According to statistics, almost every second middle-aged and elderly person complains to a doctor about lower back pain. 80% of people experience this discomfort 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 lower back pain
There are many different causes and factors that cause back pain, especially often in the lower back. Some diseases occur more often, others are quite rare, but it is important to see a doctor in time to determine the real cause and help relieve the pain.
Muscle and ligament injuries
One of the causes of lower back pain is tension and damage to the muscles and ligaments that support the back. The pain is usually localized to the muscles that run next to the spine and can be accompanied by spasms in these muscles. Painful sensations can move to the buttocks, and extremely rarely - to the legs.
Disc herniation
Disc herniation is characterized by prolapse of the inner part of the disc towards the spinal canal, which often causes severe, unbearable back pain in the lumbar region. When a displaced and damaged disc in the lumbar region ruptures, a hernia occurs, the reason for which is that the structure of the disc degenerates (ages) to such an extent that the shell of the disc literally cracks, collapses and a dense gel (nucleus pulposus) is formed 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)
Intervertebral discs are strong and flexible cartilage shock absorbers between the vertebrae. As a result of the aging process, the intervertebral discs begin to shrink, lose their elasticity, and become flattened. In the case of osteochondrosis, pain occurs along the spine, most often in the lower back, which requires treatment.
Not everyone with disc degeneration has back pain. However, in 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)
Until recently, osteoarthritis was thought 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, injuries, sedentary lifestyle, excessive back stress and other factors are believed to contribute to this process. Spondyloarthrosis is one of the common diseases that cause lower back pain.
Scoliosis
Spinal stenosis is the narrowing of the spinal canal itself or the reduction of the lumen of the openings where the spinal nerves leave the spinal column. This condition usually develops with age, against the background of pronounced degenerative-dystrophic changes in the structure of the spine, and leads to a significant pain syndrome, which is difficult to treat with the possible development of disability.
Spondylolysis
This term means a congenital or acquired condition, a split, crack, or fracture due to stress in one of the vertebrae. In some cases, a stress fracture weakens the bone so much that it cannot maintain its proper position in the spine. The vertebra starts to shift or slip, causing back pain especially in the lower back.
Osteoporosis
Today, osteoporosis is a pressing problem for many women over 50 and some men. It is a bone disease that occurs when the body loses too much bone tissue without having time to make new, young bone. The loss of bone tissue leads to its thinning and fragility, due to which it loses strength, and the vertebra can break from a fall or an awkward movement when lifting a heavy object. In some cases, back pain can be caused by osteoporosis itself, even in the absence of a vertebral fracture.
Tension
When it comes to back pain, stress is one of the common triggers for back pain. Stress causes muscles to become more toned and spasms occur, making it difficult to move the lower back and causing pain.
Other factors
Certain conditions can also contribute to back pain, including:
- infections with bone damage (osteomyelitis),
- malignant oncology, especially if metastases have occurred in the bones of the spine,
- psoriasis, especially in case of arthritis,
- fibromyalgia.
Sometimes they refer to lower back pain, that is, it occurs against the background of pathology in other organs and tissues, but it is felt in the spine:
- urinary tract infections,
- diseases of the abdominal organs, kidneys and pelvic organs.
Postural problems
Back pain usually occurs as a result of strenuous daily activities. Back pain, especially in the lower back, can often be caused by poor posture and weak abdominal muscles. It is precisely these areas that need to be treated and strengthened in order to relieve discomfort and prevent pain from returning in the future.
But how do abdominal muscles affect the lower back? It's simple. The trunk is the only muscular corset that supports the body, and if the front (abdominal) muscles are weak, guess which one gets more strain? It is true that the lumbar muscles in the lower back of the body suffer more than others. Weak abs eventually cause additional tension around the back, which overloads the psoas muscles, causing pain. Most people with chronic back pain can reduce their pain by strengthening their core muscles. Performing exercises daily can improve the condition.
Lower back pain during pregnancy
Women may experience lower back pain for the first time when carrying a baby. This is due to a change in the center of gravity, a change in posture and an increased curvature of the spine in the lumbar region. This condition is not dangerous, but it can later lead to changes in posture, muscle tension and pinched nerves. To avoid back problems or reduce discomfort when spinal pain, especially in the lower back, has already occurred, treatment includes support bandages, comfortable low-heeled shoes, and often side-lying.
Types of sensations of back pain in the lumbar region
Back pain can be acute if it comes on suddenly and lasts no more than 2-3 weeks. If the sensations last for months or even years, it is chronic pain syndrome. According to the arising feelings, we can distinguish:
- Severe, burning, sharp and almost unbearable pain. It is characteristic of hernia, radiculitis, lumbago (back lumbago).
- Dull, aching, tearing, or dull pain. It often occurs due to 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 increases into a burning, aching or shooting sensation. They weaken when resting, wearing corsets or in certain body positions.
Low back pain diagnosis
To determine the cause of your pain, your doctor may prescribe:
- A series of laboratory tests to rule out inflammatory processes and pathologies of internal organs.
- X-ray of the spine (often in two views: direct and lateral). This helps to identify bone disorders, vertebral and joint deformities.
- Computerized optical topography of the spine to assess postural abnormalities, to determine the degree of spinal deformation and pelvic distortion.
- MRI (magnetic resonance imaging) is the most frequently prescribed and informative method for diagnosing spinal diseases. An MRI can show damage to the intervertebral discs, joints, spinal cord, vertebrae, and other structures.
- ENMG (electroneuromyography) - to assess the state of neuromuscular transmission, the functioning of nerves and muscles.
Treatment of pain in the lumbar spine
Procedures for the treatment of back pain are prescribed individually by the doctor and may include the following:
- Pain relievers, decongestants and anti-inflammatories, muscle relaxants and vitamins (tablets, ointments, injections, drips);
- physiotherapy techniques (intrastitial electrical stimulation, carboxy and ozone therapy, electrophoresis, magnet therapy, amplipulse therapy);
- kinesio taping,
- massage, manual therapy and osteopathy;
- acupuncture;
- physical therapy and other methods.
In severe cases, in the absence of the effect of conservative therapy, surgical treatment is recommended. These can be disc replacement, hernia removal, fusion of vertebrae (spinal fusion), vertebroplasty, etc.
Prevention of back pain
In order to prevent the appearance and progression of back pain, you must monitor your posture, consult a specialist immediately at the first appearance of back pain, regularly participate in preventive procedures on medical advice, lead an active lifestyle, and engage in special physical activity. exercises and avoid excessive physical activity and injury if possible.
Which doctor should I see?
If you have back pain, especially in the lower back, you should see a neurologist for diagnosis and treatment. In some cases, a consultation with a physiotherapist, neurosurgeon or urologist or gynecologist may be necessary.
F. A. Q
How can you tell if your back or kidneys hurt?
Very often there are situations when the spine imitates kidney diseases, and vice versa, when kidney diseases masquerade as spinal diseases. In order to clarify the cause of the pain, a doctor should be consulted and, if necessary, further examination should be carried out.
What is the best position to sleep in if you have lower back pain?
If you have lower back pain, it is recommended to sleep on a moderately hard mattress, lying on your side, in the so-called "fetal position".
Can lower back pain be caused by gynecological diseases?
Yes. Some gynecological diseases (inflammations, neoplasms, etc. ) can cause indicative pain in the lower back.
Is exercise therapy possible 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 pain reduction and only then start active therapeutic exercises.
Can sports cause back pain?
Yes possible. Especially when practicing traumatic sports, in addition to not complying with the requirements of safe training, even without a preliminary warm-up.