Recurrent back pain in the lumbar region may be associated with excessive strain on muscles, tendons and ligaments. But in most cases, the appearance of this clinical symptom signals 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 you should contact for a complete differential diagnosis, what to do at home.
To understand the potential causes of this clinical syndrome, it is important to have an idea of how the part of the body that is usually called the back is arranged and functioning. The lower back usually refers to the lower back. So, the back in our understanding is the back of the chest, the lower back and the sacrum. Two scapular bones adjoin the thorax, 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 of them has its own anatomical features:
- the thoracic region secures the costal arches with the help of bone and spine joints, its vertebral bodies have additional processes;
- the lumbar region consists of five massive vertebral bodies that carry the maximum cushioning load during various movements of the human body;
- sacrum - five vertebrae, fused into one bone, are responsible for fixing the lower limbs through the formation of ilio-sacral joints.
The intervertebral discs are located between the vertebral bodies. They are absent only between the sacral vertebrae. Inside the spine is the spinal cord, surrounded by hard membranes. It is also divided into thoracic, lumbar and sacral segments. Each of them is responsible for the innervation of a certain part of the human body. To be innervated by the structures of the spinal cord, the radically paired nerves branch off through the lateral openings of the foramine in the spinal bodies. As they branch, the radicular nerves form nerve plexuses. Large nerves are released from them, for example sciatic, femoral, inguinal from the lumbosacral split.
The mobility and flexibility of the human body is provided by the muscular frame. The paravertebral muscles also provide diffuse nutrition to the cartilaginous tissues of the intervertebral discs. The intervertebral discs do not have their own circulatory system. If the paravertebral muscles are disrupted, the entire load falls on the end plates, which separate the annular fibrosis from the body of the spine.
The stability of the position of the vertebral bodies is ensured by a complex mechanism. It includes:
- intervertebral joints - they provide some mobility and stability of the position of the vertebral bodies relative to each other;
- longitudinal (long) and transverse (short) connections of the spine;
- intervertebral discs - provide uniform height of the spaces between the vertebral bodies, compensate for the cushioning load and protect the root nerves from compression.
Also, the most important structural parts of the back and waist are the blood and lymph vessels. They provide tissue nutrition and remove toxins, cell 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. Meanwhile, an important practical tip. If you have back pain in the lumbar region, 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, radicular nerve and their branches) in chiropractic clinics.
The reasons why the back hurts in the lumbar region
There are various reasons why the back hurts in the lumbar region, these can be both physiological factors and pathological changes in the tissues. First of all, you should always rule out the possibility of traumatic exposure:
- soft tissue bruises on the back after bumps or falls;
- stretching of the ligament and tendon apparatus of the spine (may occur with awkward movement, falling, lifting unusual weights, etc. );
- cracks in the spinous processes and fractures of the vertebral bodies (young people leading an active lifestyle and the elderly suffering from osteoporosis) are at risk);
- spinal cord injury and the development of a hematoma in hard membranes (this can provoke compression and cause a number of concomitant neurological manifestations).
Also, as a result of trauma, there may be displacement of the spinal body, rupture of the intervertebral disc, dislocation or subluxation of the joint between the individual vertebrae. To eliminate the possibility of developing such negative consequences after 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 lumbar region are degenerative dystrophic changes in the cartilage 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 annular fibrous dehydrates, the nucleus pulposus begins to lose its amortization capacity;
- convexity of the intervertebral disc - reducing its height and increasing the occupied area, there is pressure on the compression 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 pulpal nucleus coming out;
- destruction of the cartilaginous synovial layer inside the intervertebral joints - deforming spondyloarthritis;
- deformation of the ilio-sacral joints;
- coxarthrosis - deforming osteoarthritis of the hip joints.
It necessarily includes an X-ray of the spine, ilio-sacral joints. MRI is required to detect degenerative dystrophic diseases of the spine and joints.
If you experience back pain in the lumbar region, it is recommended to visit a vertebrologist or neurologist. If there was an injury the day before, see a traumatologist. The local therapist often does not have enough professional competence to make an accurate diagnosis and prescribe effective treatment.
Severe low back pain - what to do?
The first thing to do if your back hurts in the lumbar region is to stop doing any physical activity on it. The cause of the pain may be damage to the muscular, tendon or tendon apparatus. Fibromyalgic syndrome is common in young people leading an active lifestyle. This is a pathology associated with the process of disrupting the transmission of nerve impulses to myocytes. As a result, some cells receive an impulse to contract or relax prematurely, others - with a delay. There is a chaotic contraction of the muscles. This causes quite a strong pain syndrome.
Second, the pain can be caused by straining the muscles of the back for a compensatory purpose against the background of the protrusion of the intervertebral disc. In this case, stopping the spasm of muscle fibers is extremely dangerous. There are cases when after taking muscle relaxants, a patient with disc protrusion develops a rather large intervertebral hernia.
Severe back pain in the lumbar region may be a clinical symptom of sciatica or lumbago. Therefore, it is not worth diagnosing and treating on your own. You need to calm down, try to relax tense 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 necessary assistance to eliminate severe pain.
Never take painkillers before visiting your doctor. This will make it difficult to make an accurate diagnosis. The use of external painkillers (ointments, patches, compresses) is also not recommended. During the first 3 days after exacerbation of osteochondrosis, any warm-up is contraindicated, including a visit to the bath and sauna.
Treatment of back pain in the lumbar region
It is necessary to start 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. The pain always shows changes in the tissues. It is therefore important that these pathological changes are detected and, if possible, removed. Only this way to get rid of the pain syndrome is considered effective and safe.
For example, back pain in the lumbar region is provoked by a decrease in the height of the intervertebral disc (bulge) on the background of prolonged osteochondrosis. During a manual examination an experienced vertebrologist in this case will detect excessive tension of the muscle fiber, reducing the height of the intervertebral space.
To provide first aid in such a situation, you can use the procedure for manual pulling of the spine. After 2-3 sessions, the patient experiences pain relief and regains his natural mobility. But you can't stop at this stage. If you do not undergo rehabilitation treatment, the pain may return after a few months.
Further treatment of lumbar back pain is recommended using the following exposure methods:
- massage to increase the elasticity and permeability of all soft tissues of the back and waist;
- osteopathy - to accelerate the processes of microcirculation of blood and lymph fluid, it provides complete trophism of all tissues and begins regeneration;
- reflexology - the impact on biologically active points on the human body stimulates the process of repairing 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 kinesitherapy to increase muscle tone and start the disturbed process of diffuse nutrition of the cartilaginous tissues of the intervertebral discs;
- laser action to restore and activate the processes of cell regeneration.
Please note that the course of treatment is always developed strictly individually, taking into account all the characteristics of the patient's health. It also includes recommendations from your doctor about lifestyle changes. For example, if you do not change your regime of physical activity and continue to lead a sedentary lifestyle, then no, even the most effective treatment will help to restore the spine.
If you have back pain in the lumbar region, before treatment, seek a chiropractic clinic and go there for advice from a vertebrologist or neurologist.