According to statistics, almost every second person of middle and old age comes to a doctor with complaints of back pain in the lumbar region. Up to 80% of people experience such an unpleasant feeling at least once in their life.
All over the world, pain in the lumbar spine leads to the fact that a person loses mobility, undergoes long-term treatment and is forced to limit his usual activities.
Causes of lower back pain
There are many different causes and factors that cause back pain, especially often in the lower back. Some diseases are more common, others are quite rare, but it is important to consult a doctor in time to determine the real cause and help relieve the pain.
Muscle and ligament injuries
One of the causes of lower back pain is strain and damage to the muscles and ligaments that support the back. The pain is usually localized to the muscles that run up the spine and may be associated with spasms in those muscles. Painful sensations can move to the buttocks and extremely rarely - down the leg.
Disc herniation
A herniated disc is characterized by prolapse of the inner part of the disc into the spinal canal, which often causes severe, unbearable back pain in the lumbar region. A displaced and damaged disc in the lumbar region herniates when it ruptures. The reason is that the structure of the disc degenerates (ages) to such an extent that the cartilage lining literally cracks, tears and the dense gel (nucleus pulposus) inside the disc is pushed into the spinal canal. A herniated disc puts pressure on spinal nerves, which often causes pain.
Disc degeneration and aging (osteochondrosis)
Intervertebral discs are strong and elastic cartilaginous shock absorbers between the vertebrae. As a result of the aging process, the intervertebral discs begin to shrink, lose their elasticity and flatten. If osteochondrosis is present, pain appears along the spine, most often in the lower back, which requires treatment.
Not everyone who has disc degeneration has back pain. However, in those people who have ruled out all other possible back problems, the pain may be caused by degenerative changes in the discs (osteochondrosis).
Spondyloarthrosis (osteoarthrosis of the intervertebral joints)
Not long ago, osteoarthritis was thought to be caused by wear and tear on the joints over time. However, scientists now consider it a disease of the joints. Factors such as genetics, weight, injury, sedentary lifestyle, excessive stress on the back and other factors are believed to contribute to this process. Spondyloarthrosis is one of the common diseases that causes pain in the lower back.
Spinal stenosis
Spinal stenosis is a narrowing of the spinal canal itself or a reduction in the lumen of the openings where the spinal nerves leave the spine. This condition usually develops with age, against the background of pronounced degenerative-dystrophic changes in the structures of the spine and leads to a significant pain syndrome that is difficult to treat with possible development of disability.
spondylolysis
This term refers to a congenital or acquired condition, a cleft, crack, or fracture due to stress in one of the vertebrae. In some cases, a stress fracture weakens the bone so much that it cannot maintain its proper position in the spine. The vertebra begins to shift or slip, causing back pain mainly in the lower back.
osteoporosis
Today, osteoporosis is an urgent problem for many women over 50 and some men. It is a bone disease that occurs when the body loses too much bone tissue without having time to make new, young bone. Against the background of the loss of bone tissue, its thinning and fragility occurs, due to which it loses its strength and the vertebra can break from a fall or awkward movement, lifting a heavy object. In some cases, back pain can be caused by osteoporosis itself, even in the absence of a vertebral fracture.
stress
When it comes to back pain, stress is one of the common factors that can trigger back pain. Under stress, the muscles become more toned and spasms occur, which makes it difficult to move in the lower back and causes pain.
Other factors
Certain conditions can also contribute to back pain, including:
- infections with bone destruction (osteomyelitis),
- malignant oncology, especially if metastases have occurred in the bones of the spine,
- psoriasis, especially with arthritis,
- fibromyalgia.
Pain in the lower back is sometimes mentioned, i. e. it arises against the background of pathology in other organs and tissues, but is felt in the spine:
- urinary tract infections,
- diseases of the abdominal organs, kidneys and pelvic organs.
Posture problems
Back pain usually occurs as a result of strenuous daily activities. Often back pain, especially in the lower back, can be caused by poor posture and weak abdominal muscles. These are exactly the areas that need to be affected and strengthened to relieve discomfort and prevent pain from returning in the future.
