According to statistics, almost every second person in middle and old age comes to see a doctor with complaints of back pain in the lumbar region. Up to 80% of people experience such an unpleasant sensation at least once in their lives.
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 reasons 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 a timely manner to determine the true cause and help relieve 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 next to the spine and may be associated with spasms in these muscles. Painful sensations can move to the buttocks, and extremely rarely - down the leg.
Herniated disc
A herniated disc is characterized by prolapse of the inner part of the disc towards the spinal canal, which often causes severe, unbearable back pain in the lumbar region. A displaced and damaged disc in the lumbar region forms a herniation when it ruptures. The reason is that the structure of the disc degenerates (aging) to such an extent that the cartilage shell literally cracks, crumbles and the dense gel (nucleus pulposus) inside the disc is pushed out intospinal canal. A herniated disc puts pressure on the spinal nerves, often causing pain.
Disc degeneration and aging (osteochondrosis)
The discs between the vertebrae are strong and elastic cartilage shock absorbers between the vertebrae. As a result of the aging process, the intervertebral discs begin to shrink, lose their elasticity, and flatten. When osteochondrosis is present, pain occurs 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, it was believed that osteoarthritis was caused by wear and tear on joints over time. However, scientists now consider it a joint disease. Factors such as genetics, weight, injury, sedentary lifestyle, excess stress on the back and other factors are believed to contribute to this process. Spondyloarthrosis is one of the common diseases that causes lower back pain.
Spinal stenosis
Spinal stenosis is a narrowing of the spinal canal itself or a decrease in the lumen of the openings where the spinal nerves leave the spinal column. 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 the 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 slide, causing back pain mainly in the lower back.
Osteoporosis
Today, osteoporosis is a pressing problem for many women over 50 years of age and some men. This is a bone disease that occurs when the body loses too much bone tissue without having time to create new, young bone. Against the background of loss of bone tissue, its rarefaction and fragility arise, 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. When stressed, the muscles become more toned and spasms occur, making it difficult to move in the lower back and causing pain.
Other factors
Certain conditions may 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.
Sometimes lower back pain is referred, that is, it occurs 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 typically 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 addressed and strengthened to relieve discomfort and prevent the pain from returning in the future.
But how do the abdominal muscles affect the lower back? It's simple. The torso is a single muscular corset that supports the body, and if the muscles in the front (abdomen) are weak, guess which ones receive increased load? It’s true that the lumbar muscles in the posterior lower part of the body suffer more than others. Weak abdominal muscles end up creating additional tension around the back, which overworks the psoas muscles, causing soreness. Most people living with chronic back pain can reduce it by strengthening their core muscles. Performing a set of exercises daily 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 deflection of the spine in the lumbar region. This condition is not dangerous, but can later predispose to changes in posture, muscle strain, and pinched nerves. To avoid back problems or reduce discomfort when pain in the spine, mainly in the lower back, has already occurred, treatment involves wearing a support bandage, comfortable low-heeled shoes and often resting in a side position.
Types of sensations for back pain in the lumbar region
Back pain can be acute if it occurs 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:
- Severe, burning, sharp and almost unbearable pain. It is typical for hernias, radiculitis, lumbago (lumbago in the back).
- Dull, aching, bursting or vague pain. It often occurs with injury, inflammation or muscle strain, or problems with the soft tissues surrounding the spine.
- Chronic pain can be of a different nature; with movement or an uncomfortable position, it usually intensifies 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 pain, your doctor may prescribe:
- A set of laboratory tests to exclude inflammatory processes and pathologies of internal organs.
- X-ray of the spine (often in two projections: direct and lateral). This helps identify bone abnormalities, vertebral and joint deformities.
- Computer optical topography of the spine to assess postural disorders, determine the degree of spinal deformation, and pelvic distortion.
- MRI (magnetic resonance imaging) is the most frequently prescribed and informative method for diagnosing spinal diseases. MRI can detect damage to intervertebral discs, joints, spinal cord, vertebrae and other structures.
- ENMG (electroneuromyography) - to assess the state of neuromuscular transmission, function of nerves and muscles.
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;
- physical therapy and other methods.
In difficult cases, in the absence of effect from conservative therapy, surgical treatment may be indicated. These can be operations to replace a disc, remove hernias, fusion of the vertebrae (spinal fusion), vertebroplasty, etc.
Preventing back pain
To prevent the appearance and progression of back pain, it is necessary to monitor your posture, promptly consult a specialist at the first appearance of back pain, regularly undergo preventive procedures on the recommendation of a doctor, lead an active lifestyle, engage in special physical exercises, and, if possible, avoid excessive physical activity andinjuries.
Which doctor should I contact?
If you have back pain, especially your lower back, you need to see a neurologist for diagnosis and treatment. In some cases, consultation with a physiotherapist, neurosurgeon or urologist, gynecologist may be required.
FAQ
How to determine whether your back or kidneys hurt?
Very often there are situations when the spine imitates kidney diseases and vice versa, when kidney diseases masquerade 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 position to sleep in if you have lower back pain?
If you have lower back pain, it is recommended to sleep on a medium-hard mattress in a side-lying position, in the so-called "fetal position. "
Can lower back pain occur due to gynecological diseases?
Yes. Some gynecological diseases (inflammatory, neoplasms, etc. ) can cause referred 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 a reduction in pain and only then begin to perform active therapeutic exercises.
Can playing sports cause lower back pain?
Yes it is possible. Especially when practicing traumatic sports, not complying with the requirements for safe training, and also without prior warm-up.