Women seem to suffer from chronic back pain more frequently than men. Spinal Health Week is an initiative of the Chiropractors’ Association of Australia and in May 2017 focusses on Chronic Back Pain. Chronic pain often involves the low back or Lumbar Spine.
The Lumbar spine is frequently involved with low back pain issues. Women seem to have the following conditions more frequently than men:
This can be due to the slight differences in the shape and features of the pelvic girdle, hormonal factors and the effects of pregnancy and childbirth that can impact on chronic back pain.
The symptoms may be intermittent – i.e. they come and go for no apparent reason and can be associated with arthritis, depression and irritable bowel syndrome (IBS). Of the number of Fibromyalgia cases diagnosed, 80-90% effect women, usually between the ages of 40 and 75. It is not known why, but it is suspected that this is due to hormonal factors as it seems to occur in the peri-menopausal to menopausal and post-menopausal years as estrogen levels decline.
Sacroiliac Joint Dysfunction
It effects more women than men, but to what extent is unknown to date. Sacroiliac joint dysfunction is more likely in young to middle-aged women. It may be due to the effects of pregnancy and childbirth, during which the ligaments in the body are softened/relaxed to allow for delivery of the baby. The pelvis can also be stressed by the weight and position of the baby as the pregnancy develops. It takes a while after the delivery of the baby for the ligaments to return to normal.
A fall or accident can also damage the ligament.
The function of the piriformis muscle is to stabilise your hip joint and rotate the thigh to enable walking and other movements.
The symptoms of chronic pain are more common and often more severe in women than men. Early treatment can help to manage the symptoms and prevent them from worsening.
It usually effects women between the ages of 40 and 60, and is 6 times more likely to affect women than men.1
It is unknown why it affects more women but may be something to do with wider pelvis and increased angle between the pelvis and leg bone in women. The hormonal changes of pregnancy and the associated pelvic changes may have an impact on the increased frequency in women.
The cause is often unclear but it may be due to an injury or overuse. Running or other repetitive movements could cause the muscle to spasm and create the symptoms. There is increased risk in professional drivers, skiers, tennis players and long distance push bike riding.
It may present as back stiffness and pain after getting up in the morning and a dull ache with occasional bouts of severe pain. Spinal Osteoarthritis progresses gradually over a period of years and may initially feel like muscle aches. It affects all ages but is more common in men under 45 and women over 45 years of age. It occurs in 26% of women and 18% of men.
Treatment may include stretches, water therapy and physical therapy and is recommended over surgery. Your chiropractor can be of assistance to provide a programme of care to help manage your symptoms.
It is 5 times more common in women than men as it is less protected than in men and pregnancy may injure it.2 The baby’s head may press against the coccyx (tail bone) during child birth and there has been a study that correlates coccydynia with difficult births.3
The most common causes seem to be falls onto the area or childbirth but it can be difficult to identify the exact cause. The area is not very flexible so pressure may injure the coccyx and/or ligaments close to it.
Coccydynia can affect women of all ages but onset is often around 40 years of age. It may last a few weeks or months but can impact daily life when it is chronic. It can affect sitting, driving or bending. It may be caused by infection or a tumour in a rare number of cases.
This condition may have no symptoms at all or may cause irritation to local spinal nerve roots resulting in low back or leg pain. It may cause weakness or aching in the legs with long periods of walking or standing. It is often better when you sit down.
Women present with this condition 3 times more often than men. It may be associated with Osteoarthritis (which is more common in women) and 3 times more women present with Degenerative Spondylolisthesis. This may again be due to the female pelvis and lower bone density.4 Spinal ligaments and joints may be weaker as you get older, making it more difficult for the vertebrae to stay aligned well. It is more common over 50 years of age.
Compression Fractures of the Spine
It can cause loss of height or a rounded hump in the spine. It is twice as common in women as they are more likely to have osteoporosis.
If you are a woman and have sudden, intense back pain, are over 45, and at risk of osteoporosis, you should get this investigated urgently as the injury can limit mobility. Risk factors for osteoporosis include having a small frame and a personal or family history of fractures or osteoporosis.
1 Roy BA. Piriformis Syndrome. ACSM’S Health & Fitness Journal: July/August 2014. Volume 18-Issue 4-p3-4 doi: 10.1249/FIT.0000000000000055.
2 Lirette LS, Chaiban G, Tolba R, Eissa H. Coccydynia: An Overview of the Anantomy, Etiology, and Treatment of Coccyx Pain. The Ochsner Journal. 2014;14(1):84-87. www.ochsnerjournal.org/doi/abs/10.1043/1524-5012.1.84
3 Proisy M, Rouil A, Raoult H, et l. Imaging of musculoskeletal disorders related to pregnancy. AJR Am J Roentgenol. 2014;202(4):828-38
4 Kalichman L, Kim DH. Li L, Guermazi A, Berkin V, Hunter DJ. Spondylolysis and spondylolisthesis: prevalence and association with low back pain in the adult community-based population. Spine. 2009;34(2): 199-205
Cheyne graduated from Sydney College of Chiropractic and Osteopathy in 1984. She also has postgraduate qualifications in paediatric chiropractic care. Before joining Clayfield Chiropractic Clinic in 1993, Cheyne enjoyed seven years in a Sydney based practice. Cheyne has 5 children and 3 grandchildren.