Thursday, June 15, 2006

Women and Chronic Back Pain

A recent research article discussed how hormones in women may pre-determine chronic back pain.

Published in the June issue of Spine, a cross-sectional study consisted of surveying 11,000 Dutch women aged 20-59. The researchers wanted to find out if hormonal and reproductive factors in women are related to chronic low back pain and chronic upper extremity (shoulder/arm) pain.

The results of this investigation indicate that multiple sources specific to females may contribute to chronic back pain. Some intuitively logical causes such as past pregnancy were identified. But the researchers found other factors that are less obvious:

chronic low back:
  • past pregnancy
  • young maternal age at first birth
  • duration of oral contraceptive use
  • estrogen supplementation during menopause
  • irregular and prolonged menstruation
  • hysterectomy (surgical removal of uterus)
chronic upper extremity pain:
  • young age of menarche (first menstrual period)
  • irregular and prolonged menstruation
  • hysterectomy (surgical removal of uterus)

My personal thoughts:
Surprising to me, no associations in this survey were found for current pregnancy and number of children. Although since chronic back pain is the research topic, it is not surprising after all to find current pregnancy omitted. Since current pregnancy usually involves pain primarily in the 3rd trimester, the back pain would be consider acute and would not fall under the category of "chronic low back pain".

The following is an abbreviated conclusion stated by the authors:

"In adult women, hormonal and reproductive factors are associated with chronic musculoskeletal pain in general. Factors related to increased estrogen levels may specifically increase the risk of chronic low back pain."


--Wijnhoven, HAH, et al. Spine. June 1, 2006; Vol. 31, Iss. 13, pp. 1496-1502

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