Being A Woman Can Be A Real Pain in the Back
PMS and Endometriosis: Three Stretches That Will Give You Relief.
By Mary Schatz, M.D.
- Do you have back pain that seems to be related to your monthly cycles?
- Have you noticed that back pain begins when you ovulate and ends when your period begins?
- Have you been diagnosed with endometriosis?
If you answered “yes” to any of the questions above, your back pain may be associated with your menstrual cycle.
Not sure? Try keeping a Back Pain/Monthly Cycle Log for a few months to see if there’s a relationship between your back pain and your monthly cycle.
The following excerpt from Dr. Schatz’s classic yoga book, Back Care Basics, can show you how to cope with monthly back pain and get relief! Not only will it give you insight into why your back may hurt, it provides three easy and relaxing yoga poses that will rapidly help relieve your symptoms.
PMS, Endometriosis, and Back Pain
Premenstrual syndrome (PMS) and endometriosis (displaced fragments of uterine lining) are both well-known female health challenges. The symptoms of PMS (in cluding depression, mood swings, emotional fragility, fluid retention, food cravings and/or pelvic pain) and the pain and infertility caused by endometriosis are widely recognized. What is less well known, however, is that both of these conditions can be associated with back pain.
In two clinical studies of women with premenstrual syndrome, one-fourth to three-fourths of the women with PMS reported back pain that began with ovulation and ended with the onset of menstruation. The exact cause of back pain in PMS is not well understood, but it may be related to the release of hormones called prostaglandins shortly after ovulation (These hormones are also responsible for the uterine muscle contractions that women experience as cramps).
Pelvic congestion can also be a cause of back pain in the premenstrual part of the cycle. The blood vessels in the pelvis become swollen and engorged with blood as a result of the hormonal effects of ovulation. The associated swelling in the soft tissues of the pelvis causes back pain in many women.
Endometriosis is a condition in which small pieces of uterine lining tissue (endometrium) become attached to the outer surfaces of the uterus, ovaries, fallopian tubes, bladder, and intestines. They are subject to the same hormonal influences as normally located endometrium. As the monthly cycle progresses, the areas of endometriosis gradually increase in thickness, just as the uterine lining does. When it comes time for menstruation, they begin to break apart and bleed. Unlike the uterine lining, however, this tissue has no way to move out of the body. Over time, this recurrent hemorrhage causes the pelvic organs to become stuck together with adhesions and scar tissue.
Endometriotic implants on the network of nerves at the back of the pelvis can cause back pain. They have even been shown to cause classic symptoms previously thought to result only from a herniated intervertebral disc.
Although yoga exercises for PMS and endometriosis cannot cure either condition, they can relieve some of the muscle spasm that occurs due to pelvic nerve irritation, and some of the discomfort of pelvic congestion. Perhaps just as important, exercises and relaxation impart a sense of control and help reduce feelings of stress, anxiety, and depression.
The poses B.K.S. Iyengar recommends for discomfort related to the menstrual cycle demonstrate his three cardinal principles of therapeutic yoga: spreading (creating space for fresh blood to enter the organ), soaking (providing time and space for fresh blood to bathe and nourish the organ), and squeezing (removing used blood and fluid by pressure). This approach helps alleviate pain related to pelvic congestion.
Guidelines for Yoga Practice during Menstruation
Yoga teaches balance: balance of the body in relation to gravity; balance of the mind between action and observation; and balance of the neuroendocrine system between activity and relaxation.
Through a regular yoga practice, you learn which poses are effective in reestablishing balance in various aspects of your existence. Certain poses in this ancient discipline are particularly useful to establish inner balance during menstruation. These poses ease menstrual cramps, heavy bleeding, pelvic discomfort, and the lower back pain sometimes associated with menses. They are also effective at smoothing out the emotional rough edges some women encounter at this time of their cycle.
Just as some poses are helpful during menstruation, other poses should be avoided. These guidelines are based on sound physiological knowledge and time-tested applications of yogic principles to women’s special needs. Women are cyclic beings. For a woman to deny this fact interrupts the self-understanding she seeks through yoga.
The time of menstruation can be welcomed as a time for going within and allowing yourself to have low energy. Use this time to experience different aspects of your nature. High-energy exercise and vigorous yoga needs to be balanced by the quiet and peace gentle yoga can offer. The time of menstruation is a perfect time to vary your exercise routine by turning inward.
In general, poses requiring exertion and great energy are not recommended during the first few days of menstruation. Physical strength may be somewhat diminished at this time, causing you to be shaky or off balance. Attempting a strenuous practice when your energy is low can lead to injury or further depletion of energy supplies. This is a time to allow yourself to rest by practicing the restorative yoga poses that follow.