About 80% of adults have experienced low back pain at least once in their lives. It affects both men and women equally.
The pain manifests itself in various ways: from dull and constant, to sudden but very acute, which temporarily disables.
Sudden pain in the lower back occurs after an injury or lifting of a heavy object. If we consider chronic pain, then it often shows up due to age-related changes in the spine.
In this article, we will look at the main causes of low back pain.
What is the loin made of?
The lumbar spine contains 5 vertebrae (L1-L5) that support most of the weight of the upper body. The space between the vertebrae is filled with round elastic pads - intervertebral discs. They act as shock absorbers, absorb loads and soften their impact on the spine.
Ligaments hold the vertebrae in place, and tendons bind muscles to them. Inside the spine are 31 pairs of nerves that control our movements and send 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 consider the most common reasons for it:
- Sprains or tears of ligaments, tendons and musclesis the most common cause of acute low back pain. They appear after twisting the spine, lifting objects incorrectly, lifting something very heavy or excessive tension on ligaments, tendons and muscles. All this also provokes painful spasms in the muscles of the back.
- Degeneration (wear) of intervertebral discsIs another of the most common causes of low back pain. It occurs when elastic discs lose their integrity as the body ages. In healthy people, the intervertebral discs allow the trunk to bend and twist normally. When the discs fail, they lose their ability to absorb loads.
- Disc protrusion or hernia.This occurs after the intervertebral discs are strongly compressed, bulging outward (protrusion) or rupture (hernia).
- Radiculopathy.It is a condition caused by compression, inflammation and / or trauma to the spinal nerve root. Pressure on the nerve can cause low back pain and numbness or tingling sensations. These symptoms spread to the parts of the body that are innervated by the nerve coming out of the root. Radiculopathy also occurs due to compression of the nerve root with stenosis of the spinal canal, 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 runs down the back of the leg 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 pinched between the disc and the adjacent bone, not only is pain disruptive, but also numbness and weakness in the leg. This is due to a violation of the transmission of nerve signals. In rare cases, a nerve or its root is pinched due to a cyst or tumor formed.
- Degenerative spondylolisthesis- This is a condition in which the vertebrae "fall" out of their place and squeeze the nerves that come out of the spine.
- Traumafor example, due to sports activities, a car accident or a fall. Injuries are a source of sprains or tears of ligaments, muscles and tendons. They also lead to excessive compression of the spine, which in turn causes protrusion or disc 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 when you walk. 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 the middle ages. Another common disorder is hyperlordosis, in which there is excessive deflection 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, leading to fractures, as well as a decrease in muscle tone and elasticity. The 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 activity- Weak muscles in the abdomen and back may not support the spine properly. A sedentary lifestyle and lack of muscle-strengthening exercise are to blame for this. Particularly affected are people who spend an entire week without moving, and on the weekends they try to catch up and train too hard. People who exercise with moderate intensity, but most of the days of the week, experience low back pain much less frequently. Research shows that low-intensity aerobic exercise is beneficial for maintaining the integrity of the intervertebral discs.
- Pregnancy- very often back pain occurs in expectant mothers. It's all to blame - structural changes in the pelvic area and the redistribution of weight. A good thing is that after the birth, the pain disappears for almost everyone.
- Weight gain- the presence of overweight, obesity or just a sharp increase in kilograms strains the back and leads to low back pain.
- Hereditary disposition.One type of arthritis, ankylosing spondylitis, is often inherited. In this disease, the joints of the vertebrae grow together, causing pain, as well as a decrease in the mobility of the spine.
- Details of the work.If your work involves lifting, pushing or pulling weights, you risk getting injuries or pain in the lower back. Particularly dangerous is the movement of weights where the spine rotates or vibrates. Inactive work also increases the risk of experiencing pain. Particularly affected are those who do not follow their posture or sit on a chair with an unsuitable backrest all day.
The problem of overloading school children with textbooks and accessories that they have in their backpacks stands out. Experts from the American Academy of Orthopedic Surgeons note that the maximum backpack weight should not be more than 15-20% of the baby's weight.
Treatment of low back pain
The treatment strategy will depend on the type of pain that is bothering you - short-term acute or chronic. 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 all back pain, both acute and chronic. Compresses do not treat the underlying cause, but rather help relieve pain and improve joint mobility.
Maintain physical activity
Bedding should be kept to a minimum. Stretching should be performed 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. In addition, bed rest can even aggravate pain and lead to secondary complications. These include depression, decreased muscle tone and blood clots in the legs.
Strength training (in addition to the usual physical activity) is not recommended for acute pain. They can be seen as an effective remedy for accelerated recovery from chronic low back pain.
Maintenance and strengthening of the back and abdominal muscles is especially important for people who suffer from imbalances in the musculoskeletal system (scoliosis, hyperlordosis). To correct posture and muscle imbalance, consult an orthopedic traumatologist. The doctor will develop a set of exercises that will help correct these disorders.
Research also shows that yoga can also help relieve pain.
Medicine for back pain
Depending on the severity of the condition, doctors prescribe one or more drugs:
- Painkillers - to relieve pain.
- Non-steroidal 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 only recommended if progressive nerve damage or structural changes in the spine are found.
When should you see a doctor?
Seek immediate medical attention if the pain is severe and:
- Appeared after a fall, injury or blow to the back,
- It gets worse during rest or at night.
- Gets worse by coughing or urinating
- Spreads in one or both legs,
- Is accompanied by weakness, numbness or tingling in one or both legs
- Is accompanied by fever or unexplained weight loss
- Is accompanied by pain or a throbbing sensation in the abdomen
- It is accompanied by an inability to control the urination or defecation action.
Do not wait until your low back pain gets so bad that you are ready to do anything. It is better to consult an orthopedic traumatologist.