Intermittent low back pain referred from a uterine adenomyosis: a case report

Jensen, Anne M.; Bewketu, Brutawit; Sanford, Douglas W.

doi:10.1016/j.jcm.2010.08.004

Cited by 2 publications

(2 citation statements)

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“…Documented female specific intrapelvic sciatic lesions include the following: endometriosis, pregnancy/labor related complications, adenomyosis, retroverted uteri, and fibroid variants. 1,[11][12][13] Fibroids (leiomyomas, myomas, fibromyomas), which are well-circumscribed nonencapsulated benign tumors, are the most common benign mass of uterine origin. 14 In women older than 35 yrs, they are estimated to have at least a 20%-25% prevalence.…”

Section: Discussionmentioning

confidence: 99%

“…When accounting for additional female intrapelvic structures adjacent to the sciatic nerve’s origins before exiting the pelvis, there are ample additional opportunities for intrapelvic sciatic nerve lesions in women. Documented female specific intrapelvic sciatic lesions include the following: endometriosis, pregnancy/labor related complications, adenomyosis, retroverted uteri, and fibroid variants 1,11–13 …”

Section: Discussionmentioning

confidence: 99%

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Atypical Cause for Back Pain and Sciatica in a 35-Yr-Old Woman With Fibromyalgia

Naber

Netzloff

Bakshi

2023

Am J Phys Med Rehabil

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Spinal and extrapelvic lesions causing sciatic symptoms are well recognized in clinical research and practice. 1–5 We present a 35-yr-old woman with a history of axial back pain and fibromyalgia who presented with episodes of radicular type pain down her legs and associated bilateral tingling in her feet. Medicinal and therapeutic interventions for traditional sciatica etiologies failed to provide relief. Lumbar magnetic resonance imaging showed mild multilevel degenerative changes and partially visualized fibroids, but no other significant spinal pathology was appreciated. Subsequent pelvic magnetic resonance imaging revealed an enlarged retroverted uterus with multiple fibroid lesions. The patient elected for laparoscopic myomectomy, which improved her likelihood of fertility while drastically alleviating her axial spine and lower extremity symptomology. This case reinforces the importance of keeping a broad differential that includes intrapelvic etiologies when traditional workup and treatment for sciatic neuropathy fails. To our knowledge, this is the first reported case of sciatic neuropathy secondary to uterine fibroids treated with the intent of both fertility improvement and pain relief.

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