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Various clinical conditions can cause low back pain, and in most cases it is of a degenerative origin. Degenerative disc disease is a common condition which affects young to middle-aged women. Changes in the mechanical properties of the disc lead to degenerative arthritis in the intervertebral joints, osteophytes, and narrowing the intervertebral foramen or the spinal canal. Degenerative cascade is the widely accepted pathophysiologic model describing the degenerative process as it affects the lumbar spine in 3 phases. There are two forms of low back pain secondary to degenerative disc disease: a) lumbalgia and b) lumbar radiculopathy. Limitation of movement, problems with balance, pain, loss of reflexes in the extremities, muscle weakness, loss of sensation or other signs of neurological damage can be found on physical examination. For accurate diagnosis, it is often necessary to combine clinical examination and sophisticated technology. To diagnose low back pain in women, the uterus and other pelvic organs must be examined. Dysmenorrhea (functional) is often the cause, but tubo-ovarian abscess, ovarian cysts, endometriosis, fibroids, retroversionor flexion of the uterus, and uterine carcinomas must be looked for. The bladder and urethra are infrequent causes of low back pain, but a urinalysis and culture may be necessary to rule out infections. Other diseases, gastric or peptic ulcer, aortic aortic aneurysm, herpes zoster should be rule out for accurate diagnosis.
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