Repeated back pain in the lumbar region may be associated with excessive stress on muscles, ligaments and tendons. 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 to consult for a complete differential diagnosis, what to do at home.
To understand the potential causes of the development of this clinical syndrome, it is important to have an idea of how that part of the body, commonly referred to as the back, is arranged and functions. The loin usually refers to the lower back. So the back is in our understanding the back of the chest, the lower back and the sacrum. Adjacent to the chest are two shoulder bones which, with the help of acromial processes, participate in the formation of the shoulder joints.
As you can see, there are three parts of the spine and each of them has its own anatomical features:
- The thoracic region secures the costal arches by means of the rib-vertebral joints, its vertebral bodies have additional processes;
- the lumbar part consists of five massive vertebral bodies, which can withstand the maximum damping load during different movements of the human body;
- cross - five vertebrae fused into one bone, are responsible for fixing the lower extremities by forming ilio-sacral joints.
Intervertebral discs are located between the vertebral bodies. They are absent only between the sacral vertebrae. Inside the spinal column is the spinal cord, surrounded by hard membranes. It is also divided into thoracic, lumbar and sacral segment. Each of them is responsible for the innervation of a particular part of the human body. For innervation from the structures of the spinal cord, the roots of the paired nerves go through the lateral foraminal openings in the vertebral bodies. Branching, radicular nerves form nerve plexuses. Large nerves are separated from them, for example, sciatic, femoral, inguinal from the lumbosacral plexus.
The muscular framework ensures the mobility and flexibility of the human body. The paravertebral muscles also provide diffuse nutrition to the cartilaginous tissue of the intervertebral discs. Intervertebral discs do not have their own circulatory system. If the paravertebral muscles are disturbed, the entire load falls on the end plates that separate the annular fibrosus from the vertebral body.
Stability of the vertebral body position provides a complex mechanism. Contains:
- intervertebral joints - they provide a certain mobility and stability of the position of the vertebral bodies to each other;
- longitudinal (long) and transverse (short) ligaments of the spine;
- intervertebral discs - ensure uniform height of space between the bodies of the vertebrae, compensate for the load that absorbs shocks and protect the radicular nerves from compression.
Also, the most important structural parts of the back and lower back are the blood and lymph vessels. They provide tissue nutrition and removal of 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. In the meantime, one important practical tip. If you have back pain in the lumbar region, we recommend that you seek medical help immediately. Pathologies of the musculoskeletal system (spine and joints) and the autonomic nervous system (spinal cord, radicular nerve and their branches) are best treated in manual therapy clinics.
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:
- bruising of the soft tissues of the back after blows or falls;
- stretching of the ligament and tendon apparatus of the spine (may occur with clumsy movements, falls, lifting unusual weights and so on);
- cracks in spinous processes and vertebral body fractures (young people leading an active lifestyle and elderly people suffering from osteoporosis are at risk);
- contusion of the spinal cord and the development of hematomas in the hard membranes (this can cause compression and cause a number of accompanying neurological manifestations).
Also, as a result of trauma, there may be movement of the vertebral body, rupture of the intervertebral disc, dislocation or subluxation of the joint between individual vertebrae. To eliminate the likelihood of developing such negative consequences after an injury, it is necessary to visit a traumatologist as soon as possible. He will perform an X-ray examination and make an accurate diagnosis.
Another common group of causes of back pain in the lumbar region are degenerative dystrophic changes in the cartilaginous tissue of the musculoskeletal system:
- osteochondrosis - violation of the diffuse nutrition of the cartilaginous tissue of the intervertebral discs leads to the fact that the annular fibrosus dehydrates, the nucleus pulposus begins to lose amortization capacity;
- protrusion of the intervertebral disc - decrease in its height and increase in the occupied area, there is compression pressure on the soft tissues and nerve branches surrounding the spinal column;
- intervertebral hernia - rupture of the fibrous ring of the intervertebral disc and exit of part of the nucleus pulposus out;
- destruction of the cartilaginous synovial layer inside the intervertebral joints - deforming spondylarthrosis;
- deformation of iliac-sacral 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 (sciatic, femoral, inguinal). Do not rule out the possibility of developing tunnel syndrome, plexitis, radiculitis, etc. Lumbago (lower back pain) can be diagnosed in most cases only during a special examination.
It must include X-rays of the spine, iliac-sacral joints. An MRI examination is needed to detect degenerative dystrophic diseases of the spine and joints.
If you have back pain in the lumbar region, it is advisable to visit a vertebrologist or neurologist. If there was an injury the day before, visit a traumatologist. The local therapist often does not have enough professional competence 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 doing any physical activity on them. The cause of pain can be damage to the muscular, ligament or tendon apparatus. Fibromyalgia syndrome often occurs in young people who lead 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 muscle contraction. This causes a rather strong pain syndrome.
Second, the pain may be caused by excessive strain on the back muscles with a compensatory purpose in the background of the protrusion of the 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 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 give yourself peace, 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 help to eliminate the severe pain syndrome.
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. In the first 3 days after the worsening 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 effectively and safely treat pain without a therapeutic effect on the underlying pathology. Pain always indicates changes in the tissues. It is therefore important to detect these pathological changes and, if possible, remove them. Only this way of dealing with the 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 (bulge) in the background of long-term osteochondrosis. During a manual examination, an experienced vertebrologist will in this case detect excessive tension of muscle fibers, reducing the height of the intervertebral space.
To provide first aid in such a situation, you can use the procedure of manual traction of the spine. After 2-3 sessions, the patient feels pain relief and his natural mobility returns. 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 should preferably be performed using the following exposure methods:
- massage to increase the elasticity and permeability of all soft tissues of the back and lower back;
- osteopathy - in order to accelerate the processes of microcirculation of blood and lymph fluid, this ensures full 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 kinesiotherapy to increase muscle tone and initiate a disturbed process of diffuse nutrition of cartilaginous tissues of intervertebral discs;
- laser action to restore and activate the cell regeneration process.
Keep in mind that the course of treatment always develops strictly individually, taking into account all the characteristics of the patient's health. It also includes your doctor's recommendations for lifestyle changes. For example, if you do not change your physical activity and continue to lead an inactive lifestyle, then no, even the most effective treatment will help restore the spine.
If you have back pain in the lumbar region, seek treatment at a manual therapy clinic before treatment and go there for advice from a vertebrologist or neurologist.