Lower back pain is quite common. It can be caused by both normal fatigue and serious injuries and pathologies. If the pain is severe or does not go away with rest, it is important to see a doctor to rule out dangerous conditions.
What can lower back pain be like?
Lower back pain may be sharp or aching, come on suddenly or increase gradually, occur with exertion or certain movements (such as bending over), or persist regardless of what the person does.
The pain can be point-like or radiating (i. e. spreading to other areas). In this case, a person experiences pain not only in the back in the lumbar region, but also in other parts of the body, for example, in the lower abdomen, perineum, leg or buttocks.
Lower back pain may include stiffness of movement or muscle spasms. The person may have difficulty bending over or standing up from lying down, standing with a straight back, or maintaining posture while walking.
If the pain is caused by a muscle spasm or a pinched nerve, it can be unbearable and even disabling. Such pain forces you to stay in bed until you get medical help.
Why does my lower back hurt?
The most common cause of pain in the lower back is one or another pathology of the musculoskeletal system: sprains, pinching, inflammation. They are common in men who work with their hands, athletes, and new mothers.
Pain in the lower back area can also be a sign of acute or chronic diseases of the internal organs. This is because pain impulses can be transmitted to neighboring regions via nerve fibers. In this case the pain is said to "radiate" to the lower back.
Musculoskeletal disorders that cause lower back pain
Most often, lower back pain is caused by injuries and pathologies of the musculoskeletal system - muscle and ligament sprains, spinal injuries, herniated and bulging discs, joint inflammation, bone diseases.
Deformations and sprains of muscles and ligaments
Such injuries can result from awkward movements when a person lifts something very heavy or fails to follow safety precautions when handling bulky objects. Injuries can also occur during sports or simply from unsuccessful sneezing.
If you lift heavy objects without following safety precautions, you may experience lower back pain.
With sprains and strains, the pain increases with movement and cramps may occur in the muscles. It may be painful for the person to walk, bend forward, or keep their back straight.
Diagnosis of deformations and sprains of muscles and ligaments is based on data from a physical examination and instrumental studies – ultrasound, X-ray, MRI of the lumbar spine. If you suspect a sprain or deformation of muscles or ligaments, you should contact an orthopedic traumatologist.
Treatment consists of relieving acute pain and muscle spasms with ice compresses, painkillers, and medications to relieve muscle spasms (muscle relaxants). It is important to give the damaged area rest to allow the tissue to recover - this usually takes around 2 weeks. After that, it is important to begin rehabilitation: physiotherapeutic exercises to restore muscle function are indicated.
Without treatment, strains and sprains lead to limited mobility: in order not to injure the damaged area, a person reduces their activity, which can lead to weight gain, reduced bone strength and loss of muscle mass.
Injuries to the vertebral acid
Damage (usually a fracture) to one or more vertebrae occurs from falls, accidents, sports or household injuries. In people with bone density disorders (e. g. osteoporosis), such damage can be caused by even minor stress.
Treatment for spinal injuries is to prevent displacement and further deformation of the intervertebral discs. If the damage is not severe, it is recommended to sleep on a hard surface and limit physical activity. If there is significant damage, surgical methods of fixation are used.
Without treatment, damage to the intervertebral discs can lead to stenosis (narrowing) of the spinal canal and neurological disorders, including sciatica - pinched nerve fibers extending from the spine.
Pathologies of the intervertebral discs
Intervertebral discs are fibrocartilaginous plates with jelly-like contents that are located between the vertebrae. They act as shock-absorbing cushions for the vertebrae and thus ensure their mobility. Discs can become detached (protrude) or rupture (herniated), causing severe pain and limiting mobility of the spine.
Intervertebral hernias and bulges can occur in people with weak muscles and overweight, those who lead a sedentary lifestyle or lift heavy objects. People who smoke are more susceptible to intervertebral disc disease.
Intervertebral hernia – bulging of an intervertebral disc into the spinal canal
Treatment consists of relieving pain and inflammation - rest, painkillers, ointments and compresses on the inflamed area are recommended. The doctor may prescribe physiotherapy or exercise therapy. In the case of moderate damage, the intervertebral disc can recover if the cause of the prolapse or bulge is ruled out - for example by strengthening the muscle corset, reducing weight and not putting excessive strain on the spine.
If lower back pain is severe enough to interfere with daily activities, does not resolve within 1-1. 5 months, or symptoms worsen, you should contact your doctor again. In some cases, steroid therapy or even surgery may be necessary. With increasing age, degenerative disease of the intervertebral discs can occur - they become flatter and have a poorer shock-absorbing function, which can also cause pain. In this case, treatment includes pain relief and general improvement of the body.
