About 80% of adults have experienced low back pain at least once in their lives. It affects both men and women equally.
The pain manifests itself in different ways: from dull and constant, to sudden but very sharp, which temporarily weakens.
Sudden low back pain occurs after injuring or lifting a heavy object. If we look at chronic pain, then it often occurs due to age-related changes in the spine.
In this article we will look at the main causes of low back pain.
What is the lower back made of?
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 round elastic pads - intervertebral discs. They act as shock absorbers, absorbing loads and softening their impact 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 movements 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 will look at the most common reasons for this:
- Sprains or tears of ligaments, tendons and musclesis the most common cause of acute low back pain. They occur after twisting the spine, improper lifting of objects, lifting something very heavy or excessive tension of ligaments, tendons and muscles. All this provokes painful spasms in the muscles of the back.
- Degeneration (wear) of the intervertebral discsThis is another of the most common causes of low back pain. This happens when the elastic discs lose their integrity with age. In healthy people, the intervertebral discs allow the trunk to bend and twist normally. As the disks fail, they lose their ability to carry loads.
- Disc protrusion or hernia.This occurs after the intervertebral discs are highly compressed, protruding (protrusion) or ruptured (hernia).
- Radiculopathy.This is a condition caused by compression, inflammation and / or trauma to the spinal nerve root. Nerve pressure can cause lower back pain and numbness or tingling. These symptoms spread to those parts of the body that are innervated by the nerve that comes from the root. Radiculopathy also occurs due to compression of the nerve root with spinal stenosis, bulging or rupture of the intervertebral disc.
- sciatica- one of the forms of radiculopathy, which develops due to compression of the sciatic nerve. This is a large nerve that runs through the buttocks and goes down 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 buttocks and one leg. In the most severe cases, when the nerve is squeezed between the disc and the adjacent bone, it disturbs not only the pain, but also numbness and weakness in the leg. This is due to a violation of the transmission of nerve signals. In rare cases, a nerve or root is compressed due to a cyst or tumor.
- Degenerative spondylolisthesis- This is a condition in which the vertebrae "fall" out of place and press the nerves coming out of the spine.
- Traumafor example due to sports activities, a car accident or a fall. Injuries are a source of sprains or tears of ligaments, muscles and tendons. They also lead to excessive compression of the spine, which in turn causes protrusion or disc herniation.
- Spinal stenosis- This is a narrowing of the lumen, which creates increased pressure on the spinal cord and nerves. As a result, pain or tingling occurs when walking. Over time, stenosis 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 disease is hyperlordosis, in which there is excessive curvature of the spine in the lower back.
Who is most at risk for back pain?
Several factors increase the chances of encountering this problem. Between them:
- age- for the first time the pain attacks at the age of 30-50 years. Due to osteoporosis, bone strength is lost with age, leading to fractures as well as decreased muscle tone and elasticity. The intervertebral discs begin to lose fluid and flexibility, which in turn impairs 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 culprits for this are a sedentary lifestyle and lack of training to strengthen muscles. Particularly affected are people who spend a whole week without moving, and on weekends they try to catch up and train too hard. People who train with moderate intensity, but on most days of the week, experience low back pain much less often. Studies show that low-intensity aerobic exercise is helpful in maintaining the integrity of the intervertebral discs.
- Pregnancy- Back pain is very common in expectant mothers. It's all to blame - structural changes in the pelvic area and weight redistribution. One good thing is that after birth the pain disappears for almost everyone.
- Weight gain- the presence of overweight, obesity or just a sharp 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 vertebral joints grow together, causing pain as well as reduced mobility in the spine.
- The specifics of the work.If your job involves lifting, pushing or pulling weights, you risk injury or pain in your lower back. The movement of weights, in which the spine bends or vibrates, is especially dangerous. Inactive work also increases the risk of experiencing pain. Particularly affected are those who do not observe their posture or sit in a chair with an unsuitable backrest all day.
A separate problem is the overloading of students with textbooks and accessories that they carry in their backpacks. Experts from the American Academy of Orthopedic Surgeons note that the maximum weight of the backpack should be no more than 15-20% of the child's weight.
Treatment of low back pain
The treatment strategy will depend on what pain is bothering you - short-term acute or chronic. The most commonly used pain management techniques include:
Apply hot or cold compresses
Compresses are used to relieve pain and reduce inflammation. They can be used for all kinds of back pain, both acute and chronic. Compresses do not cure the root cause, but rather help relieve pain and improve joint mobility.
Maintaining physical activity
Bed rest should be kept to a minimum. Stretching should be done and normal motor activity maintained while avoiding movements that increase pain. Studies show that maintaining activity after low back pain helps maintain flexibility. Moreover, bed rest can even worsen the pain and lead to secondary complications. These include depression, decreased muscle tone and blood clots in the legs.
Strength training (in addition to normal physical activity) is not recommended for acute pain. They can be considered as an effective means of accelerated recovery from chronic low back pain.
Maintaining and increasing the strength of the muscles of the back and abdomen is especially important for people who suffer from musculoskeletal imbalances (scoliosis, hyperlordosis). To correct posture and muscle imbalance, you should contact an orthopedist-traumatologist. The doctor will develop a set of exercises that will help correct these disorders.
By the way, research shows that doing yoga can also help relieve pain.
Remedy 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 for the treatment of seizures may be useful for people with radiculopathy.
- Tricyclic antidepressants and serotonin and norepinephrine reuptake inhibitors are prescribed for chronic pain. Although their effectiveness in treating low back pain has never been proven.
- Creams and sprays - for cooling or warming.
Surgery is recommended only if progressive nerve damage or structural changes in the spine are detected.
When should you see a doctor?
See a doctor immediately if the pain is severe and:
- Occurs after a fall, injury or blow to the back,
- It gets worse during rest or at night.
- Worsens when coughing or urinating
- Spread in one or both legs,
- Accompanied by weakness, numbness or tingling in one or both legs
- Accompanied by fever or unexplained weight loss
- Accompanied by pain or throbbing sensation in the abdomen
- Accompanied by inability to control the act of urination or defecation.
Do not wait until the pain in the lower back becomes so strong that you are ready for anything. It is better to consult an orthopedist-traumatologist.