About 80% of adults have experienced low back pain at least once in their lives. It affects both men and women equally.
The pain manifests itself in a variety of ways: from dull and constant, to sudden, but very acute, temporary inability to work.
Sudden pain in the lower back that occurs after an injury or lifting a heavy object. If we consider chronic pain, then it often manifests itself due to age-related changes in the spine.
In this article, we will look at the top causes of low back pain.
What is the back made of?
The lumbar spine contains 5 vertebrae (L1-L5) that are responsible for supporting most of the upper body weight. The space between the vertebrae is filled by round elastic pads - discs. They act as shock absorbers, absorbing loads and softening their impact on the spine.
Ligaments hold the vertebrae in place and tendons attach muscles to them. Inside 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 has a mechanical origin. Next, we will look at the most common reasons for it:
- Sprain or tear of ligaments, tendons and musclesis the most common cause of acute low back pain. They appear after twisting the spine, lifting objects improperly, lifting very heavy objects, or overstretching ligaments, tendons, and muscles. All of this also causes painful spasms in the muscles in the back.
- Degeneration (wear) of discsIt is one 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 the load.
- Protrusion or herniated disc.This happens after the discs are strongly compressed, bulged out (bulging) or ruptured (herniated).
- Radical patient.This is a condition caused by compression, inflammation, and/or injury to the spinal nerve roots. Pressure on the nerve can cause lower back pain and a feeling of numbness or tingling. These symptoms spread to parts of the body that are covered by nerves that emerge from the root. In addition, the disease appears due to nerve root compression with spinal stenosis, protrusion or rupture of the disc.
- Sciatica body pain- one of the forms of diffuse myopathy, which develops due to compression of the sciatic nerve. It is a large nerve that runs through the buttocks and down the back of the leg to the heel. The compression of the sciatic nerve causes shooting or burning pain in the lower back, combined with pain in the buttocks and one leg. In the most severe cases, when the nerve is sandwiched between the disc and the bone next to it, not only does it cause pain, but it also causes 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 is pinched by a cyst or tumor that forms.
- Cervical spondylosisThis is a condition in which the vertebrae "fall" out of place and clamp the nerves that go out of the spine.
- hurtfor example due to sports activities, a car accident or a fall. Trauma is the source of sprains or tears of ligaments, muscles, and tendons. They also lead to excessive compression of the spine, which in turn causes protrusion or herniated discs.
- Spinal stenosisThis is a condition in which the blood vessels are narrowed, putting increased 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 condition in which the spine curves to one side, usually without pain until middle age. Another common disorder is hyperlordosis, in which the spine becomes excessively misaligned in the lower back.
Who is most at risk for back pain?
Several factors increase your chances of experiencing this problem. Among them:
- Grow old- the first time the pain strikes at the age of 30-50 years old. Due to osteoporosis, bone strength is gradually lost with age, leading to fractures, as well as decreased elasticity and muscle tone. The discs begin to lose fluid and flexibility, thereby reducing their ability to absorb stress. The risk of developing spinal stenosis also increases with age.
- Low level of physical activityWeak muscles in the abdomen and back may not properly support the spine. A sedentary lifestyle and lack of muscle-strengthening exercises are to blame for this. Particularly affected are those who spend a whole week not moving, and on weekends they try to catch up and over-exercise. People who exercise moderately but most days of the week experience much less low back pain. Research shows that low-intensity aerobic exercise is beneficial for maintaining the integrity of the discs.
- Pregnancy- very often, back pain appears in expectant mothers. It's all about the cause - structural changes in the pelvic region and redistribution of weight. The good news is that after giving birth, almost everyone is pain free.
- Weight gainBeing overweight, obese, or just gaining a lot of kilos puts stress on your back and leads to lower back pain.
- Genetic predisposition.One type of arthritis, ankylosing spondylitis, is often genetic. When suffering from this disease, the joints of the vertebrae grow crowded together causing pain, as well as reducing the mobility of the spine.
- The specifics of the job.If your job involves lifting, pushing, or pulling weights, you run the risk of injury or pain in your lower back. Especially dangerous is the movement of weights, in which the spine is twisted or vibrated. Working inactive also increases the risk of pain. Particularly affected are people who do not follow their posture or sit in chairs with inappropriate backrests all day.
The problem of students overloading with textbooks and the accessories they carry in their backpacks is standing out. Experts from the American Academy of Orthopedic Surgeons note that the maximum weight of a backpack should not be more than 15-20% of the child's weight.
Low back pain treatment
The treatment strategy will depend on the type of pain that is bothering you - acute or short-term chronic. The most commonly used pain management techniques include:
Apply warm or cold compress
Compression is used to relieve pain and reduce inflammation. They can be used for any back pain, both acute and chronic. Compression medications do not treat the underlying cause but help relieve pain and improve joint mobility.
Stay physically active
Bed rest should be kept to a minimum. Should stretch and maintain normal movement activities, avoid movements that increase pain. Research shows that staying active after the onset of low back pain helps maintain flexibility. Furthermore, bed rest can even worsen pain and lead to secondary complications. These include depression, decreased muscle tone, and blood clots in the legs.
Strength training (apart from normal physical activity) is not recommended for acute pain. They can be considered as an effective remedy for a quick recovery from chronic low back pain.
Maintaining and strengthening the back and abdominal muscles is especially important for people with musculoskeletal imbalances (scoliosis, hypertrophy). To correct posture and muscle imbalances, you must contact an orthopedic surgeon. Your doctor will develop a set of exercises to help correct these disorders.
By the way, research shows that practicing yoga can also help with pain.
Back pain medicine
Depending on the severity of your condition, your doctor may prescribe one or more medications:
- Analgesics - to relieve pain.
- Non-steroidal anti-inflammatory drugs (NSAIDs) - to reduce pain and inflammation.
- Anticonvulsants prescribed to treat seizures can be helpful for people who have them.
- Tricyclic antidepressants and serotonin and norepinephrine reuptake inhibitors are prescribed for chronic pain. Although their effectiveness in treating low back pain has never been proven.
- Creams and sprays - for cooling or warming.
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 right away if the pain is severe and:
- Occurs after a fall, injury or blow to the back,
- It gets worse at rest or at night.
- Gets worse when coughing or urinating
- Spread in one or both legs,
- Accompanied by weakness, numbness, or tingling in one or both legs
- Accompanied by fever or unexplained weight loss
- Accompanied by pain or throbbing sensation in the abdomen
- It is accompanied by an inability to control the behavior of urination or defecation.
Don't wait until your low back pain gets worse before you're ready to do anything. It is better to consult an orthopedic surgeon.