But how do the abs affect the lower back? It's simple. The torso is a single muscle corset that supports the body, and if the muscles in the front (abdominal) are weak, guess which ones get an increased load? It is true that the lumbar muscles in the back of the lower body suffer more than the others. Weak abdominal muscles end up creating extra tension around the back, which overloads the psoas muscles, causing soreness. Most people living with chronic back pain can reduce it by strengthening their core muscles. Daily performance of a set of exercises can improve the condition.
Lower back pain during pregnancy
For the first time, women may experience lower back pain when carrying a baby. This is due to a change in the center of gravity, a change in posture and increased curvature of the spine in the lumbar region. This condition is not dangerous, but it can predispose to postural changes, muscle tension, and pinched nerves later on. To avoid back problems or to reduce discomfort in existing spinal pain, especially in the lower back, treatment includes wearing a supportive bandage, comfortable low-heeled shoes, and frequent side-lying rest.
Types of back pain sensations in the lumbar region
Back pain can be acute if it appears suddenly and lasts no more than 2-3 weeks. If the sensations last for months or even years, this is already a chronic pain syndrome. According to the sensations that arise, we can distinguish:
- Strong, burning, sharp and almost unbearable pain. It is characteristic of hernias, sciatica, lumbago (back lumbago).
- Dull, aching, radiating, or vague pain. It often occurs with injury, inflammation or muscle strain, or problems with the soft tissues around the spine.
- Chronic pain can be of a different nature, when moving or in an uncomfortable position, it usually increases to a burning, aching or shooting sensation. When resting, wearing corsets or certain body positions, they weaken.
Diagnosis of low back pain
To determine the cause of the pain, your doctor may prescribe:
- Complex of laboratory tests to rule out inflammatory processes and pathologies of internal organs.
- X-ray of the spine (often in two projections: direct and lateral). This helps identify bone abnormalities, spinal and joint deformities.
- Computed optical topography of the spine to assess postural disorders, determine the degree of spinal deformity and pelvic curvature.
- MRI (magnetic resonance imaging) is the most frequently prescribed and informative method for diagnosing diseases of the spine. MRI can detect damage to intervertebral discs, joints, spinal cord, vertebrae and other structures.
- ENMG (electroneuromyography) - to assess the state of neuromuscular transmission, nerve and muscle function.
Treatment of pain in the lumbar spine
A set of procedures for the treatment of back pain is prescribed by a doctor individually and may include:
- Painkillers, decongestants and anti-inflammatory drugs, muscle relaxants and vitamins (tablets, ointments, injections, droppers);
- physiotherapeutic techniques (intrastitial electrical stimulation, carboxy- and ozone therapy, electrophoresis, magnetic therapy, amplipulse therapy);
- kinesio taping,
- massage, manual therapy and osteopathy;
- acupuncture;
- physiotherapy and other methods.
In difficult cases, in the absence of effect from conservative therapy, surgical treatment may be indicated. These can be operations for disc replacement, hernia removal, fusion of vertebrae (spinal fusion), vertebroplasty, etc.
Prevention of back pain
To prevent the occurrence and progression of back pain, it is necessary to monitor your posture, immediately consult a specialist at the first appearance of back pain, regularly undergo preventive procedures on the recommendation of a doctor, lead an active lifestyle, to engage in special physical exercises. exercise and avoid excessive physical activity and injury if possible.
Which doctor should I contact?
If you have back pain, especially lower back pain, you should see a neurologist for diagnosis and treatment. In some cases, a consultation with a physiotherapist, neurosurgeon or urologist, gynecologist may be necessary.
FAQ
How to tell if your back or kidneys hurt?
Very often there are situations when the spine imitates kidney diseases, and vice versa, when kidney diseases are disguised as spinal pathology. To clarify the cause of the pain, it is necessary to consult a doctor and, if necessary, conduct an additional examination.
What is the best sleeping position if you have lower back pain?
For lower back pain, it is recommended to sleep on a medium-firm mattress in a side-lying position, in the so-called "fetal position".
Can pain in the lower back appear due to gynecological diseases?
yesSome gynecological diseases (inflammatory, neoplasms, etc. ) can cause pain in the lower back.
Is it possible to do exercise therapy if you have severe lower back pain?
If there is severe pain in the lower back, at the first stage of treatment it is recommended to first achieve pain reduction and only then start performing active therapeutic exercises.
Can exercise cause lower back pain?
Yes, it is possible. Especially when practicing traumatic sports that do not meet the requirements for safe training, and also without a preliminary warm-up.