According to statistics, almost every second person in middle and old age goes to a doctor with complaints of back and lower back pain. Up to 80% of people experience this unpleasant sensation at least once in their lives.
Around the world, pain in the lumbar spine causes people to lose mobility, undergo prolonged treatments and are forced to limit their usual activities.
Causes of low back pain
There are many different reasons and factors that cause back pain, especially in the lower back. Some diseases are more common, others are quite rare, but it is important to consult a doctor in a timely manner to determine the true cause and help alleviate the pain.
Muscle and ligament injuries
One of the causes of lower back pain is strain and damage to the muscles and ligaments that support the back. The pain is usually located in the muscles near the spine and may be associated with spasms in these muscles. Painful sensations can pass to the buttocks and, extremely rarely, to the leg.
Disc herniation
A herniated disc is characterized by the prolapse of the inner part of the disc towards the spinal canal, which often causes severe and unbearable back pain in the lumbar region. A displaced and damaged disc in the lower back forms a hernia when it ruptures. The reason is that the disc structure degenerates (aging) to such an extent that the cartilage shell literally cracks, disintegrates and the dense gel (nucleus pulposus) inside the disc is pushed into the spinal canal. A herniated disc puts pressure on spinal nerves, often causing pain.
Disc degeneration and aging (osteochondrosis)
The discs between the vertebrae are strong, 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 flat. When osteochondrosis is present, pain occurs along the spine, most often in the lower back, which requires treatment.
Not everyone who has disc degeneration has back pain. However, in those people who have ruled out all other possible back problems, the pain may be caused by degenerative changes in the discs (osteochondrosis).
Spondyloarthrosis (osteoarthrosis of the intervertebral joints)
Not long ago, it was believed that osteoarthritis was caused by wear and tear on joints over time. However, scientists now consider it to be a joint disease. It is believed that factors such as genetics, weight, injuries, sedentary lifestyle, excess stress on the back and other factors contribute to this process. Spondyloarthrosis is one of the common diseases that cause low back pain.
Spinal stenosis
Spinal stenosis is a narrowing of the spinal canal itself or a decrease in the lumen of the openings through which spinal nerves exit the spinal column. This condition often develops with age, against the background of pronounced degenerative-dystrophic changes in the spinal structures and leads to a significant pain syndrome that is difficult to treat with the possible development of disability.
Spondylolysis
This term refers to a congenital or acquired condition, a cleft, fissure or fracture due to stress in one of the vertebrae. In some cases, a stress fracture weakens the bone so much that it cannot maintain its proper 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 years of age and some men. This is a bone disease that occurs when the body loses too much bone tissue without having time to create new, young bone. Against the background of loss of bone tissue, its rarefaction and fragility appears, as a result of which it loses its strength and the vertebra can break due to a fall or awkward movement, lifting a heavy object. In some cases, back pain may be caused by osteoporosis itself, even in the absence of a vertebral fracture.
Stress
When it comes to back pain, stress is one of the common factors that can trigger back pain. When stressed, the muscles become more toned and spasms occur, making it difficult to move the lower back and causing pain.
Other factors
Certain conditions can also contribute to back pain, including:
- infections with bone destruction (osteomyelitis),
- malignant oncology, especially if metastases occur in the bones of the spine,
- psoriasis, especially with arthritis,
- fibromyalgia.
Sometimes low back pain is referred, that is, it occurs against the background of pathology in other organs and tissues, but is felt in the spine:
- urinary tract infections,
- diseases of the abdominal organs, kidneys and pelvic organs.
Posture problems
Back pain often occurs as a result of strenuous daily activities. Often, back pain, especially in the lower back, can be caused by poor posture and weak abdominal muscles. These are exactly the areas that need to be addressed and strengthened to alleviate discomfort and prevent pain from returning in the future.
