Recurrent back pain in the lumbar region can lead to excessive stress on the muscles, ligaments and tendons. But in most cases, the appearance of this clinical symptom indicates that there are severe pathological changes in the tissues of the spine and other parts of the musculoskeletal system.
This article describes why your back hurts in the lumbar region, which doctor to contact for a full differential diagnosis, what to do at home.
To understand the possible causes of this clinical syndrome, it is important to have an idea of how a part of the body, commonly referred to as the back, is organized and functioning. The loin traditionally refers to the lower back. So the posterior perception is the back of the chest, the lower back and the sacrum. Two chest bones are attached to the chest, which are involved in the formation of shoulder joints through achromatic processes.
As you can see, the spine has three sections, each with its own anatomical features:
- the chest region fixes the rib arches with the help of the rib-vertebral joints, the vertebral body has additional processes;
- the lumbar region consists of five massive vertebral bodies that bear the maximum damping load during various movements of the human body;
- sacrum - five vertebrae fused into a single bone responsible for fixation of the lower extremities through the formation of ilio-sacral joints.
The vertebral discs are located between the vertebral bodies. They are only missing between the vertebrae. Inside the spinal column is the spinal cord, which is surrounded by hard membranes. It is also divided into chest, lumbar and sacral segments. Each of them is responsible for innervating a certain part of the human body. In order to innervate the structures of the spinal cord, the nerves of the root pairs leave through the lateral foraminal openings of the vertebral bodies. Branched, radical nerves form nerve braids. Large nerves leave them, such as the esophagus, femoral, and inguinal lumbosacral plexus.
The mobility and flexibility of the human body is provided by the muscle frame. Paravertebral muscles also provide diffuse nourishment to the cartilage tissues of the intervertebral discs. Intervertebral discs do not have their own circulatory system. When the paravertebral muscles rupture, the full load falls on the endplates that separate the annular fibrosis from the vertebral body.
The stability of the position of the vertebral bodies is ensured by a complex mechanism. Includes:
- intervertebral joints - provide some mobility and stability in the relative position of the vertebral bodies;
- longitudinal (long) and transverse (short) bands of the spinal column;
- vertebral discs - ensure even height in the spaces between vertebral bodies, compensate for shock-absorbing loads and protect radical nerves from compression.
The blood and lymphatic vessels are also the most important structural parts of the back and lower back. They provide nutrition to the tissues and the removal of toxins and cell debris.
Understanding the structure and physiology of this part of the musculoskeletal system of the human body can advance to the possible causes of pain. In the meantime, an important piece of practical advice. If you have back pain in the lumbar region, we recommend that you see a doctor immediately. It is best to treat pathologies of the musculoskeletal system (spine and joints) and the autonomic nervous system (spinal cord, radical nerve and their branches) in manual therapy clinics.
Causes of back pain in the lumbar region
There can be many reasons for back pain in the lumbar region, both physiological factors and abnormal tissue changes. First, you should always rule out the possibility of traumatic exposure:
- bruises on the soft parts of the back after blows or falls;
- stretching of the spinal ligament and tendon device (may occur with awkward movement, falling, lifting unusual weights, etc. );
- cracks in spinal cord processes and fractures (young people with active lifestyles and elderly people with osteoporosis are at risk);
- Spinal cord injury and hematoma formation in hard membranes (this can cause compression and cause several simultaneous neurological manifestations).
Trauma may result in displacement of the vertebral body, rupture of the intervertebral disc, dislocation or subluxation of the joint between individual vertebrae. To avoid the possibility of such negative consequences occurring after injury, a traumatologist should be called as soon as possible. He performs an X-ray and makes an accurate diagnosis.
The second common group of causes of back pain in the lumbar region is degenerative dystrophic changes in the cartilage tissues of the musculoskeletal system:
- osteochondrosis - violation of the diffuse feeding of the cartilage tissue of the intervertebral discs leads to the fact that the annulus fibrosus dries out, the nucleus pulposus begins to lose its ability to absorb; protrusion of the intervertebral disc
- - decrease in height and increase in occupied area, 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;
- destruction of the cartilage synovial layer inside the intervertebral joints - deforming spondylarthrosis;
- deformity of ilio-sacral joints;
- coxarthrosis - deforming hip joint osteoarthritis.
