The main causes of back pain in women are:

1. Poor posture and crossing legs when sitting

2. Scoliosis (which happens during puberty)

3. Pregnancy

4. Abdominal separation during pregnancy (diastasis recti)

5. Caesarian scar

When adopting a poor posture in sitting and standing, the back muscles becomes tight, they turn into spasm and cause back pain.

Subsequently, the core muscles and gluteus muscles become lazy resulting into an even worse posture.

When crossing legs while sitting, the pelvis becomes misaligned, thus causing one side of the pelvis to become higher than the other. 

In order to compensate for the misalignment, the other side of the back muscle becomes tight and turn into spasm.

Treatment for poor posture and misaligned pelvis may include:

• Biomodulator machine

• Muscle release techniques

• Tendon and muscle blade therapy

• Modern oil cupping

• Acupuncture/ Dry needling 

• Pelvis and spinal realignment technique

• Posture correction exercises 

• Kinesio taping

It is an idiopathic condition causing the spine to curve sideways into a C shape or S shape. 

It affects mostly female during puberty, with a ratio of 8 female to 1 male.

According to the data, 3-5% of Hong Kong population has scoliosis. That's around 370,000 people with scoliosis, and most of the people are not aware that they have scoliosis.

Treatment for scoliosis may include:

• Biomodulator machine

• Muscle release techniques

• Acupuncture/ Dry needling 

• Lumbar side stretches

• Thoracic rotation mobilization 

• Strengthening of mid-thoracic muscles and core muscles

• Pilates with reformer

Back pain during pregnancy is common, but it is not normal.

Appropriate treatment can abolish back pain and it can also be prevented.

Treatment for pregnancy back pain may include:

• Muscle release techniques

• Modern oil cupping

• Pelvis and spinal realignment therapy 

• Ultrasound

• Pilates with reformer

While pregnant, the belly becomes overextended and ruptures the abdominal muscles causing abdominal separation.

This renders the core muscles dysfunctional.

With a dysfunctional core, the lumbar spine is forced to sustain increased in back pressure and increased in back pain.

After pregnancy, the belly becomes loose and flabby. The abdomen lacks core strength and the pelvis is overly lax. This increase the probability of having back pain even after giving birth.

Treatment for abdominal separation during and after pregnancy may include:

• Pelvis and spinal realignment therapy

• Posture correction exercises 

• Kinesio taping

• Pilates with reformer

• Home core strengthening exercises

During caesarean, 8 layers of tissues are being cut through. Hence, the scar is deep and makes core reactivation very difficult.

Treatment for caesarean scar may include:

• Biomodulator machine 

• Ultrasound therapy

• Shockwave therapy

• Scar management home exercises

• Pilates with reformer

• Lower abdominal strengthening exercises 

• Abdominal obliques strengthening exercises

A case study into the diagnosis, prognosis, treatment and recovery of back pain in a patient. 

A 33 years old woman came to see me after giving birth through caesarean.

She complained of constant back and right buttock pain.

The back pain started on the first trimester during her pregnancy. The back pain gradually became worse and referred down to her right buttock.

She also had pain on the caesarean scar causing her to hunch forward in order to avoid stretching the scar

She thought that the back pain would disappear after delivery. 

However, she noticed that the pain was worse after giving birth.

The back pain was aggravated with sitting, bending, carrying, lifting and turning on the bed

After seeing the doctor, she was recommended to see a women's health physiothetapist.

During examination, she presented with these signs and symptoms:

• Increased in back arching when standing

• Mild S shape scoliosis 

• Tenderness on right side of her back

• Decreased in motion of her back, specially during bending

• Muscle spasm on the right back muscles and right buttock

• Width of abdominal separation was 2 fingers apart

• Weak core muscle strength 

• Tenderness on caesarean scar 

• Difficulty in activating the lower abdominal muscles 

Treatment:

• Biomodulator and modern oil cuppingto release back muscle spasm  

• Acupuncture to back and right buttock to improve blood circulation and blood flow

• Biomodulator and ultrasound to the caesarean scar to decrease tenderness and to break down adhesion 

• Education about proper sitting and standing posture, correct lifting, and carrying techniques

• A post pregnancy corset was prescribed

Home exercises

• Specific scoliosis stretches

• Back flexion and rotation stretches

• Caesarian scar massage

• Hot pack to the back muscles

Lifestyle recommendations

• To wear the post pregnancy corset when doing aggravating activities and when attending to the baby

• To avoid hunching forward in order to avoid stretching the scar

Treatment progressed to:

• Acupuncture to the back and right butttock with electric stimulation 

• Shockwave therapy to the caesarean scar to break up deep adhesions

• Core strengthening exercises with Pilates

• Specific scoliosis strengthening exercises

Improvement 

After 4 sessions, the back pain was 70% better. The right buttock pain was gone. The tenderness on her caesarean scar was gone.

The treatment focus was shifted from pain management to core strengthening with Pilates.

After 10 sessions of Pilates, she was 100% better.

She no longer has pain when sitting, bending, carrying, lifting and turning on the bed.

The width of her abdominal separation was reduced to 1 finger.

She is extremely pleased with her improvements.

She was not aware that she had scoliosis all these years until my assessment found it out.

Now that she is aware,

she wants to continue with our Pilates session in order to prepare for her next pregnancy.

These are the reasons why women are more likely to have back pain compared to men.

As a woman myself, I fully understand the challenges we need to go through. 

Do not despair. The appropriate assessment, the right diagnosis and the onpoint treatment can solve all pain and discomfort.

For any enquiries, contact us at +852 2530 0073, or email appt@sportsandspinal.hk.