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 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 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 at the right time to determine the real cause and help relieve the pain.
Muscle and ligament injuries
One of the causes of back pain is strain and damage to the muscles and ligaments that support the back. The pain is usually localized in the muscles that run near the spine and may be accompanied by spasms in these muscles. Painful sensations can move to the buttocks, and extremely rarely - down the leg.
Disc herniation
A herniated disc is characterized by the prolapse of the inner part of the disc towards the spinal canal, which often causes severe, excruciating back pain in the lumbar region. A displaced and damaged disc in the lumbar region forms a hernia when it ruptures. The reason is that the structure of the disc degenerates (ages) to the extent that the cartilage shell cracks, crumbles and the dense gel (nucleus pulposus) inside. the disc is pushed out into the spinal canal. A herniated disc puts pressure on spinal nerves, often causing pain.
Disc degeneration and aging (osteochondrosis)
The intervertebral discs are strong and elastic shock absorbers of the cartilage 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 with 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 believed to be caused by wear and tear on the joints over time. However, scientists now consider it a joint disease. 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 decrease in the lumen of the holes 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, which is difficult to treat with the possible development of disability.
Spondylolysis
This term refers to a congenital or acquired condition, a crack, fissure or fracture due to stress in one of the vertebrae. In some cases, a stress fracture weakens the bone so much that it cannot hold 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. This is a bone disease that occurs when the body loses too much bone tissue without having time to make new and new bones. Against the background of the loss of bone tissue, its rarity and fragility arises, due to which it loses its strength and the vertebra can be broken by a fall or a difficult 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 cause back pain. When stressed, the muscles become more toned and spasms occur, making it difficult to move the lower back and causing pain.
Other factors
Several 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.
Sometimes back pain is referred, that is, it occurs against the background of pathology in other organs and tissues, but is felt in the back:
- urinary tract infections,
- diseases of abdominal organs, kidneys and pelvic organs.
Problems with posture
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. It is precisely these areas that need to be addressed and strengthened to relieve discomfort and prevent future pain recurrence.
But how do the abdominal muscles affect the lower back? It's easy. The trunk is a single girdle of muscles that supports the body, and if the muscles in the front (abdominal) are weak, guess which ones get the added load? It is true that the lumbar muscles in the lower back of the body suffer more than others. Weak abdominal muscles end up creating extra tension around the back, which overloads the psoas muscles, causing pain. Most people living with chronic back pain can reduce it by strengthening their core muscles. Doing a set of exercises every day can improve the condition.
Lower back pain during pregnancy
For the first time, women may experience pain in the lower back when carrying a child. This is due to a change in the center of gravity, a change in posture and increased deviation of the spine in the lumbar region. This condition is not dangerous, but it 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 includes wearing a supportive bandage, comfortable low-heeled shoes, and frequent rest in a positionlateral.
Types of sensations for back pain 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 typical for hernias, radiculitis, lumbago (back lumbago).
- Dull, aching, shooting 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 you rest, wear corsets or certain body positions, they weaken.
Diagnosis of low back pain
To determine the cause of the pain, your doctor may prescribe:
- A set 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 in identifying bone abnormalities, vertebral and joint deformities.
- Computed optical topography of the spine to assess postural disorders, to determine the degree of spinal deformity and pelvic distortion.
- MRI (magnetic resonance imaging) is the most prescribed and informative method for diagnosing diseases of the spine. MRI can detect damage to the 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 lower back
A set of procedures for the treatment of back pain is prescribed by a doctor individually and may include:
- Pain relievers, decongestants and anti-inflammatories, 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 a hernia, fuse vertebrae (spinal fusion), vertebroplasty, etc.
Back pain prevention
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 with a doctor's recommendation, lead aactive lifestyle, engage in special physical activities. exercise and, if possible, avoid excessive physical activity and injuries.
Which doctor should I contact?
If you have back pain, especially in the lower back, you should 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 if your back or kidneys hurt?
Very often there are situations when the spine mimics kidney diseases and vice versa, when kidney diseases are disguised as spine pathology. To clarify the cause of the pain, it is necessary to consult a doctor and, if necessary, do an additional examination.
What is the best position to sleep if you have lower back pain?
If you have pain in the lower back, it is recommended to sleep on a mattress of medium firmness in the position lying on the side, in the so-called "fetal position".
Can back pain occur due to gynecological diseases?
Yes. Some gynecological diseases (inflammatory, neoplasia, 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, in the first stage of treatment it is recommended to first achieve a reduction in pain and only then start performing active therapeutic exercises.
Can sports cause lower back pain?
Yes it is possible. Especially when practicing traumatic sports, not respecting the requirements for safe training, and also without pre-warming.