About 80% of adults have suffered from low back pain at least once in their life. It affects men and women equally.
The 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 after lifting a heavy object. If we consider chronic pain, it often arises 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) which 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 cushioning their impact on the spine.
The ligaments hold the vertebrae in place and the tendons attach the muscles to them. Within the spine, 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 of mechanical origin. Next, we will consider the most common reasons for this:
- Sprains or tears of ligaments, tendons and musclesit is the most common cause of acute low back pain. They appear after rotating the spine, lifting objects improperly, lifting something very heavy, or putting too much 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 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 discs fail, they lose their ability to absorb loads.
- Disc protrusion or herniation.This happens after the intervertebral discs have been severely compressed, bulging out (protrusion) or ruptured (hernia).
- Radiculopathy.It is a condition caused by compression, inflammation and / or trauma to the spinal nerve root. The pressure on the nerve can cause lower back pain and numbness or tingling sensations. These symptoms spread to those parts of the body that are innervated by the nerve emerging from the root. Also, radiculopathy occurs due to nerve root compression with spinal canal 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 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 stabbing or burning pain in the lower back, which is combined with pain in the buttocks and leg. In severe cases, when the nerve gets stuck between the disc and the adjacent bone, not only is the pain bothersome, but also the numbness and weakness of 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 that come out of the spine.
- Traumafor example due to sports activities, a traffic 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 results in protrusion or herniated disc.
- Spinal stenosis- This 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 leads to weakness and numbness in the legs.
- Scoliosis and other skeletal imbalances.Scoliosis is a lateral curvature of the spine that does not usually cause pain until middle age. Another common ailment is hyperlordosis, in which there is excessive deflection of the spine in the lower back.
Who is most at risk of having back pain?
Several factors increase the chances of encountering this problem. Between them:
- Age- the first time the pain attacks at the age of 30-50. Due to osteoporosis, bone strength is lost with age, which leads to fractures, as well as a decrease in 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. The fault lies with a sedentary lifestyle and a lack of muscle strengthening workouts. Particularly affected are people who spend a whole week without moving and try to recover and train too hard on weekends. People who train with moderate intensity but most days of the week suffer from lower back pain much less often. Research shows that low-intensity aerobic exercise is helpful in maintaining the integrity of the intervertebral discs.
- Pregnancy- very often, back pain appears in expectant mothers. It's all your fault: structural changes in the pelvic area and weight redistribution. A good thing is that after giving birth, the pain goes away for almost everyone.
- weight gain- the presence of excess weight, obesity or even just a sharp increase in kilograms puts stress on the back and leads to lower 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 and a decrease in the mobility of the spine.
- The specificities of the work.If your job involves lifting, pushing, or pulling weights, you run the risk of lower 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 all day in a chair with an unsuitable backrest.
The problem of overloading schoolchildren with textbooks and accessories they carry in their backpacks is a separate one. 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.
Treatment for low back pain
The treatment strategy will depend on the type of pain that is bothering you: acute or chronic in the short term. The most commonly used pain management techniques include:
Application of hot or cold compresses
Tablets are used to relieve pain and reduce inflammation. They can be used for any back pain, both acute and chronic. The tablets do not treat the underlying cause, but rather 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 maintained, avoiding movements that increase pain. Research shows that staying active after the onset of low back pain helps maintain flexibility. Additionally, bed rest can even make pain worse and lead to secondary complications. These include depression, decreased muscle tone, and blood clots in the legs.
Strength training (other than normal 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 the strength of the back and abdominal muscles is particularly important for people suffering from musculoskeletal imbalances (scoliosis, hyperlordosis). To correct posture and muscle imbalance, you need to contact an orthopedic traumatologist. The doctor will develop a series of exercises that will help correct these ailments.
By the way, research shows that doing yoga can also help relieve pain.
Back pain medications
Depending on the severity of the condition, doctors prescribe one or more drugs:
- Pain relievers - for pain relief.
- Non-steroidal anti-inflammatory drugs (NSAIDs) - to relieve pain and inflammation.
- The 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 - 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,
- Worsens during rest or at night.
- It gets worse when coughing or urinating
- Spreads in 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 urination or defecation.
Don't wait for your lower back pain to get so bad that you're ready to do anything. It is best to consult an orthopedic traumatologist.