Low back pain: causes and treatment.

back pain in the lumbar region

One of the most common pain syndromes is associated with the lower back. According to some experts, pain in the lower back is a kind of retribution for humanity for walking upright, when the greatest load falls on the lumbar spine, which bears the main burden of the mass of the human body. Physical inactivity, unhealthy diet, obesity, and stress also have a detrimental effect. For many, back pain (lumbodynia) is so common that it becomes a part of everyday life. It can arise only once and disappear without a trace, or it can return again and again, causing considerable suffering.

Many of us at least once, but worried about lower back pain. Statistics say that this type of pain occurs in 90% of the population. The lower back can hurt with diseases of the gastrointestinal tract, kidneys, genitals, accompany menstruation in women. But most of the time, these pains are caused by osteochondrosis, degenerative-dystrophic changes in the spine. And among all the many painful syndromes of osteochondrosis, back pain ranks high.

Low back pain can be of a different nature: pain, which arises after a prolonged static load while sitting or during sleep, or a sharp pull, which occurs with a sudden movement or is caught in an awkward position. All of them are associated with pinching of the nerve roots, as well as spasms, swelling and irritation of the muscles and ligaments of the lumbar spine, which occur with osteochondrosis.

Causes of back pain

The lumbosacral spine is under maximum stress and the intervertebral discs (pads between the vertebrae) wear out much faster here. There are many causes of osteochondrosis in the lower back, but two of the main ones are: heavy and prolonged static load and a sudden maximum load, which usually occurs when bending over to lift heavy objects. Below are some numbers. According to biomechanics, in the supine position, the intervertebral discs experience a pressure of 50 kg, in the standing position - 100, in the sitting position with a straight back without support - 150 and sitting hunched over - 220.

Now calculate how much you sit in a day. . . And how much of this time hunched over, with a round back. . .

More figures: when the body leans forward only 20 ° without a load on the hands - 150, and with a load of only 10 kilograms (a couple of bags with food) - 200 kg, and if it leans even lower, at an angle of 70 °, the load will increase to 300 kg. For example, according to biomechanical data, when a person lifts a weight of 50 kg in the forward lean position, the load on the spine is 700 kg. Now answer yourself the question: do you lift heavy things? And from the ground? And with a tilt and a turn?

Back pain can be divided into primary and secondary pain. As you know, the spinal column is a series of vertebrae interconnected by elastic tissues - muscles and ligaments. These (in addition to bone tissue) contain nerve endings and can become a source of back pain.

The causes of primary back pain are due to the pathology of the spine: dystrophic and functional changes in the joints of the vertebrae, intervertebral discs, muscles, tendons, ligaments.

The secondary pain syndrome in the lower back is associated with traumatic injuries of the spine, tumor and infectious processes, diseases of the internal organs, osteoporosis and other pathologies. This is a kind of alarm signal about a malfunction of the body. Particularly common causes of persistent low back pain are benign and malignant diseases of the pelvic organs (endometriosis, uterine fibroids, dysmenorrhea, lesions of the great vessels, kidneys, chronic prostatitis, some diseases of the nervous system).

There are 5 most common causes of back pain:

Osteochondrosis (dorsopathy)- The most common source of pain in the lower back. The examination reveals degenerative diseases of the spine: osteoarthritis, osteoarthritis, osteoporosis. The height of the intervertebral discs decreases, which leads to disturbances in the mechanical balance between the structures of the spine, hence the constant pain, quite tolerable, but periodically increasing in the lower back.

Muscle spasmDid you experience acute low back pain while engaging in strenuous and excessive physical activity that is unusual for you? The predisposing factor is a prolonged static incorrect position of the body (at the computer, squatting, bent in half during work in the summer cottage). As a result, a muscle spasm develops that limits the mobility of a certain part of the spine. Tight muscles become a source of suffering, triggering a vicious cycle of low back pain - muscle spasm - pain. This condition can persist for a long time and lead to many unpleasant minutes. Attention! For persistent low back pain, especially if it starts quickly and acutely, see a doctor to identify the underlying conditions and develop a modern and correct treatment.

Disc herniation, which compresses the roots of the spinal cord, is especially common in men over 40 years of age. The first symptom of the problem is lumbodynia in combination with a number of additional signs: pain along the root from the buttock to the foot when coughing, sneezing and laughing, difficulties bending and extending the spine in the lumbar region (this is especially evident when putting on socks and shoes), increased unpleasant sensations when lifting a straight leg lying on its back. This back pain is often referred to as the outdated term sciatica or the colloquial word lumbago. The pain intensifies in an upright position and subsides in a horizontal position.

