Approximately 80% of adults have experienced back pain at least once in their lifetime. It affects men and women equally.
Pain manifests itself in different ways: from dull and persistent to sudden but very severe, temporary incapacity.
Sudden pain in the lower back after being injured or lifting a heavy object. If we consider chronic pain, then it is usually manifested by age-related spinal changes.
In this article, we will study the main causes of low back pain.
What makes the lower back?
The lumbar spine contains 5 vertebrae (L1-L5), which support most of the weight of the upper body. The space between the vertebrae is filled with circular elastic cushions-intervertebral discs. They act as shock absorbers, absorbing loads and reducing their impact on the spine.
Ligaments hold the vertebrae in place, and tendons attach muscles to them. There are 31 pairs of nerves in the spine, which control our movement and transmit signals from various parts of the body to the brain.
Why does the lower back hurt?
In most cases, the pain is mechanical. Next, we will consider the most common reasons:
- Sprains or tears of ligaments, tendons, and musclesIt is the most common cause of acute low back pain. They appear after twisting the spine, lifting objects incorrectly, lifting very heavy objects or excessive tension in ligaments, tendons, and muscles. All of these can also cause pain and cramps in the back muscles.
- Degeneration of the intervertebral disc (wear and tear)It is the other most common cause of low back pain. It occurs when the elastic intervertebral disc loses its integrity as the body ages. In healthy people, the intervertebral disc allows the trunk to bend and twist normally. When the brake disc fails, they will lose the ability to absorb the load.
- Herniated disc or hernia.This occurs after the intervertebral disc is strongly compressed, bulged out (protruding), or ruptured (hernia).
- Radiculopathy.It is a disease caused by spinal nerve root compression, inflammation and/or trauma. The pressure on the nerves can cause back pain and numbness or tingling. These symptoms will spread to those parts of the body innervated by the roots. In addition, radiculopathy occurs due to nerve root compression, spinal stenosis, herniated or ruptured intervertebral disc.
- Sciatica-A form of radiculopathy that develops due to compression of the sciatic nerve. It is a large nerve that passes through the buttocks and extends from the back of the leg to the heel. Compression of the sciatic nerve can cause burning or burning pain in the lower back, accompanied by pain in the buttocks and one leg. In the most severe cases, when the nerve is sandwiched between the intervertebral disc and the adjacent bones, not only is the pain and disturbing, but the leg is numb and weak. This is due to a violation of the transmission of neural signals. In rare cases, nerves or their roots can be squeezed due to the formation of cysts or tumors.
- Degenerative spondylolisthesis-This is a condition in which the vertebrae "fall" out of their place and clamp the nerves coming out of the spine.
- traumaFor example, due to sports activities, car accidents or falls. Injury is the root cause of sprains or tears in ligaments, muscles, and tendons. They can also cause excessive compression of the spine, which can lead to a herniated or herniated disc.
- Spinal stenosis-This is the narrowing of the lumen, which leads to increased pressure on the spinal cord and nerves. Therefore, pain or numbness may occur when walking. Over time, stenosis can cause weakness and numbness in the legs.
- Scoliosis and other bone imbalances.Scoliosis is a lateral curvature of the spine that usually does not cause pain until middle age. Another common disease is excessive lordosis, that is, excessive deflection of the lower back spine.
Who is most likely to suffer from back pain?
There are several factors that increase the chance of encountering this problem. in:
- age-The first episode of pain is 30-50 years old. Due to osteoporosis, bone strength decreases with age, which can lead to fractures and decreased muscle tone and elasticity. The intervertebral discs begin to lose fluidity and flexibility, which in turn weakens their ability to absorb pressure. The risk of spinal stenosis also increases with age.
- Low level of physical activity-Muscle weakness in the abdomen and back may not support the spine properly. A sedentary lifestyle and lack of muscle strengthening exercises are the culprits for this situation. Particularly affected are those who haven't moved for a whole week, and they try to catch up and train hard on weekends. People who exercise at moderate intensity have much less low back pain for most of the week. Studies have shown that low-intensity aerobic exercise helps maintain the integrity of the intervertebral disc.
- Pregnant-Many times, mothers-to-be have back pain. This is the culprit-structural changes in the pelvic area and redistribution of weight. One good thing is that almost everyone’s pain disappears after delivery.
- Weight gain-Overweight, obesity, or rapid weight gain can put pressure on the back and cause low back pain.
- Genetic predisposition.One type of arthritis, ankylosing spondylitis, is usually inherited. In this disease, the joints of the vertebrae grow together, which causes pain and decreased spinal mobility.
- The specific situation of the work.If your job involves lifting, pushing, or pulling, you are at risk of waist injury or pain. Particularly dangerous is the movement of heavy objects, in which the spine is twisted or vibrated. Inactive work also increases the risk of experiencing pain. Particularly affected are those who do not follow their posture all day long or sit on chairs with inappropriate backrests.
The problem of overloading of textbooks and accessories in primary school students' backpacks is particularly prominent. Experts from the American Academy of Orthopaedic Surgeons pointed out that the maximum weight of the backpack should not exceed 15-20% of the child's weight.
Low back pain treatment
The treatment strategy will depend on the type of pain that is bothering you-short-term acute pain or chronic pain. The most commonly used pain management techniques include:
Apply hot or cold compresses
Compression is used to relieve pain and reduce inflammation. They can be used for any acute and chronic back pain. Compression does not treat the underlying cause, but helps relieve pain and improve joint mobility.
Stay physically active
Bed rest should be kept to a minimum. Stretching exercises should be performed and normal exercise activities should be maintained, and exercises that increase pain should be avoided. Studies have shown that staying active after the onset of low back pain helps maintain flexibility. More importantly, bed rest can even aggravate the pain and cause secondary complications. These include depression, decreased muscle tone, and thrombosis in the legs.
For acute pain, strength training (except for usual physical activity) is not recommended. They can be regarded as effective drugs to accelerate the recovery of chronic low back pain.
Maintaining and increasing the strength of the back and abdominal muscles is especially important for people with musculoskeletal imbalance (scoliosis, excessive lordosis). To correct posture and muscle imbalance, you must contact an orthopedic trauma doctor. The doctor will develop a set of exercises to help correct these diseases.
By the way, research shows that doing yoga can also help relieve pain.
Medications for back pain
Depending on the severity of the condition, the doctor will prescribe one or more drugs:
- Analgesics-to relieve pain.
- Non-steroidal anti-inflammatory drugs (NSAID)-relieve pain and inflammation.
- Anticonvulsants used to treat seizures may be helpful for patients with radiculopathy.
- Tricyclic antidepressants, serotonin and norepinephrine reuptake inhibitors are used to treat chronic pain. Although their effectiveness in treating low back pain has never been proven.
- Creams and sprays-for cooling or heating.
Surgery is only recommended if there is progressive nerve damage or changes in the structure of the spine.
When should you see the doctor?
If the pain is severe and:
- Appears after a fall, injury, or back blow,
- It gets worse at rest or at night.
- Getting worse when coughing or urinating
- One leg or both legs spread out,
- With weakness, numbness, or tingling in one or both legs
- With fever or unexplained weight loss
- With abdominal pain or throbbing
- It is accompanied by the inability to control urination or defecation.
Don't wait until your lower back pain becomes so severe that you are ready to do anything. It is best to consult an orthopedic trauma specialist.