Recurring back pain in the lumbar spine can be associated with excessive strain on muscles, ligaments and tendons. However, in most cases, the appearance of this clinical symptom indicates 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 spine. Which doctor should be contacted for a full differential diagnosis of what to do at home.
In order to understand the possible causes for the development of this clinical syndrome, it is important to have an idea of how this part of the body, usually called the back, is arranged and functions. The loin traditionally 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 border the chest and are involved in the formation of the shoulder joints with the help of acromial processes.
As you can see, there are three sections of the spine, each with their own anatomical features:
- The thoracic region offers the attachment of the costal arches using the costal and vertebral joints. The vertebral bodies have additional processes.
- The lumbar region consists of five massive vertebral bodies, which carry the maximum payback load with various movements of the human body.
- Sacrum - five vertebrae fused into a single bone are responsible for the fixation of the lower extremities through the formation of the sacroiliac joints.
Intervertebral discs are located between the vertebral bodies. They are only missing between the sacral vertebrae. The spinal cord is located in the spine, surrounded by hard membranes. It is also divided into thoracic, lumbar, and sacral segments. Each of them is responsible for innervating a specific part of the human body. For innervation from the structures of the spinal cord, root-paired nerves go through the lateral foraminal openings in the vertebral bodies. The radicular nerves branch out to form nerve plexuses. Large nerves deviate from them, for example, sciatica, femur, groin from the lumbosacral plexus.
The mobility and flexibility of the human body is guaranteed by the muscle frame. The paravertebral muscles also supply the cartilage tissue of the intervertebral discs with diffuse nourishment. The intervertebral discs do not have their own circulatory system. When the paravertebral muscles are disturbed, the entire load falls on the endplates that separate the fibrosal annulus from the vertebral body.
The stability of the position of the vertebral bodies is ensured by a complex mechanism. It contains:
- intervertebral joints - they offer a certain mobility and stability of the position of the vertebral bodies relative to each other;
- longitudinal ligaments (long) and transverse ligaments (short) of the spine;
- Intervertebral discs - ensure that the spaces between the vertebral bodies are even, balance the shock-absorbing load and protect the radicular nerves from compression.
The main structural parts of the back and lower back are blood and lymph vessels. They take care of the nourishment of the tissue and the removal of toxins and cell debris.
If you understand 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 spine, we recommend that you consult a doctor immediately. It is best to treat pathologies of the musculoskeletal system (spine and joints) and autonomic nervous system (spinal cord, radicular nerve and their 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. These can be both physiological factors and pathological changes in the tissue. First of all, you should always rule out the possibility of traumatic exposure:
- bruising of the soft tissues of the back after being hit or fell;
- stretching of the ligament and tendon apparatus of the spine (can occur with uncomfortable movements, falls, lifting unusual weights, etc. );
- cracks in the spinous processes and fractures of the vertebral bodies (young people who lead active lifestyles and the elderly who suffer from osteoporosis are at risk);
- Spinal cord injury and development of a hematoma in hard membranes (this can provoke compression and cause a number of accompanying neurological manifestations).
As a result of trauma, a displacement of the vertebral body, a fracture of the intervertebral disc, dislocation or subluxation of the joint between the individual vertebrae can be observed. To exclude the likelihood of such negative consequences after an injury, it is necessary to see 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 tissue 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, and the nucleus pulposus loses its amortization capacity;
- protrusion of the intervertebral disc - a decrease in its height and an increase in the occupied area, there is compression 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 part of the nucleus pulposus to the outside;
- Destruction of the cartilaginous synovial layer within the intervertebral joints - deformation of the spondylarthrosis;
- Deformity of the sacroiliac joints;
- Coxarthrosis - deforming arthrosis of the hip joints.
Sometimes the causes of back pain in the lumbar region lie in damage to the tissues of the spinal cord, radicular nerves, plexuses and large nerves (sciatica, femur, groin). Do not rule out the possibility of the development of tunnel syndromes, plexitis, radiculitis, etc. Lumbago (lower back pain) can in most cases only be diagnosed during a special examination.
It undoubtedly contains an X-ray of the spine, the sacroiliac joints. An MRI scan is required to detect degenerative dystrophic diseases of the spine and joints.
If you have back pain in the lumbar region, it is advisable to see a vertebrate or neurologist. If there was an injury the day before, see a traumatologist. The local therapist often does not have sufficient expertise to make an accurate diagnosis and prescribe effective treatment.
Severe lower back pain - what to do?
The first thing to do when your back hurts in the lumbar spine is to stop doing any physical activity. The cause of pain can be damage to the muscles, ligaments or tendons. Fibromyalgic syndrome is common 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 receive the impulse to contract or relax prematurely, others - with a delay. A chaotic muscle contraction occurs. This causes quite a severe pain syndrome.
Second, the pain can be caused by overloading the muscles of the back with a compensatory purpose against the background of the protrusion of the intervertebral disc. In this case, it is extremely dangerous to stop the hamstring spasm. There are cases when a patient with a herniated disc developed a fairly large intervertebral hernia after taking muscle relaxants.
Severe back pain in the lumbar region can be a clinical symptom of the development of sciatica or lumbago. Therefore, it is not worthwhile to diagnose and treat independently. You need to feed yourself with peace and try to relax tense muscles without the use of pharmacological drugs. See a neurologist or vertebrate as soon as possible. During the initial examination, these specialists can diagnose and provide the necessary assistance to eliminate the severe pain syndrome.
Never take pain medication until you see your doctor. This makes it difficult to make an accurate diagnosis. It is also not recommended to use external pain relievers (ointments, plasters, compresses). In the first 3 days after osteochondrosis exacerbation, warming up is contraindicated, including a visit to the bath and sauna.
Treatment of back pain in the lumbar region
Treatment must be started if the back hurts in the lumbar region according to the differential diagnosis. The fact is that pain syndrome is not a disease in itself. It is impossible to effectively and safely treat pain without having a therapeutic effect on the underlying pathology. Pain always indicates changes in the tissue. It is therefore important to identify these pathological changes and, if 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) against the background of long-term osteochondrosis. During a manual examination, an experienced vertebrate in this case will notice 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 spine traction procedure. After 2-3 sessions, the patient experiences pain relief and regains his natural mobility. But you can't stop at this point. If you don't do rehabilitation treatment, the pain may return after a few months.
Further treatment of back pain in the lumbar region is advisable with 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 microcirculation of blood and lymph fluid, a full trophism of all tissues is achieved and regeneration is started.
- Reflex Therapy - The influence 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 kinesiotherapy to increase muscle tone and initiate the disturbed process of diffuse nutrition of the cartilage tissue of the intervertebral discs;
- Laser action to restore and activate the cell regeneration processes.
Please note that the course of treatment is always designed 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, even the most effective treatment will help restore the spine.
If you have back pain in the lumbar region before treatment, go to a manual therapy clinic and seek advice from a vertebrate or neurologist.