According to statistics, almost every second middle-aged and elderly person comes to the doctor complaining 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 in the lower back. Some diseases are more common, others are quite rare, but it is important to consult a doctor promptly to determine the true cause and help relieve the pain.
Muscle and ligament injuries
One cause 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 associated with spasms in these muscles. Painful sensations can move to the buttocks and, extremely rarely, down the leg.
Slipped disc
Herniated disc is characterized by a prolapse of the internal part of the disc towards the spinal canal, which often causes severe and unbearable back pain in the lumbar region. A displaced and damaged disc in the lumbar region forms a herniation when it ruptures, because the structure of the disc degenerates (ages) to such an extent that the cartilaginous shell literally breaks, crumbles, and the dense gel (nucleus pulposus) inside it disk is pushed out into the spinal canal. A herniated disc puts pressure on spinal nerves, often causing pain.
Disc degeneration and aging (osteochondrosis)
The discs between the vertebrae are strong, elastic cartilaginous shock absorbers between the vertebrae. As a result of the aging process, the intervertebral discs begin to shrink, lose elasticity and become flattened. When osteochondrosis is present, pain occurs along the spine, most often in the lower back, and requires treatment.
Not everyone with disc degeneration suffers from back pain. However, in those who have ruled out all other possible back problems, the pain may be caused by degenerative changes in the discs (osteochondrosis).
Spondyloarthrosis (osteoarthritis of the intervertebral joints)
Not long ago it was believed that osteoarthritis was 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 stress on the back and other factors are believed to contribute to this process. Spondyloarthrosis is one of the most common diseases that cause back pain.
Spinal stenosis
Spinal stenosis is a narrowing of the spinal canal itself or a decrease in the lumen of the openings where the spinal nerves leave the spine. 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 that is difficult to treat with the possible development of disability.
Spondylolysis
This term refers to a congenital or acquired condition, a fissure, crack, or stress fracture 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 begins to shift or slip, causing back pain especially in the lower back.
Osteoporosis
Today, osteoporosis is an urgent problem for many women over the age of 50 and for some men. This is a bone disease that occurs when the body loses too much bone without having time to create new, young bone. Against the background of loss of bone tissue, its rarefaction and fragility arise, due to which it loses its strength and the vertebra can break due to a fall or awkward movement, lifting a heavy object. In some cases, back pain can be caused by osteoporosis itself, even in the absence of a vertebral fracture.
Fatigue
When it comes to back pain, stress is one of the most common factors that can trigger it. When stressed, the muscles become more toned and spasms occur, making it difficult to move the lower back and causing pain.
Other factors
Some 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 lumbar pain is reported, that is, it occurs against the background of pathologies in other organs and tissues, but is felt in the spine:
- urinary tract infections,
- diseases of the abdominal organs, kidneys and pelvic organs.
Posture problems
Back pain typically occurs due to strenuous daily activities. Often back pain, especially in the lower back, can be caused by poor posture and weak abdominal muscles. These are exactly the areas that need to be addressed and strengthened to relieve discomfort and prevent the pain from recurring in the future.
But how do the abdominal muscles affect the lower back? Is simple. The torso is a single muscular corset that supports the body and if the muscles in the front (abdomen) are weak, guess which ones receive a greater load? It is true that the lumbar muscles of the lower back part of the body suffer more than the others. Weak abdominal muscles end up creating additional tension around your back, which overloads your psoas muscles, causing pain. Most people living with chronic back pain can reduce it by strengthening their core muscles. Performing a series of exercises daily can improve the condition.
Back pain during pregnancy
For the first time, women may experience lower back pain while carrying a baby. This is due to the change in the center of gravity, the change in posture and the increased deflection of the spine in the lumbar region. This condition is not dangerous, but can subsequently predispose to changes in posture, muscle strain, and nerve compression. To avoid back problems or reduce discomfort when pain in the spine has already occurred, especially in the lower back, the treatment involves the use of a support bandage, comfortable shoes with low heels and often resting in a lateral position .
Types of sensations for back pain in the lumbar region
Back pain can be acute if it comes on suddenly and lasts no longer than 2-3 weeks. If the sensations last for months or even years, it is already a chronic pain syndrome. Depending on the sensations that arise we can distinguish:
- Strong, burning, sharp and almost unbearable pain. It is typical for hernias, radiculitis, lumbago (lower back pain).
- Dull, aching, shooting, or vague pain. It often occurs with injuries, inflammation or strains of muscles, 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 stabbing sensation. When they rest, wear corsets, or assume certain body positions, they become weak.
Diagnosis of low back pain
To determine the cause of the pain, the doctor may prescribe:
- A series of laboratory tests to exclude inflammatory processes and pathologies of the internal organs.
- X-ray of the spine (often in two projections: direct and lateral). This helps identify bone abnormalities, spinal and joint deformities.
- Computerized optical topography of the spine to evaluate postural disorders, determine the degree of spinal deformation and pelvic distortion.
- Magnetic resonance imaging (MRI) is the most frequently prescribed and informative method for diagnosing spinal diseases. MRI can detect damage to intervertebral discs, joints, spinal cord, vertebrae, and other structures.
- ENMG (electroneuromyography) - to evaluate the state of neuromuscular transmission, the function of nerves and muscles.
Treatment of pain in the lumbar spine
A set of procedures for treating back pain is prescribed individually by the doctor and may include:
- Painkillers, decongestants and anti-inflammatories, muscle relaxants and vitamins (tablets, ointments, injections, droppers);
- physiotherapeutic techniques (intrastitial electrical stimulation, carboxytherapy and ozone therapy, electrophoresis, magnetotherapy, amplipulsotherapy);
- Kinesiotaping,
- massage, manual therapy and osteopathy;
- acupuncture;
- physical therapy and other methods.
In difficult cases, in the absence of effect of conservative therapy, surgical treatment may be indicated. These can be disc replacement surgeries, removal of hernias, fusion of the vertebrae (spinal fusion), vertebroplasty, etc.
Prevent back pain
To prevent the appearance and progression of back pain, you need to monitor your posture, promptly consult a specialist at the first appearance of back pain, regularly undergo preventive procedures on the recommendation of a doctor, lead an active lifestyle, engage in special physical activities exercises and, if possible, avoid excessive physical activity and injuries.
Which doctor should I contact?
If you suffer from back pain, particularly 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 necessary.
FAQ
How to determine 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 pathology. To clarify the cause of the pain, it is necessary to consult a doctor and, if necessary, conduct an additional examination.
What is the best sleeping position if you suffer from back pain?
If you suffer from low back pain, it is advisable to sleep on a medium-hard mattress in a lying position, in the so-called "fetal position".
Can low back pain occur due to gynecological diseases?
YES. Some gynecological diseases (inflammatory, neoplasms, etc. ) can cause pain referred to the lower back.
Is it possible to do physical therapy if you suffer from 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 relief and only then start performing active therapeutic exercises.
Can playing sports cause back pain?
Yes, it is possible. Especially when practicing traumatic sports, without complying with the requirements for safe training and even without prior warming up.