Low back pain: causes and treatment

Back pain in the lumbar area

One of the most common pain syndromes is associated with the lower back. Lower back pain, according to some experts, is a kind of retaliation for humanity for walking upright when the greatest burden falls on the lumbar spine, which bears the brunt of the bulk of the human body. A lack of exercise, an unhealthy diet, obesity and stress also have negative effects. Back pain (lumbodynia) is so widespread for many that it is part of everyday life. It can appear only once and go away without a trace, or it can keep coming back and cause considerable suffering.

Many of us have worried about lower back pain at least once. Statistics say this type of pain occurs in 90% of the population. The lower back can be painful in diseases of the gastrointestinal tract, kidneys, genitals and can accompany menstruation in women. But most often such pain is caused by osteochondrosis - degenerative-dystrophic changes in the spine. And among all the numerous pain syndromes of osteochondrosis, back pain occupies a leading position.

Lower back pain can be of different types - pain that occurs after long static exposure while sitting or sleeping, or sharp shooting that occurs with sudden movements or being trapped in an uncomfortable position, as well as cramps, swelling and irritation of the muscles and nerve rootsLigaments of the lumbar spine that occur in osteochondrosis.

Causes of Back Pain

The lumbar spine is subjected to maximum stress and the intervertebral discs (pads between the vertebrae) wear out much faster here. There are many causes of lower back osteochondrosis, but two main causes are: heavy, sustained static load and a heavy maximum load that usually occurs when bending over with heavy lifting. Here are some numbers. According to biomechanics, the intervertebral discs experience a pressure of 50 kg in the supine position, 100 kg when standing, when sitting with a straight back without support - 150 and when sitting bent forward - 220.

Now calculate how much you sit in a day. . . And how much of that time stooped, with a rounded back. . .

Other figures: if the body is inclined forward only 20 ° without a load in 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 anglefrom 70 ° the load increases to 300 kg. For example, if a person in the forward leaning position lifts a weight of 50 kg, the load on the spine is 700 kg according to biomechanical data. Now answer the question: Do you lift heavy things? And from the ground? And with tilting and turning?

Back pain can be divided into primary and secondary pain. As you know, the spine is made up of a series of vertebrae linked together by elastic tissues - muscles and ligaments. They contain (in addition to bone tissue) nerve endings and can lead to 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.

Secondary pain syndrome in the lower back is associated with traumatic injuries to the spine, tumor and infectious processes, diseases of the internal organs, osteoporosis and other pathologies. This is a kind of alarm signal about malfunctions in 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 large vessels, kidneys, chronic prostatitis, some diseases of the nervous system).

There are the 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, arthrosis, osteoporosis. The height of the intervertebral discs decreases, which leads to disturbances of the mechanical equilibrium between the structures of the spine - hence the constant, tolerable, but periodically increasing pain in the lower back.

Muscle cramp.Have you had acute back pain from intense and excessive physical activity that is unusual for you? Persistent static poor posture of the body (at the computer, squatting, halving when doing summer housework) is predisposing. As a result, a muscle spasm develops, which restricts the mobility of a certain part of the spine. Tense muscles become a source of suffering and trigger a vicious cycle of lower back pain - muscle cramps - pain. This condition can last for a long time and cause many uncomfortable minutes. Attention! For persistent low back pain, especially if it starts quickly and acutely, consult a doctor to identify the underlying conditions and develop modern and correct treatment.

disc prolapse, which compresses the roots of the spinal cord, is particularly common in men over 40 years of age. The first symptom of the discomfort is lumbodynia combined with a number of other signs: pain along the root from the buttocks to the foot when coughing, sneezing and laughing, difficulty bending and stretching the spine in the lumbar region (this occurs especially when tighteningSocks and shoes), increased uncomfortable sensations when lifting a stretched leg lying on your back. This back pain is often referred to as the outdated term sciatica or the slang term lumbago. The pain increases in an upright position and subsides in a horizontal position.

