About 80% of adults have experienced low back pain at least once in their life. It affects men and women alike.
Pain manifests itself in different ways: from dull and constant, to sudden, but very acute, temporarily disabling.
Sudden lower back pain occurs after an injury or lifting a heavy object. If we consider chronic pain, it often manifests itself 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) that bear 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 vertebrae in place and tendons attach muscles to them. Within the spinal column 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 mechanical in origin. Next, we will consider the most common reasons for this:
- Sprains or tears of ligaments, tendons and muscles.it is the most common cause of acute low back pain. They appear after twisting the spine, lifting objects improperly, lifting something very heavy, or excessive stress 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 trunk to bend and rotate normally. When discs fail, they lose their ability to absorb loads.
- Bulging or herniated disc.This happens after the intervertebral discs become heavily compressed, bulge out (bulges), or rupture (hernia).
- Radiculopathy.It is a condition caused by compression, inflammation, and / or trauma to the spinal nerve root. Pressure on the nerve can cause low back pain and numbness or tingling. These symptoms spread to those parts of the body that are innervated by the nerve emerging from the root. In addition, radiculopathy occurs due to compression of the nerve root with stenosis of the spinal canal, protrusion or rupture of the intervertebral disc.
- 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. Compression of the sciatic nerve causes a 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 clamped between the disc and the adjacent bone, not only the pain is disturbing, but also the numbness and weakness in the leg. This is due to a violation of the transmission of nerve 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 place and squeeze 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 tears to ligaments, muscles, and tendons. They also lead to excessive compression of the spine, which in turn causes bulging or herniated discs.
- Spinal stenosis- It is a narrowing of the lumen, which creates greater pressure on the spinal cord and nerves. As a result, pain or numbness occurs when walking. Over time, the 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 an excessive deviation of the spine in the lower back.
Who is most at risk for back pain?
Several factors increase the chances of encountering this problem. Among them:
- Get older- the first time the pain strikes at the age of 30-50 years. Due to osteoporosis, bone strength is lost with age, leading to fractures, as well as a decrease in muscle tone and elasticity. The intervertebral discs begin to lose fluid and flexibility, which in turn affects 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 workouts are to blame for this. Particularly affected are people who spend a whole week without moving, and on weekends they try to catch up and train too much. People who exercise moderately but most days of the week experience low back pain much less frequently. Research shows that low intensity aerobic exercise is beneficial in maintaining the integrity of the intervertebral discs.
- The pregnancy- very often back pain appears in pregnant women. Everything is to blame: structural changes in the pelvic area and weight redistribution. One good thing is that after delivery, the pain goes away for almost everyone.
- Weight gain- the presence of excess weight, obesity or simply a sudden increase in kilograms puts pressure 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 grow together, causing pain, as well as decreased mobility in the spine.
- The details of the job.If your job involves lifting, pushing, or pulling weights, you risk low back injury or pain. Particularly dangerous is the movement of weights, in which the spine twists or vibrates. Inactive 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 backrest throughout the day.
The problem of overloading schoolchildren with textbooks and accessories that they carry in their backpacks stands out. Experts from the American Academy of Orthopedic Surgeons point 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: acute or short-term 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 any back pain, both acute and chronic. Compresses do not treat the underlying cause, but instead help relieve pain and improve joint mobility.
Maintain physical activity
Bed rest should be kept to a minimum. Stretching should be done and normal motor activity should be maintained, avoiding movements that increase pain. Research shows that staying active after low back pain starts helps you stay flexible. In addition, bed rest can even worsen pain 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 considered an effective remedy for accelerated recovery from chronic low back pain.
Maintaining and increasing the strength of the back and abdominal muscles is especially important for people suffering from musculoskeletal imbalances (scoliosis, hyperlordosis). To correct posture and muscle imbalance, you should contact an orthopedic traumatologist. The 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 condition, doctors prescribe one or more medications:
- Analgesics: to relieve pain.
- Non-steroidal anti-inflammatory drugs (NSAIDs): to relieve pain and inflammation.
- Anticonvulsants that are 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 the treatment of 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 are found in the spine.
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 during rest or at night.
- It gets worse when coughing or urinating
- It spreads on one or both legs,
- It is accompanied by weakness, numbness, or tingling in one or both legs.
- It is accompanied by a fever or unexplained weight loss.
- It is accompanied by pain or shooting sensation in the abdomen.
- It is accompanied by an inability to control the act of urination or defecation.
Don't wait until your low back pain gets so bad that you are ready to do anything. It is better to consult an orthopedic traumatologist.