Recurrent back pain in the lumbar region may be associated with excessive pressure on muscles, ligaments and tendons. But in most cases, the appearance of these clinical symptoms indicates that there are serious pathological changes in the tissues of the spinal space and other parts of the musculoskeletal system.
The article explains why back pain in the lumbar region, to which a doctor should be contacted for a full 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 the body parts, commonly referred to as the back, are arranged and function. The waist conventionally refers to the lower back. So, the back part of our understanding is the back of the chest, lower back and sacrum. Two scapular bones adjacent to the chest, which, with the help of an acromial process, participate in the formation of the shoulder joint.
As you can see, there are three parts of spinal space and each has its own anatomical features:
- the thoracic region provides binding of the costume arch using the vertebral-vertebral joints, the vertebral body has an additional process;
- The lumbar region consists of five large vertebral bodies, which bear the maximum amortization load during various movements of the human body;
- sacrum - five vertebrae joined together into a single bone, responsible for repairing the lower leg through the formation of ilio-sacral joints.
The intervertebral disc is located between the vertebral bodies. They are not present only between the sacral vertebrae. Inside the spinal cord are the spinal cord, surrounded by a hard membrane. It is also divided into thoracic, lumbar, and sacral segments. Each of them is responsible for the preservation of certain parts of the human body. For the preservation of spinal cord structure, nerves pair roots through lateral foraminal openings in the vertebral body. Branched, the radicular nerve forms the nerve plexus. Large nerves depart from them, for example, sciatic, femoral, inguinal from the lumbosacral plexus.
Mobility and flexibility of the human body are provided by skeletal muscle. The paravertebral muscles also provide nutrients that permeate the cartilage tissue of the intervertebral disc. The intervertebral disc does not have its own circulatory system. If the paravertebral muscles are disturbed, the entire load falls on the end plate separating the fibrosus annulus from the vertebral body.
The stability of the vertebral body position is provided by complex mechanisms. It includes:
- intervertebral joints - they provide certain mobility and stability of the interconnected vertebral body position;
- longitudinal (long) and transverse (short) ligaments in spinal space;
- intervertebral disc - ensures uniformity of space between vertebral bodies, balances shock-absorbing loads and protects radicular nerves from compression.
Also, the most important structural parts of the back and lower back are the blood vessels and lymph. They provide tissue nutrition and removal of toxins, cellular debris.
Understanding the structure and physiology of this part of the musculoskeletal system of the human body, you can move on to possible causes of pain. In the meantime, an important practical advice. If you have back pain in the lumbar region, we recommend that you seek medical attention immediately. It is better to treat the pathology of the musculoskeletal system (spine and joints) and the autonomic nervous system (spinal cord, radicular nerve and its branches) in a manual therapy clinic.
Reasons why the back hurts in the lumbar region
There are various reasons why back pain in the lumbar region, it can be a physiological factor and pathological changes in the tissue. First and foremost, you should always exclude the possibility of traumatic exposure:
- bruises on soft tissue in the back after a blow or fall;
- stretching of ligament and tendon apparatus in spinal space (may occur with awkward movements, falls, unusual weight lifting, etc. );
- cracks in the process of rotation and fracture of the vertebrae (young people living an active lifestyle and older people suffering from osteoporosis are at risk);
- spread of the spinal cord and the development of hematomas on the hard membrane (this can trigger compression and cause a number of concomitant neurological manifestations).
As a result of trauma, vertebral body displacement, rupture of intervertebral discs, dislocation or subluxation of joints between individual vertebrae may be observed. To eliminate the possibility of such negative consequences after the injury, it is necessary to see a traumatologist as soon as possible. He or she will perform an X-ray examination and make an accurate diagnosis.
The second group of causes of back pain in the lumbar region is the change in degenerative dystrophy in the cartilage tissue of the musculoskeletal system:
- osteochondrosis - a violation of dietary permeability to the cartilage tissue of the intervertebral disc leads to the fact that the fibrosus annulus becomes dehydrated, the nucleus pulposus begins to lose its healing capacity;
- protrusion of the intervertebral disc - a decrease in its height and an increase in the occupied area, there is compressive pressure on the soft tissues and nerve branches around the spinal space;
- intervertebral hernia - rupture of the fibrous ring of the intervertebral disc and the protrusion of the outer part of the pulposus;
- destruction of the synovial layer of cartilage in the intervertebral joint - deformation of spondylarthrosis;
- ilio-sacral joint defects;
- coxarthrosis - deformity of osteoarthritis of the hip joint.