Spinal instabilityIs a typical problem for middle-aged women. 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 intervertebral disc or intervertebral joint and often occurs against a background of moderate obesity. It is difficult for such patients not to bend but to straighten up, to make "additional" 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 even lying down or sitting it always hurts so much that it is impossible to sit on the "sore" buttocks. The syndrome of a narrow spinal canal is a consequence of degenerative changes, a proliferation of bone and joint structures of the spine, which leads to an injury to the roots of the spinal nerves.

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

  • Obesity
  • You love summer housework
  • Spend a lot of time driving a car or computer
  • Lead a predominantly sedentary (office worker) or upright lifestyle (vendors, waiters, street signs, surgeons)
  • Overload yourself in the gym or health club. Be extremely careful if you have recently started exercising.
  • Do dynamic physical work with a sharp change in posture (especially if your specialty involves vigorous physical activity)

Additional risk for women:

  • You are pregnant or have recently given birth
  • Have reached post menopause, which is beneficial for the development of osteoporosis

What to do with back pain:

And now, based on the reasons above, the same advice we promised for those who want to relieve chronic lumbar discomfort and prevent lower back pain from occurring.

  1. Spend less time sitting. And if you have to, sit in the right position.
  2. If you are sitting for long periods of time, take a break every hour to perform multiple movements (stretching, bending over, simply walking, etc. ).
  3. Do not lift heavy objects. If you need to lift them, follow the rules for lifting heavy objects.
  4. Tense your abdominal muscles as if you were closing tight pants. The abdominal muscles support the lumbar spine and the strain on the abdomen slightly relieves the pressure on the lower back.
  5. Exercise regularly for the spine and strengthen the muscle corset. Strong muscles will help you relieve excessive lower back stress in any position. Having a flexible spine helps prevent blood vessels and nerve endings from being squeezed together.
  6. Find a comfortable orthopedic mattress.

For back pain, too, your doctor will usually recommend:

  • A specialist may prescribe muscle relaxants to relieve muscle spasms, as well as diuretics and vascular medications to reduce swelling of the nerve roots and improve blood flow to the affected area.
  • Relax for 2-5 days. As a rule, we speak of bed rest on a hard, level surface.
  • Take pain relievers and anti-inflammatory drugs - nonsteroidal anti-inflammatory drugs. They are available in tablets, solutions for injection, and ointments.
  • Wear a special bandage if necessary.
  • Do physical therapy to consolidate the positive effects as your well-being improves. Physiotherapeutic procedures (magnetotherapy, electrophoresis, phonophoresis) as well as massage and physiotherapy exercises release muscle tension, improve blood circulation and stop the inflammatory process
  • For local therapy with ointments and gels with analgesic, anti-inflammatory or warming components.

Recently, double-acting agents have become available to doctors - analgesics and muscle relaxants (muscle relaxants), which are very important in the treatment of pain syndrome in the pathology of the musculoskeletal system and muscle spasms. These are drugs that have a triple effect - analgesic, muscle relaxing and neuroprotective (protecting nerve cells from damage). In fact, we are talking about a fundamentally new approach to the treatment of back pain.

Whatever the cause of back pain, it is impossible to determine for yourself with certainty. If the back does not rest day or night, then it is better to consult a specialist in time, who will tell you the tactics of treatment. All of these tips will help you prevent and reduce lumbar spine discomfort. However, if you have acute lower back and sacrum pain, do not postpone seeing the doctor. Give the final diagnosis to a specialist! Low back pain has a variety of causes that are not necessarily related to spinal pathology. For back pain and lumbago, it is recommended to undergo computed tomography (shows the condition of the bone tissue of the spine) and magnetic resonance imaging (allows the condition of the soft tissues to be assessed). Usually the majority of patients recover within 2-3 months, only a few patients with complaints of lumbodynia show serious illnesses.