One of the most common complaints when visiting a therapist, when we are not talking about colds, is back pain. Statistically, 80% of people have had lower back pain at least once, and 40% experience such pain periodically or constantly. The lumbar vertebral region, located in the lower back, bears the greatest amount of stress placed on the human spine. Therefore, the lower back is injured more often than other areas, and is also affected by various diseases. In addition, there are a number of internal organs, pathological processes in which can also cause pain.
Pain in the back, lower back
Why does your lower back hurt?
Most often, the pain that occurs in the lower back is associated precisely with the spine and the changes occurring in it. The lumbosacral area is a high-risk area due to the load placed on it. In order to be able to stand on your feet, walk, run, jump, bend, turn your body, lift and carry heavy objects, a person’s lumbar area “works.”
When lifting and carrying heavy objects, the main load falls on the lower back
Therefore, the slightest pathology that occurs when carrying out any of the listed loads to an excessive degree leads to painful sensations.
By the way. Low back pain can result from genetic abnormalities, but this is much less common. Tumors and infections are also not the most common causes of pain.
The pain in this area varies in strength from mild and completely tolerable, passing within a short time, to severe pain that a person cannot tolerate, and medicine is powerless to reduce with medications that last for months. This depends on the nature of the pathology that caused the pain, and on the individual tolerance of pain, called the pain threshold. Also, a direct dependence is observed on the age and physiology of the patient, and the stage (degree) of the disease.
Pain can vary in intensity
Lumbar pain is divided according to its origin into primary and secondary. The first are a direct consequence of spinal diseases. The latter give rise to other diseases and pathologies. There are also a number of provoking factors that contribute to increased pain.
Table. Causes of pain in the lumbar area.
| Causes | Description |
| · Osteochondrosis in the lumbar vertebral area (one third of all patients experiencing back pain suffer from it). · Protrusions in intervertebral disc tissues. · Intervertebral hernial formations. · Radiculitis. · Spondyloarthrosis disease. · Spondylosis, as well as spondylolisthesis. |
| · Fracture caused by osteoporosis. · A tumor growing in the lumen of the spinal canal. · Injury to the spine followed by its fracture. · Long-term tension or static muscles. · Anatomical anomaly due to which the spinal canal is narrowed. · Acquired scoliosis. · Kyphotic deformities. · Scheuermann-Mau disease. · Arthritis – rheumatic and psoriatic, as well as osteoarthritis. · Tuberculous lesions of the vertebral zone. · Osteomyelitis. |
Differential diagnosis
Differential diagnosis is based on the features of the clinical picture of the disease. For example, with ankylosing spondylitis there are no lesions of symmetrical joints and rheumatoid nodules characteristic of rheumatoid arthritis. Rheumatoid arthritis causes joint deformity, but rheumatoid arthritis does not. A duodenal ulcer can be suspected in the presence of dyspeptic symptoms, and pyelonephritis can be suspected in the presence of concomitant urological disorders with systemic manifestations of malaise and fever. Immunopathological diseases are mainly diagnosed by laboratory methods. Dystrophic and degenerative - instrumental.
It is necessary to conduct a comprehensive diagnosis to accurately determine the pathology
“Three pillars” of lumbar pain
Pain itself, as a phenomenon, is a “watchdog mechanism” that protects a person from disease. It is the body’s pain signal about a health hazard that is most understandable to a person. After receiving it, the brain activates its defenses, and the patient, thanks to the timely received signal, goes to the doctor, who identifies the pathology at a stage at which it can be cured. Therefore, pain in the lower back (as well as in other parts of the body) cannot be ignored, but it is necessary to draw the attention of professional doctors to it.
Your doctor can determine the cause of lower back pain.
The causes of pain of spinal etiology are considered to be three main medical problems.
Osteochondrosis is the cause of lumbar pain
More than thirty percent of patients who complain of lumbar pain are caused by dystrophic pathological changes in the spine, united by the medical term “osteochondrosis.” What it is?
Important! Osteochondrosis is a complex change that occurs in the bone and ligamentous vertebral segments and is caused by degenerative lesions of the discs connecting the vertebrae. The meaning of the term also includes the formation of osteophytic growths that disturb the nerves and cause a pain reaction.
What happens to the intervertebral disc when affected by osteochondrosis. Since this is a biconvex lens, which fits with both convexes into the corresponding recesses of the connected vertebrae, any damage to it, in the form of a crack or a growth that appears on it, makes the vertebra more mobile.
The structure of the intervertebral disc
As soon as it moves, the canal lumen narrows, pinching the nerve root running along it.
Osteochondrosis
By the way. Patients with osteochondrosis are subjected to quite severe pain, since, together with irritation of the nerves, rupture of the membranes and intervertebral septa occurs. This releases substances that cause additional irritation to pain receptors.
The cause of osteochondrosis is not unique, but doctors say the main cause is impaired fat-salt metabolism. It can also, in rarer cases, be a congenital anomaly. Contributing factors include drafts, muscle strain, infections and mechanical injuries.
