Post hysterectomy patients presenting with low back pain: a preliminary case study

Author(s): Zea, J., Bolton, J.

Abstract: A retrospective patient case file study was carried out to determine the prevalence of referred and/or radiating pain in women with low back pain, in relation to the presence or absence of a history of hysterectomy.In a random sample of 436 women with low pack pain, aged from 50 to 70 years, 33.8% were found to have undergone a hysterectomy. From the case files of these patients, pain patterns were categorised according to the literature, as either referred, radiating or both referred and radiating, A significantly greater prevalence of referred pain was demonstrated in women with a history of hysterectomy (88.2 %), compared with women without (77%, p < 0. 05), and conversely a significantly greater prevalence of radiating pain (19.6%) was found in women without a history of hysterectomy compared with post-hysterectomy women (9.3 %, p < 0. 05).Several factors may contribute specifically to low back pain in posthysterectomy women, namely viscero-somatic and somato-visceral reflexes, as well as operative and Post-operative procedures. The increased prevalence of referred pain in post-hysterectomy women may be the result of one or a combination of these.As a pilot study, suggestions are made for future prospective investigations, including more objective pain pattern categorisation.

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