Recurrent back pain in the lumbar region can be associated with excessive stress on muscles, ligaments and tendons. But in most cases, the appearance of this clinical symptom indicates that there are serious pathological changes in the tissues of the spine and other parts of the musculoskeletal system.
The article describes why the back hurts in the lumbar region, which doctor should be contacted for a full differential diagnosis, what to do at home.
To understand the potential causes for the development of this clinical syndrome, it is important to have an idea of how this part of the body, which is commonly referred to as the back, is organized and functions. The loin classically refers to the lower back. So, the back in our understanding is the back of the chest, the lower back, and the sacrum. Two bones of the scapula adjoin the chest, which with the help of acromial processes take part in the formation of the shoulder joints.
As you can see there are three sections of the spine and each of them has its own anatomical features:
- the thoracic region provides anchorage of the costal arches with the help of the costal-vertebral joints, its vertebral bodies have additional processes;
- the lumbar region consists of five massive vertebral bodies, which bear the maximum damping load during various movements of the human body;
- sacrum - five vertebrae fused into a single bone, are responsible for fixing the lower limbs by forming the iliosacral joints.
The intervertebral discs are located between the vertebral bodies. They are absent only between the sacred vertebrae. Inside 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 innervation from the structures of the spinal cord, the radicular nerves leave through the lateral foraminal openings in the vertebral bodies. By branching, the radicular nerves form nerve plexuses. Large nerves deviate from it, for example, sciatica, femoral, inguinal lumbosacral plexus.
The mobility and flexibility of the human body is provided by the muscle structure. Paravertebral muscles also provide diffuse nutrition to the cartilage tissue of the intervertebral discs. Intervertebral discs do not have their own circulatory system. If the paravertebral muscles are disturbed, all the load falls on the endplates that separate the fibrous ring from the vertebral body.
The stability of the position of the vertebral bodies is ensured by a complex mechanism. It includes:
- intervertebral joints - they 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 - ensure uniformity of the height of the spaces between the vertebral bodies, compensate for the shock absorption load and protect the radicular nerves from compression.
In addition, the most important structural parts of the back and lower back are the blood and lymphatic vessels. They provide tissue nutrition and the elimination of toxins, cellular debris.
By understanding the structure and physiology of this part of the musculoskeletal system of the human body, you can move on to the potential causes of pain. In the meantime, some important practical advice. If you have back pain in the lumbar region, we recommend that you seek immediate medical attention. Pathologies of the musculoskeletal system (spine and joints) and autonomic nervous system (spinal cord, radicular nerve and their branches) are best treated in manual therapy clinics.
The reasons why the back hurts in the lumbar region
There are various reasons why the back hurts in the lumbar region, it can be both physiological factors and pathological changes in the tissues. First of all, you should always rule out the possibility of traumatic exposure:
- bruising of the soft tissues of the back after bumps or falls;
- stretching of the ligament and tendon apparatus of the spine (may occur with awkward movements, unusual falling, lifting of weights, etc. );
- cracks in the spinous processes and fractures of the vertebral bodies (young people leading active lives and elderly people with osteoporosis are at risk);
- contusion of the spinal cord and development of a hematoma in the hard membranes (this can cause compression and cause a number of concomitant neurological manifestations).
Also, as a result of trauma, displacement of the vertebral body, rupture of the intervertebral disc, dislocation or subluxation of the joint between 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 perform an x-ray examination and make an accurate diagnosis.
The second common group of causes of back pain in the lumbar region are degenerative dystrophic changes in the cartilage tissues of the musculoskeletal system:
- osteochondrosis - a violation of the diffuse nutrition of the cartilage tissue of the intervertebral discs leads to the fact that the annulus fibrosus dehydrates, the nucleus pulposus begins to lose its cushioning capacity;
- protrusion of the intervertebral disc - a decrease in its height and an increase in the occupied area, there is compressive pressure on the soft tissues and nerve branches surrounding the spine;
- intervertebral hernia - rupture of the fibrous ring of the intervertebral disc and part of the nucleus pulposus came out;
- destruction of the cartilaginous synovial layer inside the intervertebral joints - deforming spondyloarthrosis;
- deformity of the iliosacral joints;
- coxarthrosis - deforming osteoarthritis of the hip joints.
