Low backache is a frequent complaint of parous women in a gynecologic clinic. It may be the part of the gynecological complaints or the case may be referred by an orthopedic surgeon to exclude the pelvic pathology to account for the low backache.
The reasons to refer are:
- The low backache often dates back to childbirth process or gynecological operation.
- The symptoms often aggravate in relation to period.
To establish a correlation between the low backache and gynecologic pathology, the following facts are to be remembered.: -
- As the posterior peritoneum is poorly innervated, the pain is dull and diffuse.
- Backache of pelvic origin never reaches beyond the 4th lumbar vertebra.
- The pain pointed by fingertip is not of gynecologic origin.
CAUSES: Common causes of backache of pelvic origin are:
Prolapse: Uterine prolapse produces backache due to stretching of the ligaments supporting the uterus in position. If the ligaments are atrophic, there will be no pain. Vaginal prolapse does not cause backache.
The pain in prolapse subsides when the patient is at rest and aggravates on standing.
Retroversion: Retroverted uterus may produce backache only when it is fixed by inflammatory or endometriotic adhesions. Mobile retroverted uterus does not produce backache.
Chronic pelvic infection: Chronic PID producing adhesions and TO mass formation may be responsible for backache. There are associated menstrual abnormalities and dyspareunia. Chronic cervicitis produces backache by parametritis.
ENDOMETRIOSIS: Endometriosis involving the pelvic peritoneum, uterosacral ligament or rectovaginal septum produces backache and deep dyspareunia.
NEOPLASM: Benign neoplasm like ovarian tumor or fibroid will not ordinarily produce backache. However, cervical or broad ligament fibroid can cause backache by producing pressure on the nerve routes over the sacrum.
Pelvic malignancy produces backache by involving the nerve roots, metastasis in the vertebrae or involving the lateral pelvic wall.
HOMOEOPATHIC MANAGEMENT OF LOW BACKACHE
Homoeopathic medicines are a great alternative compared to allopathic medicines because it has no side effects. The several homoeopathic medications that may be used for back pain are as follows:-
Sulphur: - A great remedy for patients who have back pain due to slouching posture and whose pain worsens when they stand up.
Ruta graveolens: - For cases where patient experiences stiffness in joint or muscles accompanied with feeling of soreness and lameness all over back.
Aesculus:- A good homoeopathic remedy in cases of very low back pain ,which gets worse when the patient tries to stand upright from a previously sitting position.
Rhus toxicodendron:- In cases of pain of the lower back,shoulders and neck. Pain is worsened by damp and cold weather and by movement.
Arnica:- It has good effects on soft tissues and muscular pain.
Nux vomica:- A great Homoeopathic remedy for cases where pain gets worse by damp and cold weather, especially at night and painful muscle cramps are experienced in the lower back.
Ignatia:- A good remedy for emotional distress and for pain in the muscles if the lower back.
Kali carb:- A great remedy for patients who have frequent and strong night pains, accompanied by increased back pain during menses.