Sometimes the causes of back pain in the lumbar region lie in damage to the spinal cord, radicular, plexus and large nerves (sciatic, femoral, inguinal). Do not exclude the possibility of developing tunnel syndrome, plexitis, radiculitis, and so on. Lumbago (pain in the lower back) can be diagnosed in most cases only during a special examination.
It without fail includes X-ray images of the spine, ilio-sacral joints. To detect degenerative dystrophic diseases of the spine and joints, MRI examination is required.
If you experience back pain in the lumbar region, it is recommended to see a vertebrologist or neurologist. If there is an injury the day before, visit a traumatologist. Local therapists often do not have sufficient professional competence to make an accurate diagnosis and prescribe effective treatment.
Severe 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 cause of pain can be damage to muscles, ligaments or tendons. Fibromyalgic syndrome often occurs in young people who lead an active lifestyle. This is a pathology related to the process of interfering with the transmission of nerve impulses to the mosit. As a result, some cells receive the urge to contract or rest prematurely, others - with delay. Chaotic muscle contraction occurs. This causes a pretty strong pain syndrome.
Second, the pain may be caused by strain on the back muscles with the aim of compensating against the background of protrusion of the intervertebral disc. In this case, it is very dangerous to stop muscle fiber spasms. There are cases when, after taking muscle relaxants, patients with disc protrusion develop a relatively 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 it to make a diagnosis and treatment independently. You need to give yourself peace of mind, try to relax tense muscles without using pharmacological drugs. See a neurologist or vertebrologist as soon as possible. During the initial examination, the specialist will be able to diagnose and provide the necessary assistance to get rid of the severe pain syndrome.
Never take painkillers before seeing a doctor. This will make it difficult to make an accurate diagnosis. Also not recommended using external pain relievers (ointments, plasters, compresses). In the first 3 days after an increase in osteochondrosis, any warming is contraindicated, including visits to the bath and sauna.
Treatment of back pain in the lumbar region
Start treatment if the back hurts in the lumbar region after differential diagnosis. The fact is that pain syndrome is not an independent disease. It is not possible to treat pain effectively and safely without the therapeutic effect on the underlying pathology. Pain always indicates a change in the tissue. It is therefore important to detect these pathological changes and, if possible, eliminate them. The only way to get rid of pain syndrome is to consider it 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 muscle fiber tension, a decrease in the height of the intervertebral space.
To provide first aid in such a situation, you can use the procedure for manual traction on the spine. After 2-3 sessions, the patient experiences pain and returns to normal motion. But you can not stop at this stage. If you do not carry out rehabilitation treatment, then after a few months the pain may return.
Further treatment of back pain in the lumbar region is recommended to be done using the following exposure methods:
- massage to increase the elasticity and permeability of all soft tissues of the buttocks and lower back;
- osteopathy - to accelerate the circulatory process of blood and lymph fluid, this gives full trophism of all tissues and initiates regrowth;
- reflexotherapy - the effect on biologically active points on the human body stimulates the process of recovery of damaged tissue by activating the hidden storage of the human body;
- physiotherapy - to increase metabolic processes at the cellular level, accelerate recovery;
- therapeutic gymnastics and kinesiotherapy to improve muscle tone and initiate the process of pervasive nutritional disorders in the intervertebral disc cartilage tissue;
- laser action to restore and activate the cell regrowth process.
Please note that treatment is always carried out individually, taking into account all features of the patient's health condition. This also includes recommendations from your doctor for lifestyle changes. For example, if you do not change your physical activity and continue to lead an inactive lifestyle, then no, the most effective treatment will help restore the spinal canal.
If you experience back pain in the lumbar region, before treatment, seek a manual therapy clinic and go there for the advice of a vertebrologist or neurologist.