Reasons for the development of osteochondrosis
Intervertebral hernia as a stage of osteochondrosis
When osteochondrosis lesions enter an advanced stage without proper treatment, the disc protrudes and forms an intervertebral hernia. Most often, this process occurs in old age, and at the level of the fourth and fifth lumbar vertebrae, as well as after the fifth, at its connection with the sacral vertebral area. There is an explanation for this - the canal in this segment is the narrowest, but the nerve roots are as massive as in the rest of the canal.
Intervertebral hernia
Important! Intervertebral hernia is very dangerous. It severely pinches the roots, producing severe pain, and at the same time puts pressure on a certain area of the spinal cord. This may result in paralysis or complete disruption of genitourinary function.
Protrusion of the hernia into the spinal canal contributes to compression of the spinal cord, thereby causing numbness or paralysis of the limbs
The visual symptoms of intervertebral hernia are known to many older people:
- when getting up from a sitting position, the patient is forced to lean on something with his hand;
- when lying on your stomach, the pain subsides only when something is placed under your stomach (a rolled up blanket, a pillow);
- if you need to lift something, the patient will not be able to bend over and will have to sit down.
A lumbar disc hernia is accompanied by pain in the lower back, which radiates to the leg or buttock
Radiculitis is a manifestation of osteochondrosis
Osteochondrosis in the form of its manifestation is associated with another popular ailment - lumbar radiculitis. The pain with this diagnosis is of a different nature, it can be either sharp or dull, and can radiate to the buttocks and legs to the level of the shin. Pain increases when the spatial position of the body changes, as well as during coughing, sneezing and any effort that requires straining.
Radiculitis
By the way. Pain from radiculitis may be accompanied by numbness and burning, tingling and itching. Muscles may ache and the skin may become hypersensitive.
Visually, the symptoms are expressed as follows:
- posture “breaks”, the patient begins to stoop;
- gait changes, becomes shuffling;
- the torso moves forward while walking or in the direction where there is less pain;
- the leg to which the pain radiates remains in a half-bent position and does not fully unbend;
- spinal muscles are in constant tension;
- The lower back is practically immobilized.
Lower back pain due to radiculitis
Advice. If you notice these symptoms, you should not diagnose yourself and rush to the conclusion that you have sciatica. Another disease, panniculitis, can have exactly the same symptoms, when the metabolic movements of subcutaneous fats are disrupted and the fatty tissue becomes inflamed. The symptoms of joint damage are also similar.
Panniculitis
It’s impossible to talk about radiculitis without mentioning lumbago, or popularly known as lumbago. It may well be a manifestation of radiculitis. Most often it occurs in physically working patients, or in those who have become hypothermic after being in a draft. Occasionally, lumbago is caused by an infection. The onset of the disease is characterized by severe pain, which occurs suddenly, is difficult to relieve and can last from several days to a couple of weeks.
If you want to find out in more detail what causes nagging pain in the lower back, and also consider the pathologies, you can read an article about this on our portal.
Shot in the lower back
Back pain in the shoulder blade area at night
Many patients have back pain when lying down at night due to poor posture and as a result of serious deformation of the spinal column. It only seems at first glance that the habit of bending your back while sitting or standing is not a serious vice. in fact, in such a position, deformation of all tissues of the spinal column occurs. The pathological process begins with a sprain of the ligamentous apparatus. After the posterior and anterior longitudinal ligaments of the spine are deformed, it becomes increasingly difficult for the patient to straighten his back - his posture is disturbed.
Then deformation of the vertebral bodies and the intervertebral discs separating them begins. Unnatural positions of the vertebrae arise, then the ligaments and fibrous rings of the intervertebral discs become deformed, and incorrect posture appears.
In most cases, if the back hurts in the area of the shoulder blades at night, the patient is diagnosed with the development of scoliosis. This is a curvature of the spinal column with a deviation to the left or right side. Emergency help is required as this disease tends to get worse quickly.
Preventive measures
To minimize the likelihood of lumbar pain, it is necessary to follow preventive measures.
- Do not lift excessive weights, but lift feasible ones correctly.
- Do not make sudden physical movements.
- Do exercises to strengthen the spine and muscles.
Exercises to strengthen the lower back - Refuse the soft sleeping place, replacing it with a more rigid and anatomical one.
- Maintain good posture.
- Go swimming.
- Eat right so that the menu contains vitamins, acids, fats and minerals, and unhealthy foods are consumed in minimal quantities.
How to eat healthy - Do not abuse alcohol and do not smoke.
- Sitting less, especially in uncomfortable positions.
- When working sedentarily, do exercises periodically.
Orthopedic chair
Pigeon sitting on the table
Stretching on a sofa or chair
Bridge
These simple rules will help you avoid seeing a doctor for lumbar pain for as long as possible. And if they do arise, you should not try to cope on your own. Yes, often the pain goes away on its own in a matter of days, but it is also often a sign of a serious illness, the untimely treatment of which can lead to spinal surgery.