Recurring 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 the back hurts in the lumbar region, which doctor should be contacted 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, which is usually called the back, is organized and functions. The loin conventionally refers to the lower back. Hence, the back in our understanding is the back of the chest, the lower back, and the sacrum. Two scapular bones 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 fixation of the costal arches using the vertebral costal joints, its vertebral bodies have additional processes;
- the lumbar region consists of five massive vertebral bodies, which bear the maximum depreciation load during the various movements of the human body;
- sacrum - five vertebrae fused into one bone, are responsible for fixing the lower limbs through the formation of the ilio-sacral joints.
The 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 segments. Each of them is responsible for the innervation of a certain part of the human body. For innervation from the structures of the spinal cord, nerves coupled to the roots depart through the lateral foraminal openings in the vertebral bodies. As they branch off, the root nerves form nerve plexuses. Large nerves branch off from them, for example, sciatic, femoral, inguinal from the lumbosacral plexus.
The mobility and flexibility of the human body are provided by the muscle structure. The paravertebral muscles also provide widespread nutrition to the cartilage tissues of the intervertebral discs. The intervertebral discs do not have their own circulatory system. If the paravertebral muscles are disrupted, the entire load falls on the end plates that separate the fibrous annulus 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 relative to each other;
- longitudinal (long) and transverse (short) ligaments of the spine;
- intervertebral discs - ensure uniform height of the spaces between the vertebral bodies, compensate for the shock absorption load and protect the root nerves from compression.
Furthermore, the most important structural parts of the back and lower back are the blood and lymphatic vessels. They provide nourishment to the tissues and removal 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 potential causes of pain. In the meantime, an important practical tip. If you suffer from 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 autonomic nervous system (spinal cord, root nerve and their branches) in manual therapy clinics.
The reasons why the back hurts in the lumbar region
There are various 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 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 awkward movements, falls, lifting unusual weights, and so on);
- cracks in the spinous processes and fractures of the vertebral bodies (young people who lead an active lifestyle and the elderly with osteoporosis are at risk);
- Spinal cord injury and development of hematoma in hard membranes (this can cause compression and cause a number of concomitant neurological manifestations).
Furthermore, 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 can be observed. To eliminate the likelihood of developing such negative consequences after an 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 widespread nutrition of the cartilage tissue of the intervertebral discs leads to the fact that the annulus fibrosus dehydrates, the nucleus pulposus begins to lose its amortization capacity;
- protrusion of the intervertebral disc - a decrease in its height and an increase in the occupied area, there is a 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 cartilage synovial layer inside the intervertebral joints - deforming spondylarthrosis;
- deformity of the ileo-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 syndromes, plexitis, radiculitis, and so on. Low back pain (pain in the lower back) can only be diagnosed in most cases during a special examination.
It invariably includes an X-ray image of the spine, ileo-sacral joints. To detect dystrophic degenerative 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 a traumatologist. The local therapist often does not have sufficient 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 exercising any physical activity on it. The cause of pain can be damage to the muscle, ligament or tendon system. Fibromyalgia syndrome often occurs in young people who lead an active lifestyle. This is a pathology associated with the process of impaired 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 a fairly strong pain syndrome.
Secondly, pain can be caused by an overload of the back muscles with a compensatory purpose against 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 disc protrusion developed a rather large intervertebral hernia.
Severe back pain in the lumbar region may be a clinical symptom of the development of sciatica or low back pain. Therefore, it is not worthwhile to independently diagnose and treat. You need to find 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 assistance to eliminate severe pain syndrome.
Never take painkillers before visiting the doctor. This will make 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 an exacerbation of osteochondrosis, any rewarming is contraindicated, including a visit to a bath and sauna.
Treatment of back pain in the lumbar region
Treatment should be started if the back hurts in the lumbar region after 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 indicates changes in the tissues. Therefore, it is important to detect these pathological changes and, if possible, to eliminate them. Only this way to get rid of the 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 (protrusion) against the background of long-term osteochondrosis. During a manual examination, an experienced vertebrologist in this case will find excessive tension of the muscle fiber, a decrease in the height of the intervertebral space.
To provide first aid in such a situation, the procedure for manual traction of the spine can be used. After 2-3 sessions, the patient experiences pain relief and regains his natural mobility. But you can't stop at this stage. If you don't get rehabilitation, the pain may return after a few months.
It is recommended to perform further treatment of back pain in the lumbar region using the following methods of exposure:
- 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, provides a full-fledged trophism of all tissues and initiates regeneration;
- reflexotherapy: the impact on biologically active points of the human body stimulates the process of restoring 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 kinesitherapy to increase muscle tone and start the disturbed process of diffuse nutrition of the cartilage tissues of the intervertebral discs;
- laser action to restore and activate cell regeneration processes.
Note that the course of treatment is always developed strictly individually, taking into account all the features of the patient's health condition. It also includes doctor's advice for lifestyle changes. For example, if you don't change your physical activity mode 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, before treatment, seek out a manual therapy clinic and go there for the advice of a vertebrologist or neurologist.