Low Back Pain
Dx: Endometriosis (Gyneologic System)
Clinical Presentation: Endometriosis is a condition that can occur in women, who may present with intermittent, cyclical, or constant pelvic and/or back pain.1 Symptoms tend to come and go with the menstrual cycle and can be a key sign to recognizing the condition.1 Other symptoms of endometriosis include pain in the hypogastric and perineal region, and pain in lower back and lower extremities.1 Hallmark symptoms of endometriosis are general pelvic pain, dysmenorrhea, and dyspareunia.2 Other symptoms may include painful bowel movements or pain during urination while on menstrual period, spotting before and between periods, heavy or irregular menstrual bleeding, nose bleeds, coughing up blood,
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Immediate Medical Referral, physician referral, or no referral
Endometriosis is not life threatening and therefore would only require a physician referral. However, endometriosis can cause several comorbidities, result in infertility, and lead to chronic pelvic pain. Therefore, as a physical therapist you would want to make a call to the patient’s physician, and advise the patient to see their physician as soon as possible, to avoid an late term effects.
Journal Case Summary and Reflection
Endometriosis is a common gynecological disorder that can cause and be mistaken for musculoskeletal symptoms to the low back.2 This disorder occurs in women in their childbearing years, and is one of the leading causes of chronic pelvic pain, hysterectomy, infertility, and gynecologic hospitalization.2 Endometriosis is when the endometrium, the lining of the internal cavity of the uterus, is external to the uterus, attaching to pelvic visceral structures and proliferates within the pelvic cavity.2 The endometrium undergoes necrosis, hemorrhage, and discharge which leads to the process of menstruation.2 Therefore, this condition can lead to internal pelvic bleeding, inflammation, and
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Her PCP order radiographs and an MRI both which appeared unremarkable.2 Due to the negative radiographs, her PCP referred her to an orthopedic who linked her back pain to lifting boxes at work, prescribed analgesics, and referred the patient to physical