Scoliosis of the lumbar spine
Scoliosis (curvature) of the spine is a displacement of the spine to the right or left relative to the vertical axis. The pathology leads to increased pressure on certain areas of the intervertebral discs and vertebrae, as well as pinched tissue and nerve fibers. Scoliosis can cause severe pain in the lower back area on the right or left - where most stress occurs - and severely limit the mobility of the spine.
Scoliosis (curvature) of the spine can cause severe pain in the area of the lower back that is subjected to high stress
Scoliosis can occur due to a weakening of the muscle corset with a lack of physical activity and a sedentary lifestyle (in schoolchildren, office workers). In this case, it is difficult for the muscles to maintain the physiological position of the back and curvatures are formed.
Treatment includes the introduction of balanced physical activity (physiotherapy, swimming), massage and manual therapy, as well as physiotherapeutic procedures to strengthen muscles, for example, electrical stimulation. In case of serious injuries, wearing a corset is recommended, which will help maintain the correct position of the spine.
Arthritis and arthrosis
Inflammation and degenerative processes in the joints of the spine can also cause severe pain in the lower back. There are many forms of arthritis, including osteoarthritis (damage to cartilage and adjacent tissue) and ankylosing spondylitis (bechterew's disease - damage to the joints of the spine leading to the fusion of the vertebrae).
Arthritis can be caused by natural aging, genetics, or autoimmune diseases.
Treatment of arthritis, depending on the form, may include the use of non-steroidal and steroidal anti-inflammatory and analgesic agents, physiotherapeutic procedures (magnetotherapy, electrophoresis), therapeutic massage and physical therapy.
Physiotherapeutic procedures help relieve pain due to joint diseases
Spondylolisthesis
A displacement of a vertebra relative to the spine (spondylolisthesis) occurs as a result of injuries or degenerative processes in the spine. The pathology occurs in athletes, the elderly or people with a hereditary predisposition to bone diseases (e. g. osteoporosis - a disorder of bone density). Spondylolisthesis can cause severe pain in the lower back, buttocks, and legs and cause cramps or weakness in the legs.
Treatment involves relieving pain and inflammation caused by compression of adjacent tissues by the vertebra. Depending on the severity of the pain syndrome, the doctor may prescribe non-hormonal painkillers in tablet form or injections of corticosteroid drugs. At the same time, physiotherapeutic procedures and exercise therapy are prescribed to strengthen the muscles and restore the position of the vertebrae. If spondylolisthesis is accompanied by very severe pain, surgical treatment is used.
In traumatic and non-infectious musculoskeletal diseases, lower back pain usually subsides or decreases when the person assumes a comfortable position.
If spondylolisthesis is accompanied by severe pain, your doctor may prescribe corticosteroid injections.
Infectious diseases of the spine
Inflammation of the bone tissue (osteomyelitis) and inflammation of the intervertebral disc (discitis) can cause severe pain in the lower back. These pathologies are usually secondary in nature, that is, they arise as a complication of inflammation of other organs (the infection enters the tissues through the bloodstream).
Treatment involves hospitalization, lasts up to 1 month, and then requires rehabilitation, which lasts 6 to 12 months.
Tumor diseases of the spine
Neoplasms can develop under the influence of hereditary or external factors (e. g. radiation), but most often appear as repeated foci (metastases) in cancers of other organs - lungs, mammary glands, prostate, thyroid, kidneys.
One of the most characteristic symptoms of tumor pathologies is pain that does not subside when changing position or after rest. Symptoms such as numbness, partial paralysis, uncontrolled urination and a sharp increase in body temperature with chills are also possible. Without treatment, symptoms worsen.
Treatment is prescribed depending on the type of tumor, its location and symptoms and may include chemotherapy, radiation therapy and surgical removal of tumors. Pain relief is achieved with non-hormonal or steroidal medications. To stabilize your spine, your doctor may prescribe you to wear a corset.
Orthopedic corset helps stabilize the spine
Diseases of the internal organs that cause pain in the lower back
Lower back pain can occur in diseases that are not related to pathologies of the spine and adjacent tissues. Acute or painful, it can be accompanied by inflammation of internal organs: pyelonephritis, urolithiasis, abdominal aortic aneurysm. Women may experience lower back pain due to gynecological diseases.
Urolithiasis disease
A disease in which stones form in the kidneys and bladder - hard structures made from the sediment of chemical components of urine. Lower back pain is one of the main symptoms of any pathology. Depending on their size and location, kidney stones can cause a dull and aching pain that occurs periodically and subsides, or a very sharp pain that does not go away on its own and requires emergency medical care.
