About 80% of adults have experienced back pain at least once in their lifetime. It affects men and women equally.
The pain manifests itself in different ways: from dull and continuous, to sudden, but very acute, which temporarily weakens.
Sudden pain in the lower back occurs after injury or lifting a heavy object. If we take into account the 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 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 round elastic pads - intervertebral discs. They act as shock absorbers, absorbing loads and softening their impact 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 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 look at the most common reasons for this:
- Sprains or tears of ligaments, tendons and musclesis the most common cause of acute back pain. They appear after twisting the spine, lifting objects improperly, lifting something too heavy or too tight on the ligaments, tendons and muscles. All this also causes painful spasms in the back muscles.
- Degeneration (wear) of intervertebral discsIt is another of the most common causes of back pain. It occurs when the discs lose their integrity as the body ages. In healthy people, the intervertebral discs allow the trunk to bend and twist normally. As the disks fail, they lose their ability to absorb loads.
- Disc protrusion or hernia.This occurs after strong compression of the intervertebral discs, swelling upwards (protrusion) or rupture (hernia).
- Radical disease.It is a condition caused by compression, inflammation and / or trauma to the spinal nerve root. Pressure on the nerve can cause back pain and numbness or tingling. These symptoms spread to those parts of the body that are innervated by the nerve that emerges from the root. Also, root disease occurs due to compression of the nerve root with narrowing of the spinal canal, protrusion or rupture of the intervertebral disc.
- Sciatica- one of the forms of root disease, which develops due to compression of the sciatic nerve. It is a large nerve that runs through the buttocks and descends from the back of the foot to the heel. Compression of the sciatic nerve causes fever or burning pain in the lower back, combined with pain in the buttocks and one leg. In the most severe cases, when the nerve is tightened between the disc and the adjacent bone, not only pain but also numbness and weakness in the leg bother. This is due to a violation of the transmission of nerve signals. In rare cases, a nerve or its root is pressed due to the formation of a bladder or tumor.
- Degenerative spondylolisthesis- This is a condition in which the vertebrae "fall" from their position and tighten the nerves coming out of the spine.
- Woundfor example due to sports activities, car accident or 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, there is pain or numbness when walking. Over time, the 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 flexion of the spine in the lower back.
Who is most at risk for back pain?
Several factors increase your chances of experiencing this problem. Between them:
- Age- the first time the pain manifests itself at the age of 30-50 years. Due to osteoporosis, bone strength is lost with age, which leads 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 activityWeak muscles in the abdomen and back may not support the spine properly. Sedentary lifestyle and lack of muscle training are responsible for this. People who spend a whole week without moving and on the weekends try to catch up and train very hard are especially affected. People who exercise moderately, but most days of the week, experience much less frequent back pain. 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 their fault - the structural changes in the pelvic area and the redistribution of weight. One good thing is that after childbirth, the pain subsides in almost everyone.
- Weight gain- the presence of overweight, obesity or just a sudden increase in weight puts pressure on the back and leads to lower back pain.
- Hereditary predisposition.One type of arthritis, ankylosing spondylitis, is often inherited. In this disease, the joints of the vertebrae develop together, which causes pain as well as reduced mobility in the spine.
- The peculiarities of the work.If your job involves lifting, pushing or pulling weights, you run the risk of injury or lower back pain. Particularly dangerous is the movement of weights, during which the spine is twisted or vibrated. Inactive work also increases the risk of pain. Particularly affected are those who do not follow their posture or sit in a chair with an unsuitable back all day.
The problem of overloading students with textbooks and accessories they carry in their backpacks stands out. Experts from the American Academy of Orthopedic Surgeons note that the maximum weight of the backpack should not exceed 15-20% of the child's weight.
Treatment of lower 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 any back pain, acute and chronic. Compresses do not cure the underlying cause, but rather 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 lower back pain helps maintain flexibility. In addition, bed rest can even worsen the pain and lead to secondary complications. These include depression, decreased muscle tone and blood clots in the legs.
Strength training (in addition to normal physical activity) is not recommended for acute pain. They can be considered as an effective remedy for rapid 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, hyperlordia). 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.
Remedy for back pain
Depending on the severity of the condition, doctors may prescribe one or more medications:
- Painkillers - for pain relief.
- Non-steroidal anti-inflammatory drugs (NSAIDs) - to relieve pain and inflammation.
- Anticonvulsants prescribed for the treatment of seizures may be useful for people with rhizopathy.
- Tricyclic antidepressants and serotonin and norepinephrine reuptake inhibitors are prescribed for chronic pain. Although their effectiveness in the treatment of 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?
See a doctor immediately if the pain is severe and:
- Appeared after a fall, injury or blow to the back,
- It worsens at rest or at night.
- It gets worse when you cough or urinate
- Spreads 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 a throbbing sensation in the abdomen
- Accompanied by inability to control the act of urination or defecation.
Do not wait until the pain in your back becomes so intense that you are ready to do anything. It is best to consult an orthopedic traumatologist.