Recurrent back pain in the lower back can be associated with excessive stress on muscles, ligaments and tendons. But in most cases, the appearance of this clinical symptom signals that there are serious pathological changes in the tissues of the spine and in other parts of the musculoskeletal system.
The article describes why it hurts the back in the lower back, which doctor should be consulted for a complete differential diagnosis, what to do at home.
In order to understand the potential causes of the development of this clinical syndrome, it is important to have an idea of how that part of the body, usually called the back, is organized and works. The loin refers conditionally to the lower back. So, the back in our understanding is the back of the chest, lower back and sacrum. Two shoulder bones are adjacent to the chest which, with the help of acromial processes, participate in the formation of the shoulder joints.
As you can see, there are three sections of the spine and each has its own anatomical features:
- the thoracic region protects the costal arches using the costal-vertebral joints, their vertebral bodies have additional processes;
- the lumbar region consists of five massive vertebral bodies, which support the maximum amortization load during various movements of the human body;
- sacrum - five vertebrae fused into a single bone, are responsible for fixing the lower extremities through the formation of the ilio-sacral joints.
The intervertebral discs are located between the vertebral bodies. They are absent only between the sacral vertebrae. Within the spine is the spinal cord, surrounded by hard membranes. It is also subdivided into thoracic, lumbar and sacral segments. Each of them is responsible for the innervation of a certain part of the human body. For the innervation of the structures of the spinal cord, the pairs of root nerves break through the lateral foraminal openings in the vertebral bodies. Branching out, the root nerves form the nervous plexuses. Large nerves start from them, for example, sciatic, femoral, inguinal lumbosacral plexus.
The mobility and flexibility of the human body are provided by the muscular structure. The paravertebral muscles also provide diffuse nutrition to the cartilaginous tissues of the intervertebral discs. Intervertebral discs do not have their own circulatory system. If the paravertebral muscles are interrupted, the entire load falls on the end plates that separate the fibrous ring from the vertebral body.
The stability of the position of the vertebral bodies is provided by a complex mechanism. Includes:
- intervertebral joints - provide a certain mobility and stability of the position of the vertebral bodies in relation to each other;
- longitudinal (long) and transverse (short) ligaments of the spine;
- intervertebral discs - guarantee the uniformity of the height of the spaces between the vertebral bodies, compensate for the shock absorption load and protect the root nerves from compression.
In addition, the most important structural parts of the back and lower back are the blood and lymph vessels. They provide tissue nutrition and the removal of toxins, cellular waste.
By understanding the structure and physiology of this part of the musculoskeletal system of the human body, you can proceed to the possible causes of pain. Meanwhile, important practical advice. If you have back pain in your lower back, we recommend that you seek medical attention immediately. It is best to treat pathologies of the musculoskeletal system (spine and joints) and the autonomic nervous system (spinal cord, root nerve and its branches) in manual therapy clinics.
The reasons why the back hurts in the lower back
There are several reasons why the back hurts in the lower back, it can be physiological factors and pathological changes in the tissues. First, you should always exclude the possibility of traumatic exposure:
- hematomas of the soft tissues of the back after strokes or falls;
- stretching of the ligamentous and tendinous apparatus of the spine (can occur with awkward movements, falls, lifting unusual weights and so on);
- fissures in the spinous processes and fractures of the vertebral bodies (young people with an active lifestyle and elderly people with osteoporosis are at risk);
- spinal cord injury and development of hematoma in hard membranes (this can cause compression and cause a series of concomitant neurological manifestations).
In addition, as a result of trauma, displacement of the vertebral body, rupture of the intervertebral disc, displacement or subluxation of the joint between the individual vertebrae can be observed. To eliminate the likelihood of developing such negative consequences after an injury, it is necessary to consult a traumatologist as soon as possible. He will do an X-ray and make an accurate diagnosis.
The second common group of causes of back pain in the lower back are degenerative dystrophic changes in the cartilaginous tissues of the musculoskeletal system:
- osteochondrosis - a violation of the diffuse nutrition of the cartilaginous tissue of the intervertebral discs leads to the fact that the fibrous ring dehydrates, the nucleus pulposus begins to lose its ability to amortize;
- protrusion of the intervertebral disc - decrease in its height and increase in the occupied area, compression pressure occurs in the soft tissues and nerve branches that surround the spine;
- intervertebral hernia - rupture of the fibrous ring of the intervertebral disc and exit of a part of the nucleus pulposus outward;
- destruction of the cartilaginous synovial layer within the intervertebral joints - deforming spondyloarthrosis;
- deformity of the ilio-sacral joints;
- coxarthrosis - deforming osteoarthritis of the hip joints.