But how do the abdominal muscles affect the lower back? It's simple. The torso is a unique muscular corset that supports the body, and if the muscles in the front (abdomen) are weak, guess which ones receive the greatest load? It is true that the lumbar muscles in the lower back part of the body suffer more than the others. Weak abdominal muscles end up creating additional tension in the back, which puts stress on the psoas muscles, causing pain. Most people living with chronic back pain can reduce 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 pain in the lower back when carrying a baby. This is due to a shift in the center of gravity, a change in posture and an increase in spinal deflection in the lower back. This condition is not dangerous, but it can later predispose to changes in posture, muscle tension and pinched nerves. To avoid back problems or reduce discomfort when back pain already occurs, especially in the lower back, treatment involves the use of a support bandage, comfortable low-heeled shoes and, often, lateral rest.
Types of sensations for back pain in the lower back
Back pain can be acute if it occurs suddenly and lasts no more than 2 to 3 weeks. If the sensations last for months or even years, it is already a chronic pain syndrome. According to the sensations that arise, we can distinguish:
- Intense, burning, sharp and almost unbearable pain. It is typical of hernias, radiculitis, low back pain (lumbago in the back).
- Dull, aching, explosive or vague pain. It often occurs with injury, inflammation or muscle strain, or problems with the soft tissues surrounding the spine.
- Chronic pain can be of different nature; with uncomfortable movement or position, it often intensifies to a burning, aching, or stabbing sensation. When resting, wearing corsets or certain body positions, they weaken.
Diagnosis of low back pain
To determine the cause of the pain, your doctor may prescribe:
- A set of laboratory tests to exclude inflammatory processes and pathologies of internal organs.
- X-ray of the spine (usually in two projections: direct and lateral). This helps identify bone abnormalities, vertebral and joint deformities.
- Computerized optical topography of the spine to evaluate postural disorders, determine the degree of spinal deformation and pelvic distortion.
- Magnetic resonance imaging (magnetic resonance imaging) is the most frequently prescribed and informative method for diagnosing spinal diseases. MRI can detect damage to intervertebral discs, joints, spinal cord, vertebrae and other structures.
- ENMG (electronneuromyography) - to assess the state of neuromuscular transmission, function of nerves and muscles.
Treatment of lumbar spine pain
A set of procedures for treating back pain is prescribed by a doctor individually and may include:
- Analgesics, decongestants and anti-inflammatories, muscle relaxants and vitamins (tablets, ointments, injections, droppers);
- physiotherapeutic techniques (intrastitial electrical stimulation, carboxytherapy and ozone therapy, electrophoresis, magnetic therapy, amplipulse therapy);
- kinesio recording,
- massage, manual therapy and osteopathy;
- acupuncture;
- physiotherapy and other methods.
In difficult cases, in the absence of effect from conservative therapy, surgical treatment may be indicated. These can be operations to replace a disc, remove hernias, fusion of vertebrae (spinal fusion), vertebroplasty, etc.
Preventing back pain
To prevent the appearance and progression of back pain, it is necessary to monitor your posture, promptly consult a specialist at the first appearance of back pain, regularly carry out preventive procedures on the recommendation of a doctor, lead an active lifestyle, do special physical exercises exercise 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 will need to see a neurologist for diagnosis and treatment. In some cases, consultation with a physiotherapist, neurosurgeon or urologist, gynecologist may be required.
Common questions
How to determine if your back or kidneys hurt?
There are often situations when the spine imitates kidney disease and vice versa, when kidney disease masquerades as spinal pathology. To clarify the cause of the pain, it is necessary to consult a doctor and, if necessary, undergo additional tests.
What is the best sleeping position if you have lower back pain?
If you have lower back pain, it is recommended to sleep on a medium-hard mattress, lying on your side, in the so-called "fetal position".
Can low back pain occur due to gynecological diseases?
Yes. Some gynecological diseases (inflammatory, neoplasms, etc. ) can cause referred pain in the lower back.
Is it possible to do exercise therapy if you have 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 a reduction in pain and only then begin to perform active therapeutic exercises.
Can playing sports cause low back pain?
Yes, it is possible. Especially when practicing traumatic sports, not meeting the requirements for safe training, and also without prior warming up.