Professional Documents
Culture Documents
Mohammad A. Emam
Prof. OB& GYN
Mansoura Faculty of Medcine Mansoura integrated fertility center (MIFC) EGYPT www.ivfmifc.com
What is backache ?
Is stiffness and/or pain in the back
RATIONALE &CONCEPT
Although back pain (BaP) is a common complaint, but it is a forgotten topic in most Ob& Gyn text books. BaP represents a dilemma for the gyaecologists ,as many myths, facts and fictions not resolved by evidence- based data. Era of complementary and alternative medicine ( CAM ).
Epidemiology
Female > male. The second common complaint after headache 30-90 % in pregnancy.
Epidemiology cont
Rarely due to any serious disease. Sometimes a clear cause but mostly no cause can be elicited.
Gynaecologic Causes
Prolapse (uterine). RVF. Ch. Cervicitis. Tumours. Endometriosis. Pelvic congestain. PMTS. Ut. Contractrains (polyp). Menst. Molimia. Osteoporosis
Diagnosis (Milestones)
BaP caused by a gynecologic lesion:
Always diffuse. Midline OR bilat. Sacral, lumbo sacral and never high than L4 (LBP).
BaP which can be pointed with a finger tip local tenderness not due to intrapelvic lesion.
Role Of Gynaecologist
1. Determine cause:
History Exam Invest.
2. If no cause:
Reassurance. Correction of posture. Exercises. Simple drugs. Complementay &Alternative medicine.
Psychological.
Correction Of Posture
Advices:
Stand up straight (smart). Drop your shoulders and relax your knees when standing.
Always bend from your knees and lift objects and children from a crouching position to minimize the stress on your back.
Maintain your weight within the given parameters of weight gain. Avoid standing for long periods of time.
SPINAL EXERCISES
EXERCISES
. Simple exercises (curative). .Activity not bed rest.
1. WAIST ROTATION
2. HIP ROTATION
5. TORSO-TWIST
6. PELVIC ROCK
Praying.
Cupping (baguanfa)
Cupping therapies often follow the point selection pattern that is used for standard acupuncture therapy.
Chiropractic
"Chiropractic comes from the Greek word Chiropraktikos, meaning "effective treatment by hand "Science based on the theory that health and disease are life processes related to the function of the nervous system.
Gynecological Role
cont.
Referral to:
Physiotherapist. Osteopath. when serious problem is suspected
Psychological
In majority No gross lesion. Patient is handed from physician to Gynecolog. to orthopedic to surgeon. Anxiety neurosis sequalae.
FACTS OR FICTIONS;;
Cervical erosion (ectopy) never causes back pain. Vaginal prolapse never cause backache. Uterine prolapse and RVF rarely cause dragging pain on uterosacral and cardinal ligaments.
OB& GYN, Mansoura Faculty of Medicine Mansoura Integrated Fertility Center (MIFC) EGYPT Telfax 0020502319922 & 0020502312299 Email. mae335@hotmail.com
www.ivfmifc.com