About 80% of adults have experienced back pain at least once in their lives. It affects men and women equally.
Pain manifests itself in different ways: from dull and persistent, to sudden, but very acute, which is temporarily incapable.
Sudden pain in the lower back occurs after injury or lifting 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 back pain.
What is the lower back made 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 a round elastic pad - the intervertebral disc. They act as shock absorbers, absorbing load and softening its effects on the spine.
The ligaments hold the vertebrae in place and the tendons attach the muscles to them. Inside the spine there 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:
- Sprained or torn 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 of this also causes painful cramps in the back muscles.
- Degeneration (wear) of the intervertebral discIt is another most common cause of back pain. It occurs when the elastic disc loses its integrity as the body ages. In healthy people, the intervertebral disc allows the trunk to bend and rotate normally. When disks fail, they lose the ability to absorb load.
- Disc protrusion or hernia.This occurs after the intervertebral disc is strongly compressed, bulges outward (bulge), or ruptures (hernia).
- Radiculopathy.It is a condition caused by compression, inflammation, and / or trauma to the spinal nerve roots. Pressure on the nerves can cause lower back pain and numbness or tingling. These symptoms spread to the parts of the body that are liberated by nerves emerging from the roots. Also, radiculopathy occurs due to nerve root compression with spinal canal stenosis, protrusion or rupture of the intervertebral disc.
- Sciatica- one of the forms of radiculopathy, which develops as a result of compression of the sciatic nerve. It is a large nerve that runs through the back and flows to the back of the foot to the heel. Compression of the sciatic nerve causes shooting or burning pain in the lower back, which is combined with pain in the back and one leg. In the worst case, when the nerve is sandwiched between the disc and the adjacent bone, not only the pain bothers, but also numbness and weakness in the leg. This is due to a violation of the transmission of nerve signals. In rare cases, nerves or their roots are pinched as a result of cysts or tumors forming.
- Degenerative spondylolisthesis- This is a condition in which the vertebrae "fall" out of place and clamp the nerves coming out of the spine.
- Traumafor example due to sports activities, car accidents or falls. Injuries are the cause of sprained or torn ligaments, muscles and tendons. They also lead to excessive compression on the spine, which in turn causes protrusion or herniated discs.
- Spinal stenosis- This is a narrowing of the lumen, which creates an increase in pressure on the spinal cord and nerves. As a result, pain or numbness occurs when 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 deflection of the spine in the lower back.
Who is most at risk for back pain?
Several factors increase the chances of facing this problem. Among them:
- age- The first disease strikes 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 affects their ability to absorb stress. The risk of developing spinal stenosis also increases with age.
- Low levels of physical activity- Weak muscles in the abdomen and back may not support the spine properly. An inactive lifestyle and lack of muscle strengthening exercise are to blame for this. Particularly affected are people who spend a full week without moving, and on weekends they try to catch up and train too hard. People who exercise with moderate intensity, but most days of the week, experience lower back pain more rarely. Research shows that low -intensity aerobic exercise is beneficial for maintaining the integrity of the intervertebral disc.
- Pregnancy- Often, back pain appears in pregnant women. Everything is to blame - structural changes in the pelvic area and weight redistribution. One good thing is that after childbirth, the pain goes away for almost everyone.
- Weight gain- the presence of overweight, obesity, or just a sharp increase in kilograms puts pressure on the back and leads to back pain.
- Hereditary tendencies.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 specificity.If your job involves lifting, pushing or pulling loads, you run the risk of injury or pain in the lower back. Particularly dangerous is the movement of weights, in which 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 chairs with inappropriate backs throughout the day.
The problem of burdening school students with textbooks and accessories they carry in their backpacks became apparent. Experts from the American Academy of Orthopedic Surgeons note that the weight of the maximum backpack should be no more than 15-20% of the weight of the child.
Treatment of low back pain
Treatment strategies will depend on the type of pain that is bothering you - acute or short -term chronic. The most commonly used pain management techniques include:
Use warm or cold compresses
Compresses are used to relieve pain and reduce inflammation. It can be used for any back pain, both acute and chronic. Compressors do not treat the underlying cause, but help reduce pain and improve joint mobility.
Maintain physical activity
Bed rest should be minimized. 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 back pain helps maintain flexibility. Moreover, bed rest can exacerbate pain and lead to secondary complications. These include depression, decreased muscle tone, and blood clots in the legs.
Strength training (in addition to regular physical activity) is not recommended for acute pain. They can be seen as an effective remedy for accelerated recovery from chronic back pain.
Maintaining and improving the strength of the back and abdominal muscles is especially important for those with musculoskeletal imbalances (scoliosis, hyperlordosis). To correct posture and muscle imbalance, you must contact an orthopedic traumatologist. The doctor will develop a set of exercises that will help correct this disorder.
By the way, research shows that doing yoga can also help relieve pain.
Medicine for back pain
Depending on the severity of the condition, the doctor prescribes one or more medications:
- Pain reliever - to relieve pain.
- Nonsteroidal anti -inflammatory drugs (NSAIDs) - to relieve pain and inflammation.
- Anticonvulsants prescribed to treat seizures may be useful for people with radiculopathy.
- Tricyclic antidepressants and serotonin and norepinephrine reuptake inhibitors are prescribed for chronic pain. Although its effectiveness in treating low back pain has never been proven.
- Creams and sprays - for cooling or warming.
Surgery is only recommended if progressive nerve damage or structural changes in the spine are found.
When should you see a doctor?
See a doctor immediately if the pain is severe and:
- Appears after a fall, injury or blow to the back,
- It gets worse during rest or at night.
- Becomes worse when coughing or urinating
- Spread on one or both legs,
- Accompanied by weakness, numbness, or tingling in one or both legs
- Accompanied by fever or unexplained weight loss
- Accompanied by pain or throbbing in the abdomen
- It is accompanied by an inability to control the act of urination or defecation.
Don’t wait until your back pain gets really bad until you’re ready to do anything. It is best to consult an orthopedic traumatologist.