About 80% of adults have experienced low back pain at least once in their lifetime. It affects both men and women equally.
The pain manifests itself in different ways: from dull and constant, to sudden but very acute, which is temporarily incapacitated.
Sudden pain in the lower back occurs after an injury or lifting of a heavy object. If we consider chronic pain, then it often manifests itself due to age-related changes in the spine.
In this article, we will look at the main causes of low back pain.
What does the lower back consist 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 mitigating their impact on the spine.
The ligaments hold the vertebrae in place and the tendons connect the muscles to them. Inside the spine 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 will examine the most common reasons for it:
- Rupture or rupture of ligaments, tendons and musclesis the most common cause of acute low back pain. They appear after twisting the spine, lifting objects improperly, lifting something very heavy or excessive tension in ligaments, tendons and muscles. All this also provokes painful spasms in the muscles of the back.
- Degeneration (consumption) of intervertebral discsIt is another of the most common causes of low back pain. Occurs when elastic disks lose their integrity as the body ages. In healthy people, the intervertebral discs allow the trunk to bend and twist normally. As the drives fail, they lose their ability to absorb loads.
- Disc protrusion or hernia.This occurs after the intervertebral discs are tightly compressed, inflated (protrusion) or ruptured (hernia).
- Radiculopathy.It is a condition caused by compression, inflammation and / or trauma to the spinal nerve root. Nerve pressure can cause pain in the lower back and numbness or tingling sensation. These symptoms spread to those parts of the body that are irritated by the nerve that comes out of the root. Also, radiculopathy occurs due to compression of the nerve root with spinal canal stenosis, elongation or rupture of the intervertebral disc.
- Sciatica- one of the forms of radiculopathy, which develops due to compression of the sciatic nerve. It is a large nerve that runs through the buttocks and runs from the back of the foot to the heel. Compression of the sciatic nerve causes shooting pain or burning 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 adjacent bone, not only pain but also numbness and weakness in the leg are disturbed. This is due to the violation of the transmission of nerve signals. In rare cases, a nerve or its root is suppressed due to a cyst or tumor formed.
- Degenerative spondylolisthesis- This is a condition in which the vertebrae "fall" from their place and tighten the nerves coming out of the spine.
- Traumafor example due to sports activities, a car accident or a fall. Injuries are the source of sprains or tears of ligaments, muscles and tendons. They also lead to excessive compression of the spine, which in turn causes disc elongation or herniation.
- Spinal stenosis- This is a narrowing of the lumen, which creates increased pressure on the spinal cord and nerves. As a result, pain or numbness occurs while walking. Over time, stenosis leads to 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 excessive deviation of the spine in the lower back.
Who is most at risk for back pain?
Several factors increase the chances of encountering this problem. Among them:
- Age- the first time the pain attacks at the age of 30-50 years. Due to osteoporosis, bone strength is lost with age, which leads to fractures as well as decreased muscle tone and elasticity. Intervertebral discs begin to lose fluid and flexibility, which in turn impairs their ability to absorb stress. The risk of developing spinal stenosis also increases with age.
- Low level of physical activityWeak muscles in the abdomen and spine may not support the spine properly. A sedentary lifestyle and lack of exercise to strengthen muscles are to blame for this. Particularly affected are people who spend a whole week without moving and on weekends try to reach and train a lot. People who exercise with moderate intensity, but on most days of the week, experience lower back pain much less often. Research shows that low-intensity aerobic exercise is beneficial for maintaining intervertebral disc integrity.
- pregnant- very often, back pain appears in expectant mothers. It's all to blame - structural changes in the pelvic area and weight redistribution. One good thing is that after birth, the pain goes away for almost everyone.
- Weight gain- the presence of excess weight, obesity, or simply a sharp increase in weight stresses the back and leads to pain in the lower back.
- Hereditary predisposition.One type of arthritis, ankylosing spondylitis, is often inherited. In this disease, the vertebral joints grow together, which causes pain as well as decreased mobility in the spine.
- Job specifications.If your job involves lifting, pushing, or pulling weights, you run the risk of injury or pain in your lower back. Particularly dangerous is the movement of weights, in which the spine twists or shakes. Inactive work also increases the risk of experiencing pain. Particularly affected are those who do not follow their position or sit in a chair with an unsuitable support all day.
The problem of overloading students with textbooks and accessories they carry in their backpacks has been singled out. Experts from the American Academy of Orthopedic Surgeons note that the maximum weight of the backpack should not be more than 15-20% of the child's weight.
Treatment of low back pain
The treatment strategy will depend on the type of pain you are experiencing - acute or chronic short-term. The most commonly used pain management techniques include:
Application of hot or cold compresses
Compresses are used to relieve pain and reduce inflammation. They can be used for any back pain, acute and chronic. Compresses do not treat the underlying cause, but help relieve pain and improve joint mobility.
Maintaining physical activity
Bed rest should be kept to a minimum. Stretching should be done and normal motor activity should be maintained, avoiding movements that increase pain. Research shows that staying active after the onset of low back pain helps maintain flexibility. Moreover, bed rest can worsen the pain and lead to secondary complications. These include depression, decreased muscle tone and blood clots in the legs.
Strength training (other than regular physical activity) is not recommended for acute pain. They can be seen 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 suffering from musculoskeletal imbalances (scoliosis, hyperlordosis). To correct posture and muscle imbalance, you should contact an orthopedic traumatologist. The doctor will develop a set of exercises that will help correct these disorders.
By the way, research shows that yoga can also help relieve pain.
Medications for back pain
Depending on the severity of the condition, doctors prescribe one or more medications:
- Pain reliever - to relieve pain.
- Non-steroidal anti-inflammatory drugs (NSAIDs) - to relieve pain and inflammation.
- Anticonvulsants that are 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 detected.
When should you see a doctor?
See a doctor immediately if the pain is severe and:
- Appeared after a fall, injury or blow to the back,
- Worsens during rest or at night.
- It gets worse when you cough or urinate
- Spreads on one or both feet,
- Accompanied by weakness, numbness or tingling in one or both legs
- Associated with fever or unexplained weight loss
- Accompanied by pain or a throbbing sensation in the abdomen
- It is associated with inability to control the act of urination or defecation.
Do not wait until your back pain becomes so bad that you are ready to do anything. It is best to consult an orthopedic traumatologist.