About 80% of adults have back pain at least once in their life. It affects men and women alike.
The pain manifests itself in different ways: from dull and constant to sudden, but very acute, which temporarily makes you unable to act.
Sudden lower back pain occurs after an injury or lifting a heavy object. If you look at chronic pain, it often manifests itself as age-related changes in the spine.
In this article, we're going to look at the main causes of low back pain.
What is the lower back made of?
The lumbar spine contains 5 vertebrae (L1-L5) that carry most of the upper body weight. The space between the vertebrae is filled with round elastic pads - intervertebral discs. They act as shock absorbers, absorb loads and soften their impact on the spine.
Ligaments hold the vertebrae in place and tendons connect the muscles to them. There are 31 pairs of nerves in the spine 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 mechanical. Next, let's look at the most common reasons for this:
- Sprains or tears of ligaments, tendons, and musclesis the leading cause of acute low back pain. They occur after twisting the spine, lifting objects improperly, lifting something very heavy, or excessively tensioning ligaments, tendons, and muscles. All of this also provokes painful spasms in the back muscles.
- Degeneration (wear and tear) of the intervertebral discsAnother one of the most common causes of lower back pain is. It occurs when elastic discs lose their integrity with age. In healthy people, the intervertebral discs allow the trunk to flex and twist normally. If the discs fail, they lose their ability to take loads.
- Disc protrusion or hernia.This happens after the intervertebral discs are severely compressed, bulge outward (protrusion) or tear (hernia).
- Radiculopathy.It is a condition caused by compression, inflammation, and / or trauma to the spinal nerve root. Pressure on the nerve can cause lower back pain and numbness or tingling. These symptoms spread to the parts of the body that are innervated by the nerve emerging from the root. Radiculopathy also occurs due to compression of the nerve root with a stenosis of the spinal canal, protrusion, or a rupture of the intervertebral disc.
- sciatica- one of the forms of radiculopathy that develops due to compression of the sciatic nerve. It's 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 that is associated with pain in the buttocks and one leg. In the worst case, when the nerve is pinched between the intervertebral 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 becomes pinched due to a cyst or tumor.
- Degenerative spondylolisthesis- This is a condition in which the vertebrae "fall" out of their position and pinch the nerves coming out of the spine.
- traumafor example through sporting 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 leads to bulging or herniated discs.
- Spinal stenosis- This is a narrowing of the lumen that puts increased pressure on the spinal cord and nerves. This causes pain or numbness when walking. Over time, stenosis leads to weakness and numbness in the legs.
- Scoliosis and Other Skeletal Imbalances.Scoliosis is a sideways curvature of the spine that does not usually cause pain until middle age. Another common condition is hyperlordosis, which is an excessive deflection of the spine in the lower back.
Who is most at risk of back pain?
Several factors make this problem more likely to occur. Among them:
- Age- the pain occurs for the first time at the age of 30-50 years. Due to osteoporosis, bone strength is lost with age, leading to fractures, as well as a decrease in muscle tone and elasticity. The intervertebral discs lose fluid and flexibility, which in turn affects their ability to absorb stress. The risk of developing spinal stenosis also increases with age.
- Little physical activity- Weak abdominal and back muscles cannot properly support the spine. This is due to a sedentary lifestyle and a lack of muscle-strengthening workouts. People who spend a whole week without exercise and try to catch up and train too hard at the weekend are particularly affected. People who exercise at a moderate intensity but exercise most days of the week are much less likely to experience back pain. Research shows that low-intensity aerobic exercise is beneficial for maintaining the integrity of the intervertebral discs.
- pregnancy- Back pain is very common in expectant mothers. It's all to blame - structural changes in the pelvic area and the redistribution of weight. One good thing is that the pain goes away in almost everyone after giving birth.
- Weight gain- The presence of overweight, obesity, or just a sharp increase in the kilogram puts a strain on the back and leads to lower back pain.
- Hereditary disposition.One type of arthritis, ankylosing spondylitis, is often inherited. In this disease, the joints of the vertebrae grow together, causing pain and reducing mobility of the spine.
- The specifics of the work.Lifting, pushing, or pulling weights as you work can create a risk of injury or lower back pain. Moving weights is particularly dangerous as it causes the spine to twist or vibrate. Inactive work also increases the risk of pain. Those who do not follow their posture or who sit in a chair with an unsuitable backrest all day are particularly affected.
The problem of overloading schoolchildren with school books and accessories that they carry in their backpacks is an aside. Experts from the American Academy of Orthopedic Surgeons point out that the maximum backpack weight should not be more than 15-20% of the child's weight.
Back pain treatment
The treatment strategy depends on what kind of pain is bothering you - short-term acute or chronic. The most common pain management techniques used include:
Apply warm or cold compresses
Compresses are used to relieve pain and reduce inflammation. They can be used for acute and chronic back pain. Compresses don't treat the underlying cause, but rather help relieve pain and improve joint mobility.
Maintaining physical activity
Bed rest should be kept to a minimum. Stretches should be performed and normal motor activity should be maintained, avoiding movements that aggravate pain. Research shows that staying active after the onset of lower back pain helps maintain flexibility. In addition, bed rest can even worsen the pain and lead to complications. These include depression, decreased muscle tone, and blood clots in the legs.
Weight training (in addition to normal physical activity) is not recommended for acute pain. They can be viewed as an effective means of accelerating recovery from chronic low back pain.
Maintaining and strengthening the back and abdominal muscles is particularly important for people who suffer 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 to help correct these disorders.
By the way, research shows that yoga can also help relieve pain.
Back pain medication
Depending on the severity of the disease, doctors will prescribe one or more drugs:
- Pain relievers - to relieve pain.
- Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) - used to relieve pain and inflammation.
- Anticonvulsants prescribed to treat seizures can be helpful for people with radiculopathy.
- For chronic pain, tricyclic antidepressants, as well as serotonin and norepinephrine reuptake inhibitors, are prescribed. Although its effectiveness in treating 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 to the spine are found.
When should you see a doctor?
See a doctor right away if the pain is severe and:
- Appeared after a fall, injury or blow to the back,
- It gets worse at rest or at night.
- Worsens when you cough or urinate
- Spreads in one or both legs,
- Is 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 urination or bowel movements.
Don't wait for your lower back pain to get bad enough that you're ready to do anything. It is better to consult an orthopedic traumatologist.