About 80% of adults have experienced back pain at least once in their lives. It affects both men and women equally.
Pain manifests itself in different ways: dull and constant, sudden, but very sharp, temporary loss of ability to function.
Sudden pain in the lower back occurs after an injury or lifting a heavy object. Given chronic pain, it is often manifested by age-related changes in the spine.
In this article, we will look at the main causes of back pain.
What is the lower back made of?
The lumbar spine has 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 a shock absorber, absorb loads and soften the impact on the spine.
The ligaments hold the vertebrae in place, and the tendons connect the muscles to them. Inside the spinal column are 31 pairs of nerves that control our movements and transmit signals from all over the body to the brain.
Why does your lower back hurt?
In most cases, the pain is of mechanical origin. Then we will consider the most common reasons for this:
- Twisting or tearing of ligaments, tendons and musclesis the most common cause of acute back pain. It is seen after bending the spine, lifting objects properly, and lifting too much or too much tension in the ligaments, tendons, and muscles. All this causes painful spasms in the back muscles.
- Degeneration (wear) of the intervertebral discs.One of the most common causes of back pain. It occurs when the elastic discs lose their integrity as the body ages. In healthy people, intervertebral discs allow the body to bend and twist normally. When the discs fail, they lose their ability to absorb loads.
- Disc protrusion or hernia.This occurs after the intervertebral discs are severely compressed, protruding (protrusion) or torn (hernia).
- Radiculopathy.This is a condition caused by compression, inflammation and / or trauma of the spinal nerve root. Pressure on the nerves can cause back pain and numbness or tingling sensations. These symptoms spread to parts of the body that are innervated by nerve roots. Radiculopathy also occurs as a result of stenosis of the spinal canal, compression of the nerve root with the protrusion or rupture of the intervertebral disc.
- Sciatica- One of the forms of radiculopathy that develops as a result of compression of the sciatic nerve. This is a large nerve that runs through the hips and extends from the back of the foot to the heel. Compression of the sciatic nerve causes shooting or burning pain in the lower back, which is combined with pain in the hips and one leg. In the most severe cases, when the nerve is squeezed between the disc and the adjacent bone, not only is the pain uncomfortable, but there is numbness and weakness in the foot. This is due to a violation of the transmission of nerve signals. In rare cases, a nerve or its root is compressed due to a cyst or tumor.
- Degenerative spondylolisthesis- This is a case of "falling" of the vertebrae and squeezing the nerves coming out of the spine.
- Traumafor example, due to sports activities, a car accident or a fall. Injuries are a source of twisting or tearing of ligaments, muscles and tendons. They also lead to excessive compression of the spine, which in turn causes protrusion or herniated discs.
- Spinal stenosis- This is a narrowing of the lumen, which increases the pressure on the spinal cord and nerves. As a result, there is pain or numbness while walking. Over time, stenosis causes 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 lumbar region.
Who is more at risk for back pain?
A number of factors increase the chances of encountering this problem. Among them:
- Age- Pain attacks for the first time in 30-50 years. Osteoporosis causes bone loss with age, which leads to fractures, as well as decreased muscle tone and elasticity. The intervertebral discs begin to lose fluid and elasticity, which in turn weakens their ability to absorb stress. The risk of developing spinal stenosis also increases with age.
- Low level of physical activity- Weak abdominal and back muscles may not support the spine properly. The culprit is a sedentary lifestyle and lack of muscle-strengthening exercises. This is especially true for people who spend all week without moving and try to catch up and train a lot on the weekends. People who exercise moderately, but most days of the week, experience less back pain. Studies show that low-intensity aerobic exercise is beneficial for maintaining the integrity of intervertebral discs.
- Pregnancy- Very often low back pain is seen in expectant mothers. All are to blame - structural changes in the pelvic region and redistribution of weight. On the plus side, postpartum pain disappears in almost everyone.
- Get fat- Excess weight, obesity or just a sharp increase in kilograms puts stress on the back and causes back pain.
- Hereditary predisposition.A type of arthritis, ankylosing spondylitis is often inherited. In this disease, the joints of the vertebrae grow together, which causes pain, as well as reduced mobility in the spine.
- Features of the work.If your job involves lifting, pushing, or pulling weights, you run the risk of injury or pain in the lower back. Particularly dangerous is the movement of weights that bend or vibrate the spine. Inactive work also increases the risk of pain. Particularly affected are those who do not follow their posture or sit in a chair with a backrest that does not fit all day.
The problem of overloading schoolchildren with textbooks and accessories in their backpacks is different. Experts from the American Academy of Orthopedic Surgeons say that the maximum weight of the backpack should not exceed 15-20% of the child's weight.
Treatment of low back pain
The treatment strategy will depend on which pain is bothering you - short-term acute or chronic. The most commonly used pain treatments include:
Application of hot or cold compresses
Compresses are used to relieve pain and reduce inflammation. They can be used for any back pain, both acute and chronic. Compresses do not cure the root cause, but help reduce pain and improve joint mobility.
Maintaining physical activity
Bed rest should be minimized. Stretching should be done and normal motor activity should be ensured, avoid actions that increase pain. Studies show that staying active after the onset of back pain helps maintain elasticity. In addition, bed rest can make the pain worse and cause secondary complications. These include depression, decreased muscle tone, and blood clots in the legs.
Strength training (in addition to regular physical activity) is not recommended for acute pain. They can be seen as an effective tool for rapid recovery from chronic back pain.
Maintaining and increasing the strength of the back and abdominal muscles is especially important for people suffering from musculoskeletal imbalances (scoliosis, hyperlordosis). You should contact an orthopedic traumatologist to correct posture and muscle imbalance. The doctor will prepare a series of exercises to help correct these disorders.
By the way, research shows that practicing yoga can also help relieve pain.
Medication for back pain
Depending on the severity of the condition, doctors prescribe one or more drugs:
- Painkillers - to relieve pain.
- Non-steroidal anti-inflammatory drugs (NSAIDs) - to relieve pain and inflammation.
- Anticonvulsants prescribed to treat seizures may be helpful for people with radiculopathy.
- Tricyclic antidepressants and serotonin and norepinephrine reuptake inhibitors are prescribed for chronic pain. Their effectiveness in the treatment of low back pain has never been proven.
- Creams and sprays - for cooling or warming.
Surgery is only recommended if progressive nerve damage or structural changes are found in the spine.
When should you see a doctor?
If the pain is severe, consult a doctor immediately and:
- Appeared after a fall, injury or back injury,
- Worse during rest or at night.
- Deteriorates when coughing or urinating
- Spread on one or both feet,
- Weakness, numbness or tingling in one or both legs
- Accompanied by fever or unexplained weight loss
- Accompanied by pain or throbbing in the abdomen
- This is accompanied by inability to control the act of urination or defecation.
Don't wait until your back pain gets worse enough to be ready to do anything. It is better to consult an orthopedic traumatologist.