Back pain in the lumbar region is sometimes caused by damage to the tissues of the spinal cord, radical nerves, plexuses, and large nerves (sciatica, femoral, inguinal). Do not rule out tunnel syndromes, plexitis, radiculitis, etc. The possibility of its formation. Lumbago (pain in the lower back) can only be diagnosed in a special test in most cases.
Includes X-ray of the spinal column, the ilio-sacral joints, without failure. MRI is required to detect degenerative dystrophic diseases of the spine and joints.
If you experience back pain in the lumbar region, it is advisable to see a vertebrologist or neurologist. If an injury occurred the previous day, consult a traumatologist. The local therapist often does not have sufficient professional expertise 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 physical activity on it. The pain can be caused by damage to a muscle, ligament, or tendon device. Fibromyalgia syndrome often occurs in young people with an active lifestyle. It is a pathology associated with impaired transmission of nerve impulses to myocytes. As a result, some cells receive an impulse to prematurely contract or relax, while others receive a delay. Chaotic muscle contraction occurs. This causes a fairly severe pain syndrome.
Second, the pain may be caused by an overload of the back muscles, for compensatory purposes, against the background of the protrusion of the intervertebral disc. In this case, it is extremely dangerous to stop the spasm of the muscle fiber. There have been cases where a patient with a disc protrusion developed a rather large intervertebral injury after taking muscle relaxants.
Severe back pain in the lumbar region may be a clinical symptom of sciatica or lumbago. Therefore, it is not worth diagnosing and treating yourself. You need to be safe, try to relax tense muscles without using pharmacological medications. See a neurologist or vertebrologist as soon as possible. Already during the first examination, these professionals will be able to diagnose and provide the help needed to eliminate severe pain.
Never take painkillers before visiting your doctor. This makes it difficult to make an accurate diagnosis. The use of external analgesics (ointments, patches, compresses) is also not recommended. In the first 3 days after exacerbation of osteochondrosis, any warm-up is contraindicated, including a visit to the spa and sauna.
Treating back pain in the lumbar region
Treatment should be initiated if, after differential diagnosis, there is back pain in the lumbar region. The fact that pain syndrome is not a stand-alone disease. It is impossible to treat pain effectively and safely without having a therapeutic effect on the underlying pathology. Pain always indicates a change in tissues. Therefore, it is important to detect these abnormal changes and, if possible, eliminate them. Only this way of getting rid of the pain syndrome is considered effective and safe.
For example, low back pain is caused by a decrease in the height of the intervertebral disc (protrusion) in the background of long-term osteochondrosis. During the manual examination, an experienced vertebrologist in this case finds excessive tension in the muscle fiber, reducing the height of the intervertebral space.
In this situation, you can use the procedure for manually towing the spine to provide first aid. After 2-3 times, the patient experiences pain relief and regains his natural mobility. But you can't stop at this stage. If you do not receive rehabilitation treatment, the pain may return after a few months.
Further treatment of back pain in the lumbar region is recommended using the following exposure methods:
- massage to increase the elasticity and permeability of the soft tissues of the back and lower back;
- osteopathy - to speed up the microcirculatory processes in the blood and lymph fluid, this ensures full trophism of all tissues and initiates regeneration;
- reflexotherapy - the effect on the biologically active points of the human body stimulates the process of repairing damaged tissues by activating the hidden reserves of the human body;
- physiotherapy - improving metabolic processes at the cellular level, accelerating recovery;
- therapeutic exercise and kinesiotherapy to increase muscle tone and initiate a disturbed process of diffuse nutrition of intervertebral disc cartilage tissue;
- laser to restore and activate the processes of cell regeneration.
Please note that the course of treatment is always strictly individualized, taking into account all the characteristics of the patient's state of health. This includes your doctor’s recommendations for lifestyle changes. For example, if you don’t 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 the lumbar region, see a hand therapy clinic and seek the advice of a vertebrologist or neurologist before treatment.