About 80% of adults have experienced lower back pain at least once in their lives. It affects men and women equally.
Pain manifests itself in various ways: from dull and constant, to sudden but very acute, which temporarily disables.
Sudden lower back pain occurs after an injury or lifting a heavy object. If we take into account chronic pain, then it often manifests itself due to age-related changes in the spine.
In this article, we will look at the main causes of lower back pain.
What is the lower back made of?
The lumbar spine contains 5 vertebrae (L1-L5) that 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, absorb loads and mitigate their impact on the spine.
The ligaments hold the vertebrae in place, and the tendons attach the muscles to them. Inside the spinal column are 31 pairs of nerves that control our movements and transmit signals from all parts of the body to the brain.
Why does my lower back hurt?
In most cases, the pain is of mechanical origin. Then we will consider the most common reasons for this:
- Sprains or tears of ligaments, tendons and musclesis the most common cause of acute lower back pain. They appear after twisting the spine, improperly lifting objects, lifting something very heavy or excessive tension on the ligaments, tendons and muscles. All of this also causes painful cramps in the back muscles.
- Degeneration (wear) of intervertebral discsIt is another common cause of lower back pain. Occurs when elastic discs lose their integrity as the body ages. In healthy people, intervertebral discs allow the body to bend and twist normally. As the discs break, they lose the ability to absorb the load.
- Disc protrusion or hernia.This occurs after the intervertebral discs are strongly compressed, bulging outwards (protrusion) or rupture (hernia).
- Radiculopathy.This condition is caused by compression, inflammation and / or trauma to the spinal nerve root. Nerve pressure can cause lower back pain and numbness or tingling. These symptoms spread to those parts of the body that are innervated by a nerve coming out of the root. Also, radiculopathy occurs due to compression of the nerve root 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 goes down the back of the leg to the heel. Compression of the sciatic nerve causes shooting or burning pain in the lower back, which is combined with pain in the buttocks and one leg. In the most severe cases, when the nerve is pinched between the disc and the adjacent bone, it is disturbed not only by pain, but also by numbness and weakness in the leg. This is due to a violation of the transmission of nerve signals. In rare cases, a pinch of a nerve or its root occurs due to the formation of a cyst or tumor.
- Degenerative spondylolisthesis- This is a condition in which the vertebrae "fall out" of their place and tighten the nerves that come out of the spinal column.
- 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 protrusions or herniated discs.
- Spinal stenosis- This is a narrowing of the lumen, which creates increased pressure on the spinal cord and nerves. As a result, there is pain or numbness when walking. Over time, stenosis leads to weakness and stiffness in the legs.
- Scoliosis and other skeletal imbalances.Scoliosis is a lateral curvature of the spine that usually does not cause pain until middle age. Another common disorder is hyperlordosis, in which there is excessive deformation of the spine in the lower back.
Who is most at risk for back pain?
Several factors increase your chances of facing this problem. Among them:
- Age- first pain attack at the age of 30-50 years. Due to osteoporosis, bone strength is lost with age, which leads to fractures, as well as a decrease in muscle tone and elasticity. Intervertebral discs begin to lose fluid and flexibility, which in turn reduces 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 support the spine properly. The culprits for this are a sedentary lifestyle and a lack of muscle-strengthening exercises. People who spend the whole week without moving, and on weekends they try to catch up and train too much, are especially affected. People who exercise at a moderate intensity, but most days of the week, experience lower back pain much less often. Research shows that low-intensity aerobic exercise is useful for maintaining the integrity of intervertebral discs.
- Pregnancy- Very often, pregnant women have back pain. Everything is wrong - structural changes in the pelvic area and weight redistribution. One good thing is that after childbirth, the pain disappears from almost everyone.
- Gaining weight- the presence of excess weight, obesity or just a sudden increase in weight creates stress on the back and leads to pain in the lower back.
- Hereditary predisposition.One type of arthritis, ankylosing spondylitis, is often inherited. In this disease, the vertebral joints coalesce, causing pain as well as reduced mobility in the spine.
- Specifics of work.If your job involves lifting, pushing or pulling weights, you run the risk of injury or pain in your lower back. The movement of weights in which the spine twists or vibrates is especially dangerous. Inactive work also increases the risk of experiencing pain. Particularly affected are those who do not monitor their posture or sit in a chair with an unsuitable backrest all day.
The problem of overloading schoolchildren with textbooks and accessories in backpacks stands out. Experts from the American Academy of Orthopedic Surgeons note that the maximum weight of a backpack should not exceed 15-20% of the child's weight.
Treatment of lower back pain
The treatment strategy will depend on what kind of pain is bothering you - short-term acute or chronic. The most commonly used pain management techniques include:
Applying hot or cold compresses
Compresses are used to relieve pain and reduce inflammation. They can be used for all back pain, acute and chronic. Compresses do not treat the root cause, but 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 maintained, avoiding movements that increase pain. Research shows that staying active after lower back pain helps maintain flexibility. Moreover, resting in bed can even worsen the pain and lead to secondary complications. These include depression, decreased muscle tone and blood clots in the legs.
Strength training (in addition to normal physical activity) is not recommended for acute pain. They can be seen as an effective remedy for accelerated recovery from chronic lower back pain.
Maintaining and increasing the strength of the back muscles and abdominal muscles is especially important for people who suffer from musculoskeletal imbalance (scoliosis, hyperlordosis). To correct posture and muscle imbalance, you must consult an orthopedic traumatologist. The doctor will develop a set of exercises that will help correct these disorders.
However, research shows that practicing yoga can also help relieve pain.
A remedy for back pain
Depending on the severity of the condition, doctors prescribe one or more medications:
- Painkillers - to relieve pain.
- Non-steroidal 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 treating lower back pain has never been proven.
- Creams and sprays - for cooling or warming.
Surgery is recommended only if progressive nerve damage or structural changes in the spine are detected.
When should you see a doctor?
Contact a doctor immediately if the pain is severe and:
- Appeared after a fall, injury or blow to the back,
- It gets worse during rest or at night.
- It gets worse when you cough or urinate
- It 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 pulsating sensation in the abdomen
- It is followed by the inability to control the act of urination or defecation.
Don’t wait for your lower back pain to get so severe that you’re ready for anything. It is better to consult an orthopedic traumatologist.