About 80% of adults have suffered from lower back pain at least once in their life. It affects both men and women.
Pain manifests itself in different ways: from dull and constant, to sudden, but very sharp, which temporarily invalidates.
Sudden pain in the lower back 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'll take a 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 upper body weight. The space between the vertebrae is filled with round elastic pads - intervertebral discs. They act as shock absorbers, absorbing loads and mitigating their impact on the spine.
Ligaments hold the vertebrae in place and tendons attach muscles to them. Inside the spine 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 of mechanical origin. Next, we'll look at the most common reasons:
- Sprains or tears of ligaments, tendons and musclesis the most common cause of acute low back pain. They appear after twisting the spine, lifting objects incorrectly, lifting something very heavy, or putting excessive strain on ligaments, tendons, and muscles. All this also causes painful spasms in the back muscles.
- Degeneration (wear) of the intervertebral discsAnother of the most common causes of low back pain is. This happens when the elastic discs lose their integrity as the body ages. In healthy people, the intervertebral discs allow the trunk to bend and twist normally. When drives fail, they lose their ability to absorb loads.
- Disc protrusion or herniation.This happens after the intervertebral discs are strongly compressed, bulged outward (protruding), or ruptured (herniated).
- Radiculopathy.This is a condition caused by compression, inflammation, and / or trauma to the nerve root in the spine. Pressure on the nerve can cause lower back pain and numbness or tingling sensations. These symptoms spread to parts of the body that are innervated by the nerve that emerges from the root. Also, radiculopathy occurs due to compression of the nerve root with spinal stenosis, protrusion or rupture of the intervertebral disc.
- Sciatica- one of the forms of radiculopathy, which develops due to compression of the sciatic nerve. It's a big nerve that runs through the buttocks and down from the back of the leg to the heel. Compression of the sciatic nerve causes shooting or burning pain in the lower back, associated with pain in the buttocks and one leg. In more severe cases, when the nerve is pinched between the disc and the adjacent bone, not only is the pain bothersome, 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 its root is pinched due to a cyst or tumor formed.
- Degenerative spondylolisthesis- This is a condition in which the vertebrae "fall" out of place and block 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 a protrusion or a herniated disc.
- Spinal stenosis- This is a narrowing of the lumen, which creates increased pressure on the spinal cord and nerves. As a result, pain or numbness occurs when walking. Over time, the stenosis leads to 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 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:
- Age- 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 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 properly support the spine. A sedentary lifestyle and a lack of muscle building exercises are the culprits. Those particularly affected are people who go a whole week without moving, and on weekends they try to catch up and train too hard. People who exercise at 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- very often back pain appears in pregnant women. Everything is to blame - structural changes in the pelvic area and the redistribution of weight. A good thing is that after childbirth the pain goes away for almost everyone.
- Weight gain- the presence of excess weight, obesity or simply a strong increase in kilograms stresses the back and causes lower back pain.
- Hereditary predisposition.One type of arthritis, ankylosing spondylitis, is often inherited. In this disease, the joints of the vertebrae grow together, which causes pain, as well as reduced mobility of the spine.
- The specifics of the work.If your job is to lift, push or pull weights, you are at risk of injury or lower back pain. Particularly dangerous is the movement of weights, in which the spine twists or vibrates. Idle work also increases the risk of feeling pain. Those particularly affected are those who do not follow their posture or who sit in a chair with an unsuitable backrest all day.
The problem of overloading schoolchildren with textbooks and accessories that they carry in their backpacks is separate. Experts from the American Academy of Orthopedic Surgeons note that the maximum weight of the backpack should not exceed 15-20% of the child's weight.
Lower 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 all back pain, both acute and chronic. The compresses do not treat the underlying cause, but rather help relieve pain and improve joint mobility.
Maintaining physical activity
Bed rest should be kept to a minimum. Stretching should be performed and normal motor activity should be maintained, avoiding movements that increase pain. Research shows that staying active after the onset of low back pain helps maintain flexibility. Plus, bed rest can even make the pain worse and lead to secondary complications. These include depression, decreased muscle tone, and blood clots in the legs.
Strength training (in addition to usual physical activity) is not recommended for acute pain. They can be considered as an effective remedy for accelerated recovery from chronic low back pain.
Maintaining and increasing the strength of the back and abdominal muscles is particularly important for people with musculoskeletal imbalances (scoliosis, hyperlordosis). To correct the posture and muscle imbalance, you need to 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 help with pain relief as well.
Medication for back pain
Depending on the severity of the condition, doctors prescribe one or more medications:
- Analgesics - to relieve pain.
- Nonsteroidal 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 their effectiveness in the treatment of low back pain has never been proven.
- Creams and sprays - for cooling or heating.
Surgery is only recommended if progressive nerve damage or structural changes in the spine are detected.
When to consult a doctor?
Seek immediate medical attention if the pain is severe and:
- Appeared after a fall, an injury or a blow to the back,
- It gets worse during rest or at night.
- Worsens when coughing or urinating
- Spreads 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 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 for anything. It is best to consult an orthopedic traumatologist.