Sometimes, the reasons for back pain in the lower back are damage to spinal cord tissues, root nerves, plexuses and large nerves (sciatic, femoral, inguinal). Do not exclude the possibility of developing tunnel syndromes, plexitis, radiculitis and so on. Lumbago (pain in the lower back) can be diagnosed in most cases only during a special examination.
Necessarily includes a radiograph of the spine, the ilio-sacral joints. To detect degenerative dystrophic diseases of the spine and joints, an MRI scan is required.
If you experience back pain in your lower back, it is advisable to consult a vertebrologist or neurologist. If there was an injury the day before, visit a traumatologist. The local therapist often does not have enough professional competence to make an accurate diagnosis and prescribe effective treatment.
Severe pain in the lower back - what to do?
The first thing to do if you have back pain in your lower back is to stop exercising on it. The cause of the pain may be damage to the muscle, ligament or tendon system. Fibromyalgia syndrome often occurs in young people who lead an active lifestyle. This is a pathology associated with the process of impairing the transmission of nerve impulses to myocytes. As a result, some cells are given an impulse to contract or relax prematurely, others - with a delay. Chaotic muscle contraction occurs. This causes a very severe pain syndrome.
Secondly, pain can be caused by overexertion of the back muscles with a compensatory purpose in the context of protrusion of the intervertebral disc. In that case, it is extremely dangerous to stop the muscle fiber spasm. There are cases where, after taking muscle relaxants, a patient with disc protrusion developed a large intervertebral hernia.
Severe back pain in the lower back can be a clinical symptom of the development of sciatica or lumbago. Therefore, it is not worth diagnosing and treating independently. It is necessary to have peace, to try to relax tense muscles without the use of medication. Consult a neurologist or vertebrologist as soon as possible. During the initial examination, these specialists will be able to diagnose and provide the assistance needed to eliminate the severe pain syndrome.
Never take painkillers before visiting your doctor. This will make it difficult to make an accurate diagnosis. It is also not recommended to use external painkillers (ointments, plasters, compresses). In the first 3 days after an exacerbation of osteochondrosis, any heating is contraindicated, including a visit to the bath and sauna.
Treatment of lower back pain
It is necessary to start treatment if there is back pain in the lower back after the differential diagnosis. The fact is that pain syndrome is not an independent disease. It is impossible to treat pain effectively and safely without a therapeutic effect on the underlying condition. Pain always indicates changes in the tissues. Therefore, it is important to detect these pathological changes and, if possible, eliminate them. Only this way of getting rid of pain syndrome is considered to be effective and safe.
For example, back pain in the lower back is caused by a decrease in the height of the intervertebral disc (protrusion) in the context of long-term osteochondrosis. During a manual examination, an experienced vertebrologist, in this case, will find excessive tension in the muscle fiber, a decrease in the height of the intervertebral space.
To provide first aid in such a situation, you can use the manual spinal traction procedure. After 2-3 sessions, the patient feels pain relief and regains his natural mobility. But you cannot stop at this stage. If you do not undergo rehabilitation treatment, after a few months the pain may return.
It is advisable to perform additional back pain treatment in the lower back using the following exposure methods:
- massage
- to increase the elasticity and permeability of all soft tissues in the back and lower back;
- osteopathy - to accelerate the microcirculation processes of blood and lymphatic fluid, it provides a complete trophism of all tissues and initiates regeneration;
- reflexotherapy - the impact on biologically active points of the human body stimulates the process of restoring damaged tissues, activating the hidden reserves of the human body;
- physiotherapy - to improve metabolic processes at the cellular level, accelerate recovery;
- therapeutic gymnastics and kinesiotherapy to increase muscle tone and initiate the disturbed process of diffuse nutrition of the cartilaginous tissues of the intervertebral discs;
- laser action to restore and activate cell regeneration processes.
Please note that the treatment course is always strictly individual, taking into account all the characteristics of the patient's health status. It also includes your doctor's recommendations for lifestyle changes. For example, if you do not change your mode of physical activity and continue to lead a sedentary lifestyle, then no, even the most effective treatment will help restore your spine.
If you have back pain in your lower back, before treating, go to a manual therapy clinic and go there for advice from a vertebrologist or neurologist.