Spinal instabilityIt is a typical problem for middle-aged women. It is manifested by back pain, aggravated by prolonged physical activity and standing. At the same time, there is a feeling of fatigue and a desire to lie down. The disease is caused by damage to the disc or the intervertebral joint and often presents in a setting of moderate obesity. It is difficult for these patients not to bend, but to straighten up, to make "extra" movements.

Narrow spinal canal.The most common symptom is pain at rest combined with pain when walking. It spreads along the root from the buttocks to the feet, while it always hurts, even lying down or sitting, to the point that it is impossible to sit on the "sore" buttock. The syndrome of a narrow spinal canal is a consequence of degenerative changes, proliferation of bone and joint structures of the spine, which leads to infringement of the roots of the spinal nerves.

Also, you have a real chance of experiencing back pain on your own skin if:

  • Over weight
  • Do you like work in the summer cabin?
  • Spending a lot of time driving a car or computer.
  • Lead a predominantly sedentary lifestyle (office workers) or standing (salespeople, waiters, street markers, surgeons)
  • Overload at the gym or at the gym. Be very careful if you have recently started exercising.
  • Perform dynamic physical work with a sharp change in body position (especially if your specialty is associated with vigorous physical activity)

Additional risk for women:

  • You are pregnant or have recently given birth.
  • Having reached postmenopause, conducive to the development of osteoporosis.

What to do for back pain:

And now, based on the above reasons, the same advice promised to those who want to reduce chronic low back pain, as well as prevent the onset of low back pain.

  1. Spend less time sitting. And if you still have to, sit in the right position.
  2. If you are sitting for long periods of time, be sure to take breaks every hour to perform various movements (extensions, curves, simple walk, etc. ).
  3. Do not lift heavy objects. If you have to lift them, use the rules for lifting heavy objects.
  4. Tighten your abdominal muscles as if you were zipping up tight pants. The abdominal muscles support the lumbar spine and by tightening the abdomen, it slightly relieves the load on the lower back.
  5. Exercise regularly for the spine and strengthen the muscle corset. Strong muscles will help relieve excess tension in your lower back in any position. A flexible spine will help prevent compression of blood vessels and nerve endings.
  6. Find yourself a comfortable orthopedic mattress.

Also, for back pain, your doctor will generally recommend:

  • A specialist may prescribe muscle relaxants to relieve muscle spasms, as well as diuretics and vascular medications to reduce inflammation of the nerve roots and improve blood circulation to the affected area.
  • Relax for 2-5 days. As a general rule, we are talking about bed rest on a flat, hard surface.
  • Take pain relievers and anti-inflammatory drugs, non-steroidal anti-inflammatory drugs. They are available in tablets, injectable solutions, and ointments.
  • Use a special bandage if necessary.
  • Take a physiotherapy course to consolidate the positive effect when your well-being improves. Physiotherapy procedures (magnetotherapy, electrophoresis, phonophoresis), as well as massage and physiotherapy exercises relieve muscle tension, improve blood circulation and stop the inflammatory process.
  • Resort to local therapy with ointments and gels containing analgesic, anti-inflammatory or warming components.

Recently, doctors have at their disposal dual-action agents - analgesics and muscle relaxants (relaxing muscles), which is very important in the treatment of pain syndrome in the pathology of the musculoskeletal system and muscle spasm. These are drugs that have a triple effect: analgesic, muscle relaxant and neuroprotective (they protect nerve cells from damage). In fact, we are talking about a fundamentally new approach to treating back pain.

Whatever the cause of low back pain, it is impossible to determine yourself with certainty. If the back does not give rest either day or night, it is better to consult a specialist in a timely manner, who will indicate the treatment tactics. All these tips will help you prevent and reduce discomfort in the lumbar spine. But if you have acute pain in your lower back and sacrum, do not put off visiting the doctor. Give the final diagnosis to a specialist! Low back pain has a variety of causes, not necessarily associated with a pathology of the spine. In case of back pain and lumbago, it is recommended to undergo a CT scan (shows the state of the bone tissues of the spine) and an MRI scan (allows you to assess the state of the soft tissues). As a general rule, most patients recover within 2-3 months, only a small number of patients with lumbodynia complaints reveal serious illnesses.