord (primary tumors) and those which originate elsewhere and spread to these areas (metastatic tumors). Symptoms range from localized pain to radiating severe pain and loss of nerve and muscle function (even incontinence of urine and stool) depending on whether or not the tumors affect the nervous tissue.
Bone and joint conditions	Bone and joint conditions that lead to low back pain include those existing from birth (congenital), those that result from wear and tear (degenerative) or injury, and those that are due to inflammation of the joints (arthritis). Congenital bone conditions -- Congenital causes (existing from birth) of low back pain include scoliosis and spina bifida. Scoliosis is a sideways (lateral) curvature of the spine that can be caused when one lower extremity is shorter than the other (functional scoliosis) or because of an abnormal architecture of the spine (structural scoliosis). Children who are significantly affected by structural scoliosis may require treatment with bracing and/or surgery to the spine.
Paget's disease of bone	Paget's disease of the bone is a condition of unknown cause in which the bone formation is out of synchrony with normal bone remodeling. This condition results in abnormally weakened bone and deformity and can cause localized bone pain, though it often causes no symptoms. Paget's disease is more common in people over the age of 50. Heredity (genetic background) and certain unusual virus infections have been suggested as causes. Thickening of involved bony areas of the lumbar spine can cause the radiating lower extremity pain of sciatica.

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