The Bio-psychosocial Relevance of Non-Specific Low Back Pain (NSLBP) in Peri -and Postmenopausal Women

Abstract

Non-specific low back pain (NSLBP) in peri- and postmenopausal women is becoming an increasingly important women’s health concern. It draws attention to three major issues: the global burden of disability, a growing ageing population, and the physical, emotional, and social changes that accompany menopause.Low back pain impacts a significant population worldwide. The World Health Organization reports that 619 million people were living with low back pain in 2020, and this number is expected to rise to 843 million by 2050. It also remains the leading cause of disability worldwide, mainly due to an increase in the ageing population. According to WHO, the number of women aged 50 years and above is expected to reach 1.2 billion globally by 2050.

Peri-menopause in women is a transitional phase leading to menopause, typically beginning in mid to late 40s. Both the phases are characterized by irregular menstrual cycles and fluctuations in estrogen and progesterone resulting in hot flashes, sleep disturbances, mood changes and a shift in body composition. These changes in combination with decreasing bone density accelerate degenerative changes in the lumbar spine, thereby increasing the susceptibility to Low back pain. Common symptoms like anxiety, depression, and general psychological distress are known to be strongly associated with the transition from acute to chronic LBP. Social and family responsibilities of women as primary care takers are likely to further delay healthcare access and worsen outcomes.

All the above factors emphasize why NSLBP in peri- and postmenopausal women should be understood through a bio-psychosocial lens. Exploring and understanding this multifactorial nature of NSLBP is inevitable for a better assessment and earlier prevention, and to design individualized care.