Back pain in the lumbar region

causes of back pain in the lumbar region

Recurrent 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 spinal column and other parts of the musculoskeletal system.

The article tells about why the back hurts in the lumbar region, which doctor should be consulted for a full 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 commonly called the back, works and functions. The loin conditionally refers to the lower back. So, the back in our understanding is the back of the chest, lower back and sacrum. Two scapular bones adjoin 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 spinal column and each of them has its own anatomical features:

  1. the thoracic region secures the costal arches using the costal-vertebral joints, its vertebral bodies have additional processes;
  2. the lumbar region consists of five massive vertebral bodies, which bear the maximum amortization load during various movements of the human body;
  3. sacrum - five vertebrae fused into a single bone, are responsible for fixing the lower extremities through the formation of the 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 subdivided 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, root paired nerves depart through the lateral foraminal openings in the vertebral bodies. Branching out, the radicular nerves form nerve plexuses. Large nerves depart from them, for example, sciatic, femoral, inguinal from the lumbosacral plexus.

The mobility and flexibility of the human body is provided by the muscle frame. The paravertebral muscles also provide diffuse nutrition to the cartilaginous tissues of the intervertebral discs. The intervertebral discs have no own circulatory system. If the paravertebral muscles are disrupted, the entire load falls on the endplates separating the annulus fibrosus from the vertebral body.

The stability of the position of the vertebral bodies is provided by a complex mechanism. It 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 spinal column;
  • intervertebral discs - ensure the uniformity of the height of the spaces between the vertebral bodies, compensate for the shock-absorbing load and protect the radicular nerves from compression.

Also, the most important structural parts of the back and lower back are blood and lymph vessels. They provide tissue nutrition and the 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 the potential causes of pain. In the meantime, one 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.

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 tissues. First of all, you should always exclude the possibility of traumatic exposure:

  • bruises of the soft tissues of the back after blows or falls;
  • stretching of the ligamentous and tendon apparatus of the spinal column (may occur with awkward movement, falling, lifting unusual weights, and so on);
  • cracks in the spinous processes and fractures of the vertebral bodies (young people leading an active lifestyle and elderly people suffering from osteoporosis are at risk);
  • spinal cord injury and development of hematoma in hard membranes (this can provoke compression 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, 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 see 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 is degenerative dystrophic changes in the cartilaginous 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 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 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 the exit of a part of the nucleus pulposus outside;
  • destruction of the cartilaginous synovial layer inside the intervertebral joints - deforming spondylarthrosis;
  • deformity of the ilio-sacral joints;
  • coxarthrosis - deforming osteoarthritis of the hip joints.

Sometimes the reasons for back pain in the lumbar region lie in the damage to the tissues of the spinal cord, radicular nerves, plexuses and large nerves (sciatic, femoral, inguinal). Do not exclude the possibility of developing tunnel syndromes, 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 an X-ray image of the spine, the ilio-sacral joints. To detect degenerative dystrophic diseases of the spine and joints, an MRI examination is required.

If you experience back pain in the lumbar region, it is advisable to see 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 exerting any physical activity on it. The cause of pain can be damage to the muscular, ligamentous or tendon apparatus. Fibromyalgic syndrome often occurs in young people leading 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 to contract or relax prematurely, others - with a delay. A chaotic muscle contraction occurs. This causes a fairly strong pain syndrome.

Second, the pain may be caused by overstrain of the back muscles with a compensatory purpose against the background of protrusion of the intervertebral disc. In this case, it is extremely dangerous to stop the muscle fiber spasm. 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 can be a clinical symptom of the development of sciatica or lumbago. Therefore, it is not worthwhile to independently diagnose and treat. You need to provide yourself with 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 any pain relievers before visiting your doctor. This will make it difficult to make an accurate diagnosis. It is also not recommended to use external pain relievers (ointments, plasters, compresses). In the first 3 days after an exacerbation of osteochondrosis, any warming up is contraindicated, including a visit to a bath and a 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 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 tissues. Therefore, it is important to detect these pathological changes and, if possible, eliminate them. Only this way of getting 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 an excessive tension of the muscle fiber, 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 of the spinal column. After 2-3 sessions, the patient experiences pain relief and regains his natural mobility. But you cannot 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 advisable to carry out using the following methods of exposure:

  • 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 lymphatic fluid, this ensures a full trophism of all tissues and starts regeneration;
  • reflexotherapy - the impact on biologically active points on 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, accelerate recovery;
  • therapeutic gymnastics and kinesiotherapy to increase muscle tone and start the disturbed process of diffuse nutrition of the cartilaginous tissues of the intervertebral discs;
  • laser action to restore and activate the processes of cell regeneration.

Please note that the course of treatment is always developed strictly individually, taking into account all the characteristics of the patient's health condition. It also includes recommendations from your doctor for lifestyle changes. For example, if you do not change your mode of physical activity and continue to lead a sedentary lifestyle, then no, even the most effective treatment will help restore the spinal column.

If you have a back pain in the lumbar region, before treating, look for a manual therapy clinic and go there for the advice of a vertebrologist or neurologist.