Back pain: multiple causes

Patient

Q: I am 29 years old. I have endometriosis. I had 3 injections of depot lupron at age 22 they lasted 6 months each. After that I tried to be in a study for endo and I couldn't because I was told I was osteopenic. My T score is-1.41 z score is -1.39 my bone men density is 120.4 mg/ml. I had a scoliosis study and it said there is a pelvic tilt iliac crest higher than the right and 14 degree of levoscoliosis identified from L1-L5. I am in pain all throughout my back and even with exercise it doesn't get better. Does this sound like symtoms of fibromyalgia because none of the medicine I've taken for that help. I need some advice desperately.

Doctor

A:    Certainly, you have factors that are contributing to cause the pain that you described throughout your back. What you need to try is not just exercise, is Physical Therapy aimed to control pain , set you up with a consistent and regular  exercise routine to strengthen and stretch your back and abs muscles and give you guidelines to modify daily living activities , habits and postures that might be causing the back pain. I advise you also make sure that you are getting enough Calcium and Vitamin D with your diet. For your information,Fibromyalgia is a widespread or global pain, it can start in one site , as in your case  in the back, but becomes generalized pain for more than 3 months of duration, it can affect individuals of any age, and more women than men, but just the 2% of the general population in US meet the criteria to be diagnosed of Fibromyalgia.  If after you try all these measures, you still are in pain, I strongly recommend you a thoroughly re-evaluation, repeating densitometry and spine imaging studies just to rule out some other possible causes of your symptoms and from there decide the best treatment options your you.

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