About 80% of adults have experienced low back pain at least once in their lifetime. It affects men and women equally.
Pain manifests itself in different ways: from dull and constant, to sudden but very acute, which temporarily disables.
Sudden pain in the lower back occurs after an injury or lifting from a heavy object. If we consider chronic pain, it usually manifests itself due to age-related changes in the spine.
In this article, we'll look at the main 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 softening their impact on the spine.
Ligaments hold the vertebrae in place and the tendons hold the muscles to them. Within the spinal column there are 31 pairs of nerves that control our movements and transmit signals from all parts of the body to the brain.
Why does the lower back hurt?
In most cases, the pain is mechanical in origin. Below, we'll consider the most common reasons for this:
- Ligament, tendon and muscle sprains or tearsit is the most common cause of acute low back pain. They appear after twisting the spine, improperly lifting objects, lifting something too heavy, or excessive strain on ligaments, tendons, and muscles. All of this also causes painful spasms in the back muscles.
- Degeneration (wear) of the intervertebral discsIt is another of the most common causes of low back pain. It occurs when elastic discs lose their integrity as the body ages. In healthy people, the intervertebral discs allow the torso to bend and twist normally. As disks fail, they lose their ability to absorb loads.
- Disc protrusion or hernia.This happens after the intervertebral discs are tightly compressed, bulge out (protrusion), or rupture (hernia).
- Radiculopathy.It 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 a tingling sensation. These symptoms spread to the parts of the body that are innervated by the nerve emerging from the root. Additionally, radiculopathy occurs due to nerve root compression with spinal canal stenosis, intervertebral disc protrusion, or rupture.
- Sciatica- one of the forms of radiculopathy, which develops due to compression of the sciatic nerve. It is a large nerve that runs through the buttocks and runs down the back of the leg to the heel. Sciatic nerve compression causes sharp or burning pain in the lower back, which is combined with pain in the buttocks and one leg. In more severe cases, when the nerve is trapped between the disc and the adjacent bone, not only is the pain troubling, but so is numbness and weakness in the leg. This is due to a violation of nerve signal transmission. 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 place and trap the nerves that exit the spine.
- Traumafor example, due to sports activities, a car accident, or a fall. Injuries are a source of sprains or torn ligaments, muscles and tendons. They also lead to excessive spinal compression, which in turn causes the disc to protrude or herniate.
- spinal stenosis- This is a narrowing of the lumen, which creates more pressure on the spinal cord and nerves. As a result, pain or numbness occurs when 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 doesn't cause pain until middle age. Another common disorder is hyperlordosis, in which there is excessive spinal deflection in the lower back.
Who is most at risk for back pain?
Several factors increase the chances of encountering this problem. Between them:
- Was- the first time the pain attacks at the age of 30-50 years. Due to osteoporosis, bone strength is lost with age, which leads 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 muscles in the abdomen and back may not adequately support the spine. A sedentary lifestyle and lack of muscle-building exercises are to blame. Particularly affected are people who go a whole week without moving and on weekends try to catch up and train hard. People who exercise at a moderate intensity, but most days of the week, experience lower back pain much less often. Research shows that low-intensity aerobic exercise is beneficial in maintaining the integrity of the intervertebral discs.
- Pregnancy- Back pain often appears in pregnant women. Blame everything - structural changes in the pelvic region and weight redistribution. One good thing is that after childbirth, pain passes for almost everyone.
- Weight gain- the presence of overweight, obesity or just a marked increase in pounds puts pressure on the back and leads to lower back pain.
- Hereditary predisposition.One type of arthritis, ankylosing spondylitis, is often hereditary. In this disease, the joints of the vertebrae grow together, which causes pain as well as decreased mobility in the spine.
- The specifics of the job.If your job involves lifting, pushing, or pulling weights, you run the risk of injuring yourself or experiencing pain in your lower back. Particularly dangerous is the movement of weights, in which the spine twists or vibrates. Idle work also increases the risk of experiencing pain. Particularly affected are those who do not follow their posture or sit in a chair with an inadequate back all day.
The problem of overloading students with textbooks and accessories that they carry in their backpacks stands out. Experts at the American Academy of Orthopedic Surgeons note that the maximum backpack weight should be no more than 15-20% of the child's weight.
Treatment for low back pain
The treatment strategy will depend on the type of pain that is bothering you - acute or short-term chronic. The most commonly used pain management techniques include:
Applying 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. Sponges do not treat the underlying cause, but they help relieve pain and improve joint mobility.
Keep up physical activity
Bed rest should be minimal. Stretching must be performed and normal motor activity must be maintained, avoiding movements that increase pain. Research shows that staying active after low back pain starts helps maintain flexibility. What's more, bed rest can even make the pain worse and lead to secondary complications. This includes depression, decreased muscle tone and blood clots in the legs.
Strength training (in addition to the usual physical activity) is not recommended for acute pain. They can be seen as an effective remedy for accelerated recovery from chronic low back pain.
Maintaining and increasing strength in the back and abdominal muscles is especially important for people who suffer from musculoskeletal imbalances (scoliosis, hyperlordosis). To correct posture and muscle imbalance, you should contact an orthopedic traumatologist. Your doctor will develop a series of exercises that will help correct these disorders.
By the way, research shows that doing yoga can also help relieve pain.
Back Pain Medication
Depending on the severity of the disease, doctors prescribe one or more medications:
- Analgesics - 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. Although its effectiveness in treating low back pain has never been proven.
- Creams and sprays - to cool or heat.
Surgery is only recommended if progressive nerve damage or structural changes in the spine are found.
When should you see a doctor?
See a doctor immediately if the pain is severe and:
- Appeared after a fall, injury or blow to the back,
- It gets worse at rest or at night.
- Worse when coughing or urinating
- Spreads on one or both legs,
- It is accompanied by 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 the act of urinating or defecating.
Don't wait until your lower back pain gets so bad that you're ready to do anything. It is best to consult an orthopedic traumatologist.