[The gynaecologist's view of lower back pain (author's transl)].

Pain is a sensation, "lower back" a vague anatomical term, and lower back pain no disease, but a multilayered symptom. Women with this condition usually first see the gynaecologist, but in only approximately 10% of these cases is the pain referable to disease of the genital organs. 90% are due to inflammatory or degenerative skeletal disease. The differential diagnosis of lower back pain requires knowledge of innervation. Head's or Mackenzie's zones, blood supply, and anatomy of the pelvic area. The effects of pregnancy on the sacroiliac joints, anomalies of positive adnexitis, endometriosis, weakness of the pelvic muscles and connective tissue as a result of trauma during childbirth or on a genetic basis, as well as psychosexual vasomotor alterations may play a causative role. Differentiating pointers and therapeutic methods are presented.