About 80% of adults have experienced low back pain at least once in their lives. It affects both men and women.
The pain manifests itself in different ways: the dull and permanent, the sudden but very acute, which becomes temporarily incapacitated.
Sudden pain in the lower back occurs after an injury or lifting a heavy object. When chronic pain is taken into account, this is often due to age-related changes in the spine.
In this article, we look at the most common 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 weight of the upper body. The space between the vertebrae is filled with round elastic pads - intervertebral discs. They act as shock absorbers, absorbing loads and cushioning their effects on the spine.
The ligaments hold the vertebrae in place and the tendons attach muscles to them. Inside the spine, there are 31 pairs of nerves that control our movement and transmit signals from all parts of the body to the brain.
Why does my lower back hurt?
In most cases, the pain is of mechanical origin. Then we look at the most common reasons for this:
- Tapes, tendons and muscles are sprains or tearsthe most common cause of acute low back pain. They appear after twisting the spine, lifting objects incorrectly, lifting something very heavy, or overstretching the ligaments, tendons, and muscles. All of this also causes painful cramps in the back muscles.
- Degeneration of the intervertebral discs.The other most common cause of low back pain. Occurs when elastic cartilage discs lose their integrity as the body ages. In healthy people, the intervertebral discs allow for normal bending and twisting of the torso. If the discs fail, they will lose their load-bearing capacity.
- Disc protrusion or hernia.This occurs when the intervertebral discs are strongly compressed, bulging (protruding) or cracking (hernia).
- Radiculopathy.This is a condition caused by compression, inflammation and / or trauma to the nerve root of the spinal cord. Pressure on the nerve can cause low back pain and numbness or a tingling sensation. These symptoms spread to the parts of the body that are innervated by the nerve coming out of the root. In addition, radiculopathy is caused by compression of the nerve root and narrowing of the spinal canal, protrusion or rupture of the intervertebral disc.
- Sciatica- a form of radiculopathy caused by compression of the sciatic nerve. It is a large nerve that passes through the buttocks and runs from the back of the foot to the heel. Compression of the sciatic nerve causes shooting or burning pain in the lower back, coupled with pain in the buttocks and one leg. In the most severe cases, when the nerve gets stuck between the disc and the adjacent bone, not only is the pain disturbed, but also numbness and weakness in the foot. This is due to a violation of the transmission of neural signals. In rare cases, a nerve or its root is pinched due to the formation of a cyst or tumor.
- Degenerative spondylolisthesis- This is a condition in which the vertebrae "fall out" of their place and constrict the nerves exiting the spinal column.
- Injuryfor example due to sports activities, car accidents or falls. Injuries are sources of sprains or tears in the ligaments, muscles, and tendons. In addition, they lead to excessive compression of the spine, which in turn causes protrusion or disc herniation.
- Scoliosis- This is a narrowing of the lumen that puts increased pressure on the spinal cord and nerves. This results in pain or numbness while walking. Over time, the narrowing 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 the spine is excessively bent in the lower back.
Who is most at risk for back pain?
Several factors increase the chances of this problem. Among them:
- Disease- the pain first appears at the age of 30-50 years. Due to osteoporosis, the strength of the bones loses with age, leading to fractures and a decrease in muscle tone and flexibility. Intervertebral discs begin to lose fluid and elasticity, which in turn impairs their ability to absorb stress. The risk of developing spinal stenosis also increases with age.
- Low physical activity- Weak abdominal and back muscles may not support the spine properly. A sedentary lifestyle and a lack of muscle-building workouts can be blamed for this. Particularly affected are those who spend an entire week without exercise and on weekends trying to catch up and train too hard. People who exercise at a moderate intensity but most days of the week are much less likely to experience low back pain. Research shows that low-intensity aerobic exercise is beneficial in maintaining the integrity of intervertebral discs.
- Pregnancy- Back pain is very common in pregnant women. Everything is to blame - structural changes in the pool area and weight redistribution. One good thing is that after childbirth, the pain goes away in almost everyone.
- Obesity- overweight, obesity or even a steep increase in weight puts strain on the back and leads to low back pain.
- Hereditary predisposition.One type of arthritis, ankylosing spondylitis, is often inherited. In this disease, the joints of the vertebrae converge, causing pain as well as decreased mobility of the spine.
- Peculiarities of the work.There is a risk of injury or low back pain if your work involves lifting, pushing or pulling weights. The movement of weights is particularly dangerous when the spine is twisted or vibrating. Inactive work also increases the risk of pain. Those who do not follow their posture or sit in an unrestrained chair all day are particularly affected.
The problem of overloading schoolchildren with textbooks and accessories carried in their backpacks is separate. Experts from the American Academy of Orthopedic Surgeons note that the maximum weight of a backpack should not exceed 15-20% of a child’s weight.
Treatment of low back pain
The treatment strategy depends on the type of pain disorder - short-term acute or chronic. The most commonly used painkiller techniques are:
Apply hot or cold compresses
Compressions are used to relieve pain and reduce inflammation. They can be used for any back pain, both acute and chronic. Compresses do not treat the root cause, but rather relieve pain and improve joint mobility.
Maintaining physical activity
Bed rest should be kept to a minimum. Stretching should be performed and normal motor activity should be maintained, and pain-enhancing movements should be avoided. Research shows that staying active after the onset of low back pain helps maintain flexibility. Moreover, bed rest can further aggravate the pain and lead to secondary complications. These include depression, decreased muscle tone and blood clots in the legs.
In the case of acute pain, strength training (in addition to normal physical activity) is not recommended. They can be considered an effective cure for accelerating chronic low back pain.
Maintaining and increasing the strength of the back and abdominal muscles is especially important for those with musculoskeletal imbalances (scoliosis, hyperlordosis). You should contact an orthopedic traumatologist to correct your posture and muscle imbalance. Your doctor will develop exercises to help correct these disorders.
Incidentally, research shows that yoga can also help relieve pain.
Medicine for back pain
Depending on the severity of the condition, doctors will prescribe one or more medications:
- Painkillers - to relieve pain.
- Non-steroidal anti-inflammatory drugs (NSAIDs) - to relieve pain and inflammation.
- Anticonvulsants prescribed for the treatment of seizures may be useful for those with radiculopathy.
- Tricyclic antidepressants and serotonin and noradrenaline reuptake inhibitors are prescribed for the treatment of chronic pain. Although their effectiveness in treating low back pain has never been proven.
- Creams and sprays - for cooling or heating.
Surgery is recommended only if progressive nerve damage or structural changes in the spine are detected.
When to see a doctor?
Seek medical attention immediately if the pain is severe and:
- Appeared after a fall, injury, or back blow
- It gets worse at rest or at night.
- It gets worse when you cough or urinate
- It spreads on one or both legs,
- Weakness, numbness, or tingling in one or both legs
- It is accompanied by fever or unexplained weight loss
- It is accompanied by pain or a throbbing sensation in the abdomen
- It is accompanied by an inability to control urination or defecation.
Don’t wait until your low back pain is so gone that you’re ready for anything. It is better to consult an orthopedic traumatologist.