Adenomyosis And Back Pain
Adenomyosis is a women’s reproductive health issue that is not as well known as its “evil twin sister” endometriosis although they originate from the same place. Both of these conditions occur when cells from the inner lining, i.e endometrium, of the uterus begin to grow in other locations. In the case of adenomyosis, the cells infiltrate into the layer immediately deep into the lining, i.e. subendometrium. Endometriosis occurs when these cells grow outside of the uterus altogether; most commonly in the pelvis (e.g. ovaries, fallopian tubes, and bladder), but can potentially be anywhere in the body. Therefore, in simple terms, adenomyosis can be thought of as endometriosis that involves the uterus.
Adenomyosis, like other women’s health issues, can cause unpleasant symptoms including heavy bleeding, pelvic pain and pressure, pain during sex, and back pain that can radiate down the legs.
How Can I Tell If Adenomyosis Is Causing My Lower Back Pain?
Obtaining an accurate adenomyosis diagnosis is very challenging especially as it relates to back pain. Much of the time, lower back pain is associated with musculoskeletal disorders like a herniated disc or a strain. However, when these conditions are ruled out as a cause of the pain, other possibilities like adenomyosis or fibroids should be considered.
One of the most common reasons individuals go to the chiropractor is to seek relief from lower back pain. It is also one of the main reasons people schedule appointments to see a physical therapist or their primary care physician.
Adenomyosis lower back pain usually, but not always, coincides with a woman’s menstrual cycle. Also, the focus is on the back pain and she may not mention her other symptoms because she is unaware they are related or may think that it’s her “normal.”
This makes it very difficult for the medical professional to make an association between her back pain and a possible connection to adenomyosis, endometriosis, or uterine fibroids. Patients have been referred to the Atlanta Fibroid Center by chiropractors who obtained a lumbar spine MRI on back pain patients only to see a normal lumbar spine and a large fibroid in the back of the uterus or adenomyosis accounting for the pain.
Accurately Diagnosing Adenomyosis
Adenomyosis is often misdiagnosed because it creates symptoms that are very similar to other women’s reproductive health issues; most commonly uterine fibroids.
Historically, the only way to accurately diagnose adenomyosis was after a hysterectomy was performed. Whenever tissue is surgically removed, it is sent to Pathology for analysis. A number of patients who underwent hysterectomy and were thought to have fibroids actually had adenomyosis when examined by the Pathologist. The reason the correct diagnosis was not made prior to surgery was the fact that pelvic ultrasound often cannot make the diagnosis of adenomyosis. This is an easy diagnosis to make on pelvic MRI but this imaging tool is significantly underutilized.
If you are experiencing heavy bleeding, back pain, leg pain, or pain during sex ask and your OB-GYN is not sure of the diagnosis after a pelvic ultrasound, ask them to send you for a pelvic MRI. This produces the highest-resolution images and makes it easier for a Radiologist to identify and differentiate between adenomyosis, uterine fibroids, and endometriosis.
Can Adenomyosis Cause Back And Leg Pain?
Yes, some women who have complained of lower back pain for years eventually were diagnosed with adenomyosis.
Some experts believe that adenomyosis can create what is called referred pain which is pain that occurs somewhere besides the origin site.
Adenomyosis can enlarge the uterus up to three times its original size, and it can then exert pressure on other nearby organs or nerves that can radiate pain to other areas such as the back and legs.
One case study of a 45-year-old woman reported that she had suffered from lower back pain for over 4 years and could not find relief. She had been to several doctors, and chiropractors, and had even tried several non-traditional therapies including acupuncture, rolfing, and herbal remedies just to name a few.
Her pain was not only contained in her abdomen, she also had adenomyosis back and hip pain. At times it also settled in her groin area or above her knees.
Another woman reported having heavy periods, pelvic pain, and “mystery back pain” as her doctors called it. She was even referred to two spine specialists to try and figure out what was causing her back pain. She was finally diagnosed with adenomyosis and endometriosis.
What Does Adenomyosis Lower Back Pain Feel Like?
One woman who was diagnosed with adenomyosis, after being misdiagnosed for years, said that her adenomyosis back pain lasted anywhere from 2 days to 2 weeks and varied in how painful it was.
Adenomyosis back pain has been described by patients as:
- Severe aching where the pelvic bones meet the spine;
- Sharp pains or dull aching in the lumbar spine;
- Aches in the groin or inner thighs;
- Dull chronic ache in the hips;
- Aching or pains above the knees;
- Pain levels that range from a 2/10 to a 10/10.
What Is The Best Treatment For Adenomyosis Lower Back Pain?
- Some women find temporary relief using heat therapy or over-the-counter anti-inflammatory medications such as Advil which may provide relief for a few hours.
- Hormone Therapy
- Doctors may prescribe hormone therapy such as oral contraceptives or IUDs, etc. According to most women who have tried these, they only offer temporary symptom relief.
- Hysterectomy Surgery
- Most OB-GYN’s will suggest the surgical removal of the woman’s uterus to treat adenomyosis. While this will eliminate the condition, it may bring on many unwanted side effects.
- Uterine Artery Embolization
- Uterine Artery Embolization (UAE) is a non-surgical treatment that can provide long-term relief from adenomyosis back pain and other painful symptoms.
A recent study reported that 88% of the participating women were successfully treated for adenomyosis with UAE. Out of these women, 90% of them had not experienced a recurrence at the conclusion of the study which was 52 months. The other 10% began to exhibit symptoms at 31 months.
Researchers concluded that long-term durability was demonstrated by the UAE procedure. UAE should be offered as a nonsurgical treatment option for all women suffering from adenomyosis as an alternative to hysterectomy surgery.