Sometimes the reasons for back pain in the lumbar region lie in damage to the tissues of the spinal cord, radicular nerves, plexuses and large nerves (sciatica, femoral, inguinal). Do not rule out the possibility of developing tunnel syndromes, plexitis, radiculitis, etc. Lumbago (pain in the lower back) can in most cases only be diagnosed with a special exam.
It includes without fail an x-ray image of the spine, the iliosacral joints. To detect degenerative dystrophic diseases of the spine and joints, an MRI scan is necessary.
If you experience back pain in the lumbar region, it is advisable to consult a vertebrologist or neurologist. If there was an injury the day before, see a traumatologist. The local therapist often does not have sufficient professional skills to make an accurate diagnosis and prescribe effective treatment.
Severe lower back pain - what to do?
The first thing to do if your back hurts in the lumbar region is to stop exercising any physical activity on it. The cause of the pain may be damage to the muscle, ligament or tendon systems. Fibromyalgia syndrome often occurs in young people leading an active lifestyle. This is a pathology associated with the process of impaired 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 quite strong pain syndrome.
Second, the pain can be caused by an overload of the back muscles with a compensatory purpose against the background of the protrusion of the intervertebral disc. In this case, it is extremely dangerous to stop the spasm of the muscle fibers. There are cases when, after taking muscle relaxants, a patient with a protruding disc developed a fairly large intervertebral herniation.
Severe back pain in the lumbar region may be a clinical symptom of the development of sciatica or lumbago. Therefore, it is not worth independently diagnosing and treating. You need to get some peace, try to relax tight muscles without using pharmacological drugs. See 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 rule out severe pain syndrome.
Never take pain relievers before consulting your doctor. This will make it difficult to make an accurate diagnosis. It is also not recommended to use external analgesics (ointments, plasters, compresses). In the first 3 days after an exacerbation of osteochondrosis, any warming up is contraindicated, including visiting a bath and sauna.
Treatment of back pain in the lumbar region
Begin treatment if the back hurts in the lumbar region after the differential diagnosis. The fact is that the pain syndrome is not an independent disease. It is impossible to treat pain effectively and safely without a therapeutic effect on the underlying pathology. Pain always indicates changes in the tissues. Therefore, it is important to detect these pathological changes and, if possible, eliminate them. Only this way to get rid of pain syndrome is considered to be effective and safe.
For example, back pain in the lumbar region is caused by a decrease in the height of the intervertebral disc (protrusion) against the background of long-term osteochondrosis. During a manual examination, an experienced vertebrologist in this case will find excessive tension of 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 spine traction procedure. After 2-3 sessions, the patient feels pain relief and regains his natural mobility. But you can't stop at this point. If you do not perform rehabilitation treatment, the pain may return after a few months.
It is advisable to continue treatment of back pain in the lumbar region using the following exposure methods:
- Massage
- to increase the elasticity and permeability of all soft tissues of the back and lower back; osteopathy
- - to accelerate the processes of microcirculation of blood and lymphatic fluid, this ensures complete trophism of all tissues and begins regeneration; Reflexotherapy
- - the impact on the biologically active points of the human body stimulates the process of restoration of damaged tissues by 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 start the disturbed process of diffuse nutrition of the cartilage tissues of the intervertebral discs; Laser action
- to restore and activate cell regeneration processes.
Please note that the course of treatment is always developed strictly individually, taking into account all the characteristics of the patient's state of health. It also includes recommendations from your doctor for lifestyle changes. For example, if you do not change your physical activity and continue to lead a sedentary lifestyle, then no, even the most effective treatment will help restore the spine.
If you have back pain in the lumbar region, before treating, seek a manual therapy clinic and go for the advice of a vertebrologist or neurologist.