According to statistics, almost every second middle-aged and old person goes to the doctor with complaints of back pain in the lumbar region. Up to 80% of people experience this unpleasant feeling at least once in their life.
All over the world, pain in the lumbar spine causes a person to lose mobility, undergo long-term treatment and are forced to limit their usual activities.
Causes of lower back pain
There are many different reasons and factors that cause back pain, particularly common in the lower back area. Some diseases are more common, others are rare. However, it is important to see a doctor in a timely manner to determine the true cause and relieve the pain.
Muscle and ligament injuries
One of the causes of lower back pain is overuse and damage to the muscles and ligaments that support the back. The pain is usually limited to the muscles that run alongside the spine and may be accompanied by spasms in these muscles. Painful sensations can spread to the buttocks and, extremely rarely, to the leg.
disc prolapse
A herniated disc is characterized by a prolapse of the inner part of the disc toward the spinal canal, often causing severe, unbearable back pain in the lumbar region. If a displaced and damaged intervertebral disc in the lumbar region ruptures, it represents a herniated disc. The reason for this is that the structure of the intervertebral disc degenerates (ages) to such an extent that the cartilage shell literally tears, crumbles and the dense gel (nucleus pulposus) inside the intervertebral disc breaksis pressed into the spinal canal. A herniated disc puts pressure on the spinal nerves and often causes pain.
Degeneration and aging of the intervertebral disc (osteochondrosis)
The intervertebral discs between the vertebrae are strong and elastic cartilage shock absorbers between the vertebrae. As a result of the aging process, the intervertebral discs begin to shrink, lose their elasticity and become flatter. In the presence of osteochondrosis, pain occurs along the spine, most often in the lower back, which requires treatment.
Not everyone who suffers from disc degeneration experiences back pain. However, in people who have ruled out all other possible back problems, the pain may be caused by degenerative changes in the intervertebral discs (osteochondrosis).
Spondyloarthrosis (osteoarthrosis of the intervertebral joints)
Not long ago, it was believed that osteoarthritis was caused by wear and tear on the joints over time. However, scientists now consider it a joint disease. Factors such as genetics, weight, injuries, lack of exercise, excessive strain on the back, and other factors are believed to contribute to this process. Spondyloarthrosis is one of the most common conditions that cause lower back pain.
Spinal stenosis
Spinal stenosis is a narrowing of the spinal canal itself or a reduction in the lumen of the openings where the spinal nerves exit the spine. This condition usually develops with age against the background of pronounced degenerative-dystrophic changes in the structures of the spine and leads to significant, difficult-to-treat pain syndrome with the possible development of disability.
Spondylolysis
This term refers to a congenital or acquired disease, a cleft, crack or fracture due to stress in one of the vertebrae. In some cases, a stress fracture weakens the bone to such an extent that it can no longer maintain its correct position in the spine. The vertebra begins to shift or slide, causing back pain, especially in the lower back.
osteoporosis
Today, osteoporosis is a pressing problem for many women over 50 and some men. This is a bone disease that occurs when the body loses too much bone tissue without having time to form new, young bones. Against the background of the loss of bone tissue, its thinning and fragility occurs, as a result of which it loses strength and the vertebra can break in the event of a fall or an awkward movement when lifting a heavy object. In some cases, back pain can be caused by osteoporosis itself, even if there is no vertebral fracture.
stress
When it comes to back pain, stress is one of the most common back pain triggers. When strain occurs, the muscles tighten and cramps occur, making movement in the lower back difficult and causing pain.
Other factors
Certain medical conditions can also cause back pain, including:
- Infections with bone destruction (osteomyelitis),
- malignant oncology, especially if metastases have appeared in the bones of the spine,
- psoriasis, especially with arthritis,
- Fibromyalgia.
Sometimes pain in the lower back is referred, that is, it occurs against the background of pathology in other organs and tissues, but is felt in the spine:
- urinary tract infection,
- Diseases of the abdominal organs, kidneys and pelvic organs.
Posture problems
Back pain typically occurs as a result of strenuous everyday activities. Back pain, particularly in the lower back, can often be caused by poor posture and weak abdominal muscles. These are exactly the areas that need to be addressed and strengthened to relieve discomfort and prevent the pain from recurring in the future.