Urolithiasis – the formation of stones in the kidneys and bladder
If you suspect kidney stones, you should contact a urologist or nephrologist. The doctor will prescribe tests and instrumental examinations (ultrasound, X-ray examination, computed tomography, including with the use of a contrast agent) to make a diagnosis and select treatment tactics.
Treatment is prescribed taking into account the size, type, location of the stones and other factors. If the stone is small (5-10 mm) and there are no other indications for surgical removal, drug treatment is used. If positive dynamics do not occur within a month, removal by non-invasive or surgical methods is recommended.
Abdominal aortic aneurysm
A weakening of the walls of the abdominal aorta (aneurysm) can lead to life-threatening conditions such as aortic rupture and intra-abdominal bleeding. As a rule, the pathology occurs in older people: the risk group includes men over 65 years of age and women over 70 years of age, including smokers, people with vascular diseases (high blood pressure), previous illnesses of aneurysms or those with a hereditary predisposition to them.
Lower back pain from an abdominal aortic aneurysm does not go away over time and may be accompanied by pain in the abdomen and legs.
If an aneurysm is suspected, an ultrasound examination of the abdomen and computed tomography are prescribed.
Treatment depends on the size of the aneurysm. Minor changes require monitoring with instrumental examination twice a year and lifestyle adjustments. Significant (over 5 cm, with high risk of rupture) is an indication for abdominal or minimally invasive surgery.
How to prevent lower back pain
Since lower back pain is most often caused by traumatic injury to muscles, fascia, joints or bones, the most important recommendation for prevention is to follow safety precautions, maintain a strong muscle corset and healthy bones and joints.
Prevention of sprains and microtraumas of the lower back:
- a varied diet that contains the necessary vitamins and minerals to maintain healthy bone, muscle tissue and joints;
- maintaining a healthy weight;
- Regular physical activity: Exercises to prevent lower back pain should include strength exercises to develop muscles, stretching exercises to relieve muscle tension and spasms, and cardio training to maintain blood supply and tissue nutrition;
- Compliance with safety precautions when exercising - for example, the first classes in the gym must be supervised by a qualified trainer;
- Adhering to home safety precautions – many injuries can be avoided if you wear comfortable shoes, hold onto the banisters, and take your time when it is slippery outside;
- Observe safety precautions when lifting heavy objects - the stress on the spine will be reduced if you approach the object as close as possible (do not reach for it) and bend your legs instead of tilting your body when lifting objects from the floor.
Yoga and Pilates classes help relieve spasms and tension in the lower back
Smoking impairs blood circulation and impairs tissue nutrition, increasing the risk of damage and injury.
What to do if your lower back hurts?
If your lower back hurts, the reasons may be different, which means that treatment tactics are also different.
When you are very physically tired, your back needs rest - perhaps this is enough for the muscles to recover and the mobility of the spine to be restored.
If the pain does not go away within 1-2 days or is very severe, you should see a doctor. While you wait to see a doctor, you can try to relieve acute pain with painkillers.
At the appointment, the doctor will conduct an examination, determine the cause of the pain and give recommendations for treatment. This will help eliminate dangerous conditions and prevent the development of complications.
Heat (lumbar bandages, hot water bottle, sauna) is contraindicated for inflammation, but can relieve acute lower back pain when caused by muscle fatigue or a pinched nerve. These methods can only be used after consulting a doctor.
Which doctor should I contact if I have a complaint about lower back pain?
If you suspect pathology of the musculoskeletal system, you should contact a neurologist and orthopedic traumatologist.
Diagnosis is carried out as part of a physical examination and using instrumental methods: magnetic resonance therapy, computed tomography, X-ray and ultrasound. It is also possible to prescribe a myelogram (X-ray or CT scan with a contrast agent injected into the spinal canal) and electromyography - a study that allows you to assess the condition of nerve and muscle fibers.
If you suspect kidney disease, you should contact a urologist, nephrologist or therapist. The doctor analyzes the complaints, conducts a physical examination and then prescribes laboratory and instrumental tests to clarify the diagnosis.
Using blood and urine tests, the doctor can determine whether there is inflammation in the organs of the urinary system. Ultrasound and X-rays help visualize the organs, determine the cause of pain and select the most effective treatment tactics.
If the cause of lower back pain is unclear, you should consult a family doctor or therapist.
The doctor takes an anamnesis (anamnesis), analyzes hereditary risks, conducts a physical examination and prescribes tests that detect inflammatory processes or dysfunctions of internal organs.
A general blood test helps to identify the inflammatory process.
If necessary, the doctor will refer you for instrumental examinations (ultrasound, X-ray, MRI) or advise you to contact a specialist for further diagnosis and treatment.