I have been hands on this week covering in West Byfleet, it has been great to see you all, perhaps not reciprocated by some of you. “I keep seeing your face all over my social media, stop hijacking my scrolling.”
The Facebook algorithm works in mysterious ways, but I’m happy we are getting seen in the right places.
We are going to be trying a new line of social media posts over the next few months to see how that lands. More treatment and how we look after certain conditions, so stay tuned.
I’m off to watch England versus Italy today in the penultimate game of the six nations. England have been very jammy in their last two games and managed to sneak through.
Depending on what happens next weekend they could still be in with a shout of winning or finishing second, but there would need to be some big swings.
Anyway, let’s leave controversial sports topics and focus on something more important. We celebrated International Women’s Day last week, here is to all of you amazing women.
I wrote a blog on menopause a few weeks back and we had a lot of feedback. One of you sent me an email saying, “this is great but what about pre menopause and why do I get so much back pain when I’m on my period”?
This is something I hear every day in the clinic form our clients…..
But I’m also writing this as a man and appreciate I have no experience with my own menstrual cycle. I’m going to give you a Chiropractor’s view of what I see and what I have learnt over the years. Please bear with me and give me some feedback if you think I have got it wrong.
It varies from person to person in terms of the level of discomfort they have when menstruating.
I have chatted to some ladies that say, “I’m absolutely fine at that time of the month” and then others that say, “it’s crippling for 48 hours, and I cannot work”.
Why is it that some ladies have it worse than others when it comes to their period pain?
1)Hormonal changes-
a) Prostaglandins play a big part in this. They are chemicals released by the uterus to help shed the uterine lining at the start of the period. This also signals to the uterus to start contracting, which can create unpleasant cramps. If a lady has higher resting prostaglandin levels, then the cramps are more intense and can cause more pain.
b) Oestrogen and progesterone changes- right before menstruation the oestrogen levels drop which can increase pain sensitivity. Oestrogen peaks around day 14 of the cycle when the follicle releases an egg. If the egg is not fertilised the oestrogen levels decline leading to the shedding of the uterine lining.
2) Progesterone falls at the end of the cycle at the same time as oestrogen and can contribute towards muscle tension and inflammation making back pain worse.
Uterine contractions- the uterus is supplied by the nerves at the base of the spine called L5-S1. This is the sacral plexus that also forms the sciatic nerve that goes down the back of the leg. When the uterus is contracting right at the start of the end and beginning of the cycle this can be highlighted by these nerve fibres and refer to the low back and pelvis.
3) Inflammation- C-reactive protein (CRP) is a marker of inflammation and this is detected in women during menstruation. It leads to cramping, joint pain and muscle soreness when it Is elevated.
4) Relaxin-this is a hormone that is normally released in a large quantity in the third trimester of pregnancy. This relaxes the ligaments and means the body can be prepped for labour by allowing the pelvis to expand and make space for the baby.
There is some relaxin released at the end of the cycle to prepare for pregnancy if the egg was to be fertilised and this relaxin can create instability in the sacro-iliac joints leading to back pain.
5) Water retention- there is more fluid retention in tissues during the latter half of the cycle and this can increase pressure on the sciatic nerve and low back.
6) Endometriosis- with this condition it means the uterine tissue an grow outside of the uterus and this can intensify pain in the back as the tissue is susceptible to increased levels of prostaglandins creating contractions.
This is what happens during a cycle that can cause back pain, but is there anything that can be done about it?
How to relieve menstrual back pain?
1) Magnesium- using a magnesium supplement or spray on the tummy and back can help to reduce muscle cramps and pain. However, it can be itchy so just do a patch test first.
2) Chiropractic adjustments-whilst there is no clear research suggesting chiropractic care helps with menstrual back pain. There is research around chiropractic helping to realign the spine and reduce nerve interference to help with pelvic pain and low back pain to ensure there is less pressure on the back.
3) Exercise-yoga movements like Cat camel and cobra are very effective at helping with back pain around the beginning of the cycle. Gentle pelvic movements to help relax the ligaments around the pelvis can be very beneficial.
4) Heat-using a hot water bottle to soothe the SIJ and low back can bring blood flow to the area and help ease uterine cramps. You need to ensure that the hot water bottle is not scolding hot, and if you are having a bath ensure the water is not too hot. This can have the reverse effect.
5) Anti-inflammatory food-because the level of prostaglandins increases inflammation which can increase pain, you can reduce the level of inflammation but trying to eat anti-inflammatory foods such as omega 3-s. Omega 3″s can have a similar effect as Ibuprofen to bring inflammation down. However, Omega 3″s don’t upset the lining of the stomach. You can find them in oily fish; like salmon, mackerel and sardines or some nuts such as flaxseeds.
If you are wanting to chat more about the information above then why not book a call with me and we can go into more detail? Click here to book or if you want to get an assessment then Book a consultation with a Chiropractor here
If you do know someone who wants more advice, please send them our details. You can send them this assessment as well to diagnose their back pain. It is a great tool to understand where your back pain is coming from, it is free and takes 60 seconds. Click here for assessment