But how do the abdominal muscles affect the lower back? It's easy. The core is a single corset of muscles that supports the body. If the muscles in the front (abdomen) are weak, guess which ones get more strain? It is true that the lumbar muscles in the back lower part of the body suffer more than others. Weak abdominal muscles ultimately lead to additional tension in the back area, which overloads the psoas muscles and causes pain. Most people with chronic back pain can relieve it by strengthening their core muscles. Performing a series of exercises daily can improve the condition.
Lower back pain during pregnancy
For the first time, women may experience lower back pain while carrying a baby. This is due to a shift in the center of gravity, a change in posture and increased deflection of the spine in the lumbar region. This condition is not dangerous, but it can later lead to postural changes, muscle strains, and pinched nerves. To prevent back problems or to relieve symptoms if pain has already occurred in the spine, especially in the lower back area, treatment involves wearing a support bandage, comfortable shoes with low heels and often resting on your side.
Types of sensations in back pain in the lumbar region
Back pain can be acute if it occurs suddenly and does not last longer than 2-3 weeks. If the sensations last for months or even years, it is already a chronic pain syndrome. Based on the sensations that arise, we can distinguish:
- Severe, burning, stabbing and almost unbearable pain. It is typical for hernias, radiculitis, lumbago (lumbago in the back).
- Dull, aching, bursting or vague pain. It often occurs with injuries, inflammation or muscle strains, or with problems with the soft tissues around the spine.
- Chronic pain can be of different nature; When you move or take an uncomfortable position, they usually intensify into a burning, aching or stabbing feeling. They become weaker when resting, wearing corsets or in certain postures.
Diagnosis of back pain
To determine the cause of pain, your doctor may prescribe the following:
- A series of laboratory tests to exclude inflammatory processes and pathologies of internal organs.
- X-ray of the spine (often in two projections: direct and lateral). This helps detect bone abnormalities as well as vertebral and joint deformities.
- Computer-optical topography of the spine to assess postural disorders, determine the degree of spinal deformity and pelvic deformity.
- MRI (magnetic resonance imaging) is the most frequently prescribed and most informative method for diagnosing spinal diseases. MRI can detect damage to intervertebral discs, joints, spinal cord, vertebrae and other structures.
- ENMG (Electroneuromyography) – to assess the state of neuromuscular transmission and the function of nerves and muscles.
Treatment of pain in the lumbar spine
A number of procedures for the treatment of back pain are prescribed by a doctor individually and may include:
- Painkillers, decongestants and anti-inflammatory drugs, muscle relaxants and vitamins (tablets, ointments, injections, droppers);
- physiotherapeutic techniques (intrastitial electrical stimulation, carboxy and ozone therapy, electrophoresis, magnetic field therapy, amplipulse therapy);
- Kinesio taping,
- massage, manual therapy and osteopathy;
- Acupuncture;
- Physiotherapy and other methods.
In difficult cases where conservative therapy has no effect, surgical treatment may be indicated. These can be operations to replace an intervertebral disc, hernia removal, vertebral fusion (spinal fusion), vertebroplasty, etc.
Prevent back pain
To prevent the occurrence and progression of back pain, it is necessary to monitor your posture, immediately consult a specialist at the first appearance of back pain, regularly undergo preventive measures on the recommendation of a doctor, lead an active lifestyle and perform special physical exercisesPerform exercises and, if possible, avoid excessive physical activity and injuries.
Which doctor should I contact?
If you have back pain, especially in the lower back, you need to see a neurologist for diagnosis and treatment. In some cases, consultation with a physiotherapist, neurosurgeon or urologist or gynecologist may be required.
FAQ
How can you tell if your back or kidneys hurt?
Very often there are situations when the spine imitates kidney diseases and vice versa, when kidney diseases are disguised as spinal pathology. To clarify the cause of the pain, a consultation with a doctor and, if necessary, an additional examination are necessary.
What position is best to sleep in if you have lower back pain?
If you have lower back pain, it is recommended to sleep on your side on a medium-firm mattress, the so-called "fetal position".
Can gynecological diseases cause lower back pain?
Yes. Some gynecological diseases (inflammation, neoplasia, etc. ) can cause referred pain in the lower back.
Is exercise therapy possible for severe lower back pain?
If there is severe pain in the lower back, in the first phase of treatment it is recommended to first achieve pain relief and only then start performing active therapeutic exercises.
Can exercise cause back pain?
Yes, it's possible. Especially when practicing traumatic sports, when not complying with the requirements for safe training and also without prior warm-up.