About 80% of adults have experienced low back pain at least once in their life. It affects both men and women equally.
The pain manifests itself in different ways: from dull and constant, to sudden, but very acute, which temporarily incapacitates.
Sudden pain in the lower back 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'll look at the top causes of low back pain.
What is the lower back made of?
The lumbar spine contains 5 vertebrae (L1-L5) that support most of the upper body weight. The space between the vertebrae is filled with round elastic pads - intervertebral 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 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 the lower back hurt?
In most cases, the pain is of a mechanical origin. Next, we will consider the most common reasons for it:
- Sprains or tears of ligaments, tendons, and musclesis the most common cause of acute low back pain. They appear after twisting the spine, lifting objects improperly, lifting something very heavy or excessive tension on the ligaments, tendons and muscles. All this also provokes painful spasms in the muscles of the back.
- Degeneration (wear) of intervertebral discsIs another of the most common causes of low back pain. It occurs when elastic discs lose their integrity as the body ages. In healthy people, the intervertebral discs allow the trunk to bend and twist normally. As the discs fail, they lose their ability to absorb loads.
- Disc protrusion or hernia.This happens after the intervertebral discs are strongly compressed, bulge outward (protrusion), or rupture (hernia).
- Radiculopathy.It is a condition caused by compression, inflammation, and / or trauma to the spinal nerve root. Pressure on the nerve can cause lower back pain and numbness or tingling sensations. These symptoms spread to those parts of the body that are innervated by the nerve that emerges from the root. Also, radiculopathy occurs due to compression of the nerve root with stenosis of the spinal canal, 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 runs 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 clamped between the disc and the adjacent bone, not only pain is disturbing, but also 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 due to a cyst or tumor formed.
- Degenerative spondylolisthesis- This is a condition in which the vertebrae "fall" out of their place and clamp the nerves coming 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 protrusion 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, pain or numbness occurs when walking. Over time, stenosis leads to weakness and numbness 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 deflection of the spine in the lower back.
Who is most at risk of having back pain?
Several factors increase the chances of encountering this problem. Among them:
- Age- the first time the pain attacks 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. The intervertebral discs begin to lose fluid and flexibility, which in turn impairs 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 properly support the spine. A sedentary lifestyle and a lack of muscle-strengthening workouts are to blame for this. Particularly affected are people who spend a whole week without moving, and on weekends they try to catch up and train too hard. People who exercise with moderate intensity, but most of the days of the week, experience lower back pain much less often. Research shows that low-intensity aerobic exercise is beneficial for maintaining the integrity of the intervertebral discs.
- Pregnancy- very often, back pain appears in expectant mothers. It's all to blame - structural changes in the pelvic area and the redistribution of weight. One good thing is that after childbirth, the pain goes away for almost everyone.
- Weight gain- the presence of excess weight, obesity, or just a sharp increase in kilograms puts stress on the back and leads to lower back pain.
- Hereditary predisposition.One type of arthritis, ankylosing spondylitis, is often inherited. In this disease, the joints of the vertebrae grow together, which causes pain, as well as a decrease in mobility in the spine.
- The specifics of work.If your work involves lifting, pushing, or pulling weights, you run the risk of injury or pain in the lower back. Particularly dangerous is the movement of weights, in which the spine twists or vibrates. Inactive work also increases the risk of experiencing pain. Particularly affected are those who do not follow their posture or sit on a chair with an unsuitable backrest all day.
The problem of overloading schoolchildren with textbooks and accessories that they carry in their backpacks stands apart. Experts from the American Academy of Orthopedic Surgeons note that the maximum backpack weight should be no more than 15-20% of the child's weight.
Low back pain treatment
The treatment strategy will depend on what kind of pain is bothering - short-term acute or chronic. The most commonly used pain management techniques include:
Applying warm or cold compresses
Compresses are used to relieve pain and reduce inflammation. They can be used for any back pain, acute or chronic. Compresses do not treat the underlying cause; they only help ease pain and improve joint mobility.
Maintaining physical activity
Bed rest should be kept to a minimum. Stretching should be done and normal motor activity should be maintained, avoiding movements that increase pain. Research shows that staying active after the onset of low back pain helps maintain flexibility. What's more, 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 (in addition to the usual physical activity) is not recommended for acute pain. They can be seen as an effective remedy for accelerated recovery from chronic low back pain.
Maintaining and increasing the strength of the back and abdominal muscles is especially important for people who suffer from musculoskeletal imbalances (scoliosis, hyperlordosis). To correct posture and muscle imbalance, you must contact an orthopedic traumatologist. The doctor will develop a set of exercises that will help correct these disorders.
By the way, research shows that doing yoga can also help relieve pain.
Medication for back pain
Depending on the severity of the condition, doctors prescribe one or more drugs:
- Pain relievers - to relieve pain.
- Non-steroidal anti-inflammatory drugs (NSAIDs) - to relieve pain and inflammation.
- Anticonvulsants that are 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 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 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.
- Gets worse when coughing or urinating
- Spreads in one or both legs,
- Is accompanied by weakness, numbness, or tingling in one or both legs
- Is accompanied by a fever or unexplained weight loss
- Is accompanied by pain or a throbbing sensation in the abdomen
- It is accompanied by an inability to control the act of urination or defecation.
Don't wait until your lower back pain gets so bad that you're ready to do anything. It is better to consult an orthopedic traumatologist.