Back pain: multiple causes

Patient: 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: Certainly, you have factors that are contributing to cause the pain that you described throughout your back. What you n 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.