Recurrent back pain in the lumbar region can be associated with excessive stress on the 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 consulted for a full differential diagnosis, what to do at home.
To understand the possible causes of the development of this clinical syndrome, it is important to have an idea of how that part of the body, which is commonly called the back, functions and functions. The loin conditionally refers to the lower back. So in our understanding, the back is the back of the chest, the lower back, and the sacrum. Two bones of the shoulder 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 of them has its own anatomical characteristics:
- the thoracic region provides the anchoring of the costal arches using the costal-vertebral joints, their vertebral bodies have additional processes;
- the lumbar region consists of five massive vertebral bodies, which bear the maximum load of amortization during various movements of the human body; Sacral
- : 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 lie between the vertebral bodies. They are absent only between the sacral vertebrae. Within the spinal column is the spinal cord, surrounded by tough 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 of spinal cord structures, nerve pairs from roots exit through lateral foraminal openings in vertebral bodies. When branching, the root nerves form nerve plexuses. Large nerves start from them, for example, sciatic, femoral, inguinal from the lumbosacral plexus.
The mobility and flexibility of the human body is provided by the muscular structure. 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. In the event of rupture of the paravertebral muscles, the entire load falls on the end plates that separate the annulus fibrosus from the vertebral body.
The stability of the position of the vertebral bodies is provided by a complex mechanism. 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: guarantee the uniformity of the height of the spaces between the vertebral bodies, compensate the shock absorbing load and protect the root nerves from compression.
Also, the most important structural parts of the back and lower back are the blood and lymphatic vessels. They provide nutrition to the tissues 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 possible causes of pain. Meanwhile, some important practical advice. If you have back pain in the lumbar region, we recommend that you seek immediate medical attention. It is best to treat pathologies of the musculoskeletal system (spine and joints) and the autonomic nervous system (spinal cord, radicular nerve and its branches) in manual therapy clinics.
The reasons why the back hurts in the lumbar region
There are several 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 exclude the possibility of traumatic exposure:
- bruising of the soft tissues of the back after blows or falls;
- stretching of the ligament and tendon apparatus of the spine (can occur with uncomfortable movements, falls, unusual lifting of weights, etc. );
- cracks in the spinous processes and fractures of the vertebral bodies (young people with an active lifestyle and the elderly with osteoporosis are at risk)
- contusion of the spinal cord and development of hematoma in hard membranes (this can lead to compression and cause a series of concomitant neurological manifestations).
In addition, as a result of trauma, a displacement of the vertebral body, rupture of the intervertebral disc, dislocation or subluxation of the joint between the individual vertebrae may be observed. To eliminate the probability of developing such negative consequences after 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 fibrous ring becomes dehydrated, the nucleus pulposus begins to lose its ability to pay off;
- 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 exit of a part of the nucleus pulposus to the outside;
- destruction of the cartilaginous synovial layer within the intervertebral joints - deforming spondylarthrosis;
- ilio-sacral joint deformity;
- 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 (sciatic, femoral, inguinal). Do not exclude the possibility of developing tunnel syndromes, plexitis, radiculitis, etc. Lumbago (pain in the lower back) can be diagnosed in most cases only during a special examination.
Includes without fail an X-ray image of the spine, the ilio-sacral joints. To detect degenerative dystrophic diseases of the spine and joints, an MRI examination is required.
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, visit an orthopedist. The local therapist often does not have the 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 can be an injury to the muscular, ligamentous or tendon apparatus. Fibromyalgic syndrome often occurs in young people who lead an active lifestyle. This is a pathology associated with the process of altering the transmission of nerve impulses to myocytes. As a result, some cells receive an impulse to contract or relax prematurely, others with a delay. A chaotic muscle contraction occurs. This causes quite a strong pain syndrome.
Second, pain can be caused by overstressing of the back muscles for a compensatory purpose in the context of the bulging intervertebral disc. In this case, it is extremely dangerous to stop the spasm of muscle fibers. There are cases when, after taking muscle relaxants, a patient with a bulging disc developed a fairly large intervertebral hernia.
Severe back pain in the lumbar region can be a clinical symptom of the development of sciatica or lumbago. Therefore, it is not worth diagnosing and treating independently. Peace should be provided, try to relax tense muscles without the use of 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 syndrome.
Never take pain relievers before visiting your doctor. This will make it difficult to make an accurate diagnosis. The use of external analgesics (ointments, plasters, compresses) is also not recommended. In the first 3 days after an exacerbation of osteochondrosis, any warming up is contraindicated, including a visit to a bath and sauna.
Treatment of back pain in the lumbar region
Initiate treatment if your back hurts in the lumbar region after 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 tissues. Therefore, it is important to detect these pathological changes and, where possible, eliminate them. Only this way of getting rid of pain syndrome is considered effective and safe.
For example, back pain in the lumbar region 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 an 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 procedure for manual traction of the spine. After 2-3 sessions, the patient experiences pain relief and regains their 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 carry out additional treatment for back pain in the lumbar region using the following exposure methods:
- massage to increase the elasticity and permeability of all the soft tissues of the back and lumbar area;
- osteopathy - to accelerate the processes of microcirculation of blood and lymphatic fluid, this provides a complete trophism of all tissues and regeneration begins;
- 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 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 course of treatment is always developed on a strictly individual basis, 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 mode of 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 treatment, find a manual therapy clinic and go there for advice from a vertebrologist or neurologist.