I had a vaginal hysterectomy so no muscles were cut. Even so I'm having back pain and weakness. How do you explain this?

With advances in surgical technique many pelvic and abdominal surgeries can be done without cutting muscles or nerves. The surgeon may be able to use special tools to remove tissue through small puncture holes in the abdomen or through the vaginal canal.

Injuries or just effects of surgery can affect muscle strength and function. Stretching or compression can occur when the soft tissues are pulled out of the way, a process called retraction. Ischemia or temporary decrease in blood supply during surgery can also affect the soft tissues.

Injuries of this type can cause biomechanical changes. Sometimes the recovery of normal motor function isn't automatic. The muscles don't contract together at the right time to stabilize the trunk and spine. Pain may be another factor affecting how and when muscles function.

More and more research is showing the positive value of core training to 'reset' spinal stability. Physiotherapists teach patients specific exercises for the abdomen and trunk. This kind of rehab program may be helpful for you.

Jeffery J. Ericksen, MD, ME, et al. Does Gynecologic Surgery Contribute to Low Back Problems in Later Life? An Analysis of the Women's Health and Aging Study. In Archives of Physical Medicine and Rehabilitation. February 2006. Vol. 87. No. 2. Pp. 172-176.