Recurrent back pain in the lumbar region can 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 back pain in the lumbar region, with which the doctor should be contacted for a complete 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, is regulated and functions. The conventional thigh refers to the lower back. So the back in our sense is the back of the chest, the lower back and the sacrum. Two shoulder bones attach 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 one has its own anatomical features:
- thoracic region provides anchoring of the coastal arches using the costal-vertebral joints, its vertebral bodies having additional processes;
- the lumbar region consists of five massive vertebral bodies, which carry the maximum damping load during different movements of the human body;
- sacrum - five vertebrae fused to a single bone, responsible for fixing the lower extremities 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 solid membranes. It is also divided into thoracic, lumbar and sacral segments. Each of them is responsible for innervating a certain part of the human body. For innervation from spinal cord structures, nerves paired with roots are removed through lateral foraminal openings in the vertebral bodies. Branching, radicular nerves form nerve plexuses. Large nerves leave them, for example, sciatic, femoral, inguinal from the lumbosacral plexus.
The mobility and flexibility of the human body is ensured by the muscle frame. The paravertebral muscles also provide diffuse nourishment to the cartilaginous tissues of the intervertebral discs. Intervertebral discs do not have a circulatory system. If the paravertebral muscles break down, the entire load falls on the end plates separating the fibrosus ring from the vertebral body.
The stability of the position of the vertebral bodies is ensured by a complex mechanism. It 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 - ensure uniformity of the height of the spaces between the vertebral bodies, compensate for the shock absorption load and protect the radicular nerves from compression.
Also, the most important structural parts of the spine and lower back 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 possible causes of pain. In the meantime, 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 their branches) in manual therapy clinics.
Reasons why back pain in the lumbar region
There are various reasons why the back hurts in the lumbar region, it can be 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 (can occur with difficult movement, falling, unusual weight lifting, 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 hematoma on hard membranes (this can provoke oppression and cause a number of concomitant neurological manifestations).
Also, as a result of trauma, a displacement of the vertebral body, rupture of the intervertebral disc, displacement or subluxation of the joint between individual vertebrae may be observed. 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.
The second most common group of causes of back pain in the lumbar region are degenerative degenerative changes in the cartilage tissues of the musculoskeletal system:
- osteochondrosis - a violation of diffuse nutrition of the cartilaginous tissue of the intervertebral discs leads to the fact that the annulus fibrosus becomes dehydrated, the nucleus pulposus begins to lose its ability to cushion;
- elongation of the intervertebral disc - a decrease in its height and an increase in the occupied area, there is compression pressure in the soft tissues and nerve branches surrounding the spine;
- intervertebral hernia - rupture of the fibrous ring of the intervertebral disc and protrusion of a part of the nucleus pulposus out;
- destruction of the cartilaginous synovial layer within the intervertebral joints - deforming spondylarthrosis;
- deformation of the ilio-sacral joints;
- coxarthrosis - deforming osteoarthritis of the thigh 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 (sciatic, femoral, inguinal). Do not rule out 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.
Undoubtedly includes an X-ray image of the spine, ilio-sacral joints. An MRI examination 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 visit a vertebrologist or neurologist. If there was an injury the day before, visit a traumatologist. The local therapist often does not have sufficient professional skills to make an accurate diagnosis and prescribe an effective treatment.
Severe back pain - what to do?
The first thing you should do if your back hurts in the lumbar region is to stop doing any physical activity on it. The cause of pain can be damage to muscles, ligament apparatus or tendons. Fibromyalgic syndrome often occurs 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 an impulse for premature contraction or relaxation, others - with a delay. A chaotic muscle contraction occurs. This causes a fairly strong pain syndrome.
Second, pain can be caused by overload of the back muscles with a compensatory purpose against the background of elongation 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 disc lengthening developed a fairly large intervertebral hernia.
Severe back pain in the lumbar region may be a clinical symptom of sciatica or lumbago development. Therefore, it is not worth diagnosing and treating independently. You need to provide yourself with peace, try to relax tense muscles without the use of pharmacological medications. See a neurologist or vertebrologist as soon as possible. Already 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. It is also not recommended to use external pain relievers (oils, plasters, compresses). In the first 3 days after a worsening of osteochondrosis, any warm-up is contraindicated, including a visit to a spa and sauna.
Treatment of back pain in the lumbar region
it is usually necessary to start treatment if your back hurts in the lumbar region after the differential diagnosis. The fact is that 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 shows changes in the tissues. Therefore, it is important to detect these pathological changes and, if possible, eliminate them. Only this way to get rid of 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 (elongation) against the background of long-term osteochondrosis. During a manual examination, an experienced vertebrologist in this case will find an excessive tension of the muscle fibers, a decrease in the height of the intervertebral space.
To provide first aid in such a situation, you can use the procedure for manual spinal traction. After 2-3 sessions, the patient experiences pain relief and regains his natural movement. But you can not stop at this stage. If you do not carry out rehabilitative treatment, then after a few months the pain may return.
It is advisable to further treat back pain in the lumbar region using 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 processes of microcirculation of blood and lymph fluid, this ensures a complete trophism of all tissues and begins regeneration;
- reflexology - the impact on biologically active points in 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, to accelerate healing;
- therapeutic gymnastics and kinesiotherapy to increase muscle tone and begin the turbulent 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 conducted 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 way 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, seek out a manual therapy clinic and go there for the advice of a vertebrologist or neurologist.