About 80% of adults have experienced low back pain at least once in their lives. It affects both women and men equally.
The pain manifests itself in different ways: from dull and constant to sudden but very severe, which is temporarily incapacitated.
Sudden pain in the lumbar region occurs after an injury or lifting a heavy object. If we consider chronic pain, then it is often manifested due to age-related changes in the spine.
In this article we will discuss the main causes of low back pain.
What is the lower part of the spine made of?
The lumbar spine contains 5 vertebrae (L1-L5) that support most of the upper body weight. The space between the vertebrae is filled with round elastic pads - intervertebral discs. They act as shock absorbers, absorbing loads and softening their impact on the spine.
The ligaments hold the vertebrae and the tendons strengthen their muscles. Inside the spinal column are 31 pairs of nerves that control our movements and transmit signals from all parts of the body to the brain.
Why does the lower back hurt?
In most cases the pain is of mechanical origin. Next, we discuss the most common causes:
- Stretching or rupture of ligaments, tendons, and musclesIs the most common cause of severe lumbar pain. They appear on the ligaments, tendons and muscles after a spinal curvature, improper lifting of objects, lifting of any very heavy or excessive tension. All this also causes painful spasms in the spinal muscles.
- Degeneration of the intervertebral discs (wear).It is another of the most common causes of low back pain. This occurs when the elastic discs lose their integrity as the body ages. In healthy people, the intervertebral discs allow the stem to bend and curl normally. Due to the failure of the drives, they lose the ability to absorb the load.
- Disc protrusion or hernia.This occurs after strong compression of the intervertebral discs, protrusion (protrusion) or rupture (hernia).
- Radiculopathy.This is a condition caused by spinal nerve root compression, inflammation and / or trauma. Pressure on the nerve can cause lumbar pain and numbness or a tingling sensation. These symptoms extend to those parts of the body that are irritated by the nerve coming out of the root. Also, radiculopathy occurs due to compression of the nerve root with spinal canal stenosis, protrusion or rupture of the intervertebral disc.
- Sciatica- One of the forms of radiculopathy that develops due to compression of the sciatic nerve. It is a large nerve that runs through the buttocks and flows to the back of the foot to the heel. Compression of the sciatic nerve causes shooting or burning pain in the lower back, which is combined with pain in the buttocks and one leg. In the most severe cases, when the nerve is caught between the disc and the surrounding bone, not only pain but also numbness and weakness of the foot are disturbing. This is caused by a disturbance in the transmission of neural signals. In rare cases, the nerve or its root is twisted due to the formation of a cyst or tumor.
- Degenerative spondylolisthesis- This is the condition when the vertebrae "fall" from the place and strengthen the nerves coming out of the spine.
- TraumaFor example, due to sports activities, car accident or fall. Injuries are a source of strain or rupture of ligaments, muscles and tendons. They also cause excessive compression of the spine, which in turn causes disc protrusion or hernia.
- Spinal stenosis- This is a narrowing of the lumen, which increases the pressure on the spinal cord and nerves. As a result, there is pain or numbness while walking. Over time, the stenosis causes weakness and numbness in the legs.
- Scoliosis and other skeletal imbalances.Scoliosis is a lateral curvature of the spine that usually does not cause pain until middle age. Another common disorder is hyperlordosis, in which there is an excessive deviation of the spine in the lower part of the spine.
Who is most at risk for low back pain?
Several factors increase the chance of this problem. Between them:
- Age- The first pain attacks at the age of 30-50 years. Osteoporosis causes bone strength to be lost with age, leading to fractures as well as decreased muscle tone and elasticity. The intervertebral discs begin to lose fluid and flexibility, which in turn impairs the ability to absorb stress. The risk of developing spinal stenosis also increases with age.
- Low level of physical activity- Weak muscles of the abdomen and spine may not support the spine properly. This is due to the sedentary lifestyle and lack of muscle strengthening exercises. Particularly affected are people who spend all week without movement, and on weekends try to catch up and exercise excessively. People who exercise with moderate intensity but most days of the week are less likely to experience low back pain. Research shows that low-intensity aerobic exercise is beneficial in maintaining the integrity of the intervertebral discs.
- Pregnancy- Very often, back pain occurs in expectant mothers. The fault for all this - structural changes in the pelvis and weight redistribution. One good thing is that postpartum pain takes care of almost everyone.
- Weight gain- A sharp increase in excess weight, obesity, or just kilograms puts stress on the back and causes low back pain.
- Hereditary predisposition.One type of arthritis, ankylosing spondylitis, is often inherited. In this disease the joints of the spine grow together, which causes pain as well as decreased mobility of the spine.
- Specifics of work.If your job involves lifting weights, pushing or pulling, you run the risk of injury or pain in the lumbar region. Particularly dangerous is the movement of gravity, during which the spine twists or vibrates. Inactive work also increases the risk of pain. Those who do not maintain their posture or sit on a chair with unsuitable backs all day are especially affected.
The problem of overloading school students with textbooks and accessories that they carry in their backpacks stands alone. Experts from the American Academy of Orthopedic Surgeons note that the maximum weight of a backpack should not exceed 15-20% of the weight of the child.
Treatment of low back pain
The treatment strategy will depend on what kind of pain you are experiencing - short-term acute or chronic. The most commonly used pain management techniques include:
Apply warm or cold compresses
Compresses are used to relieve pain and reduce inflammation. They can be used for any back pain, both acute and chronic. Compresses do not cure the underlying cause, but rather help relieve pain and improve joint movement.
Maintain physical activity
Bed rest should be kept to a minimum. Stretching should be done and normal motor activity maintained, movements that increase pain should be avoided. Studies have shown that staying active after the onset of low back pain helps maintain flexibility. Moreover, bed rest can intensify the pain and lead to secondary complications. These include depression, decreased muscle tone, and blood clots in the legs.
Exercise (in addition to normal physical activity) is not recommended for severe pain. They can be considered as an effective remedy for accelerated recovery from chronic low back pain.
Maintaining and increasing the strength of the back and abdominal muscles is especially important for people who suffer from muscular imbalance (scoliosis, hyperlordosis). To correct posture and muscle imbalances, you should consult an orthopedic traumatologist. Your doctor will develop a set of exercises to help you correct these disorders.
By the way, studies have shown that doing yoga can also help relieve pain.
Medication for back pain
Depending on the severity of the condition, doctors prescribe one or more drugs:
- Painkillers - to relieve pain.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) - to relieve pain and inflammation.
- Anticonvulsants prescribed to treat seizures may be helpful for people with radiculopathy.
- Tricyclic antidepressants and serotonin and norepinephrine reuptake inhibitors are prescribed for chronic pain. Although their effectiveness in treating low back pain has never been proven.
- Creams and sprays - for cooling or heating.
Surgery is recommended only if progressive nerve damage or structural changes in the spine are found.
When should you see a doctor?
Contact your doctor immediately if the pain is severe and:
- Appeared after a fall, injury or back injury;
- It worsens at rest or at night.
- Worsens when coughing or urinating
- Apply to one or both feet;
- Accompanied by weakness, numbness or tingling in one or both legs
- Accompanied by fever or unexplained weight loss
- Accompanied by pain or pulse sensation in the abdomen
- It is accompanied by an inability to control the act of urination or defecation.
Do not wait until your back pain gets so bad that you are ready for anything. It is best to consult an orthopedic traumatologist.