According to statistics, almost every second person in middle and old age comes to the doctor with complaints of back pain in the lumbar region. Even 80% of people experience such an unpleasant feeling at least once in their life.
All over the world, pain in the lumbar spine leads to the fact that a person loses mobility, undergoes long-term treatment and is forced to limit his usual activities.
Causes of lower back pain
There are many different reasons and factors that cause back pain, especially often in the lower back. Some diseases are more common, others are quite rare, but it is important to consult a doctor in time to determine the real cause and help relieve 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 localized in the muscles that run along the spine and may be associated with spasms in those muscles. Painful sensations can be moved to the buttocks, and extremely rarely - down the leg.
Herniated disc
A herniated disc is characterized by prolapse of the inner part of the disc towards the spinal canal, which often causes severe, unbearable back pain in the lumbar region. A displaced and damaged disc in the lumbar region during rupture creates a herniation. The reason is that the disc structure degenerates (ages) to such an extent that the cartilage shell literally cracks, crumbles 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)
Intervertebral discs are strong and elastic cartilage shock absorbers between the vertebrae. As a result of the aging process, the intervertebral discs begin to shrink, lose elasticity and flatten. When osteochondrosis is present, pain occurs along the spine, most often in the lower back, which requires treatment.
Not everyone with 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 so long ago, osteoarthritis was believed to be caused by wear and tear on the joints over time. However, scientists now consider it a disease of the joints. Factors such as genetics, weight, injury, sedentary lifestyle, excess stress on the back and other factors are believed to contribute to this process. Spondyloarthrosis is one of the common diseases that causes pain in the lower back.
Spinal stenosis
Spinal stenosis is the narrowing of the spinal canal itself or the reduction of the lumen of the openings where the spinal nerves leave the spinal column. This condition usually develops with age, on the background of pronounced degenerative-dystrophic changes in the structures of the spine 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 split, crack or stress fracture 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 starts to move or slip, causing back pain mainly in the lower back.
Osteoporosis
Today, osteoporosis is a pressing problem for many women over 50 and some men. This is a bone disease that occurs when the body loses too much bone tissue without having time to make new, young bone. Against the background of loss of bone tissue, its thinning and fragility occurs, due to which it loses strength, and the vertebra can break from a fall or an awkward movement, lifting a heavy object. In some cases, back pain can 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 cause back pain. When under stress, the muscles become more toned and spasm occurs, making it difficult to move in 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 have appeared in the bones of the spine,
- psoriasis, especially in arthritis,
- fibromyalgia.
Sometimes it is referred to pain in the lower back, 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 abdominal organs, kidneys and pelvic organs.
Posture problems
Back pain usually 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 the areas that need to be addressed and strengthened in order to alleviate discomfort and prevent pain from returning in the future.
But how do abdominal muscles affect the lower back? It's simple. The torso is a single muscle corset that supports the body, and if the front (abdominal) muscles are weak, guess which ones receive an increased load? It is true that the lumbar muscles in the lower back of the body suffer more than others. Weak abdominal muscles end up creating additional tension around the back, which overloads the psoas muscles, causing pain. Most people living with chronic back pain can reduce it by strengthening their core muscles. Performing a set of exercises every day can improve the condition.
Lower back pain during pregnancy
For the first time, women may experience lower back pain when carrying a baby. This is due to a change in the center of gravity, a change in posture and an increased deflection of the spine in the lumbar region. This condition is not dangerous, but it can later lead to changes in posture, muscle strain and pinched nerves. To avoid back problems or reduce discomfort once spinal pain, mainly in the lower back, has already occurred, treatment includes wearing a supportive cast, comfortable low-heeled shoes, and frequent side-lying rest.
Types of sensations for back pain in the lumbar region
Back pain can be acute if it appears suddenly and does not last more than 2-3 weeks. If the sensations last for months or even years, it is already a chronic pain syndrome. According to the sensations that occur, we can distinguish:
- Strong, burning, sharp and almost unbearable pain. It is typical for hernias, radiculitis, lumbago (lumbago in the back).
- Dull, aching, shooting, or dull pain. It often occurs with injuries, inflammation or muscle strain, or problems with the soft tissues around the spine.
- Chronic pain can be of different nature; when moving or in an uncomfortable position, it usually increases to the point of burning, pain or shooting. When they rest, wear corsets or certain body positions, they weaken.
Diagnosis of lower back pain
In order to determine the cause of the pain, your doctor may prescribe:
- A set of laboratory tests to rule out inflammatory processes and pathologies of internal organs.
- X-ray of the spine (often in two projections: direct and lateral). This helps identify bone abnormalities, vertebral and joint deformities.
- Computer optical topography of the spine for assessment of postural disorders, determination of the degree of spinal deformation and pelvic distortion.
- MRI (magnetic resonance imaging) is the most commonly 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, nerve and muscle function.
Treatment of pain in the lumbar spine
A set of procedures for the treatment of back pain is prescribed by the doctor individually and may include:
- Painkillers, decongestants and anti-inflammatory drugs, muscle relaxants and vitamins (tablets, ointments, injections, droppers);
- physiotherapeutic techniques (intrastitial electrical stimulation, carboxy and ozone therapy, electrophoresis, magnetotherapy, amplipulse therapy);
- kinesio taping,
- massage, manual therapy and osteopathy;
- acupuncture;
- physical therapy and other methods.
In severe cases, in the absence of the effect of conservative therapy, surgical treatment may be indicated. These can be disc replacement operations, hernia removal, vertebral fusion (spinal fusion), vertebroplasty, etc.
Preventing back pain
In order to prevent the occurrence and progression of back pain, it is necessary to monitor your posture, consult a specialist in a timely manner at the first appearance of back pain, regularly undergo preventive procedures as recommended by a doctor, lead an active lifestyle, engage in special physical exercises, and, ifif possible, avoid excessive physical activity and injury.
Which doctor should I contact?
If you have back pain, especially in the lower back, you should see a neurologist for diagnosis and treatment. In some cases, a consultation with a physiotherapist, neurosurgeon or urologist, gynecologist may be required.
FAQ
How to tell if your back or kidneys hurt?
Very often there are situations when the spine imitates kidney diseases and vice versa, when kidney diseases are masked as spine pathology. In order to clarify the cause of the pain, it is necessary to consult a doctor and, if necessary, conduct an additional examination.
What is the best position to sleep in if you have lower back pain?
If you have lower back pain, it is recommended to sleep on a medium-hard mattress in a side position, in the so-called "fetal position".
Can lower back pain occur due to gynecological diseases?
Yes. Some gynecological diseases (inflammatory, neoplasms, etc. ) can cause pronounced 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 pain reduction and only then start with active therapeutic exercises.
Can playing sports cause lower back pain?
Yes, it is possible. Especially when you engage in traumatic sports, not respecting the requirements for safe training, and also without warming up beforehand.