Lumbar Back Pain – Know effects & Cure Now Or Crash Your Spine
Have you suffered from low lumbar back pain for a long time? Isn’t it strange that you carefully straighten up on one side of your body in the morning? Even during the day, do you sometimes pull more, sometimes less through the lumbar spine?
Structure of the Lumbar Spine
Our spine is a complex system of bones, muscles, and nerves that must meet great demands. It is particularly affected in our modern daily life: too little movement and long periods of sitting cause back problems.
The spine consists of three sections: the cervical, thoracic, and lumbar spine work together to ensure an upright posture. Being the bony center of the body, it not only provides sufficient stability but also connects the upper extremities, i.e. the arms, with the shoulders, chest, and head. The legs and pelvis are also connected to the spine, mainly through the nerve plexuses.
One of the main functions of the spine is to protect the spinal cord. It runs in the spinal canal and, like the lower part of the central nervous system (CNS), is responsible for movement, among other things.
The Role of the Inter-Vertebral Discs
The intervertebral discs ensure the mobility of the bones. They are found between the individual vertebral bodies and each consist of two parts: an outer ring made up of solid fibers and an inner gelatinous core, made up mostly of water. The supply of nutrients to the intervertebral disc is possible only with the help of loading and unloading.
Due to the high water content, the intervertebral disc forms an excellent shock absorber between the individual vertebral bodies and can dampen pressure loads. If individual spinal discs are not receiving enough nutrients, they cannot do their job optimally. Too little exercise prevents regular interaction between “waste removal” and nutrient absorption. The metabolism stops and, in the long term, signs of wear and structural damage may appear.
What causes lumbar back pain?
Disc Prolapse (Herniated Disc)
In the case of a herniated disc, the viscous material escapes from the nucleus pulposus. The reason for this is a rupture (tear) of the resistant connective tissue that covers the intervertebral disc (annulus fibrosus). The result is severe lumbar back pain or referred pain. The intervertebral discs of the lumbar spine between the L4 / L5 or L5 / S1 vertebrae are affected by 95%. After the lumbar spine, the cervical spine (C5 / C6 and C6 / C7) is the most affected.
No wonder a herniated disc occurs so often – our 23 intervertebral discs act as shock absorbers and pads between the vertebral bodies. They allow for tremendous mobility of the spine and withstand an incredible amount. The shear forces and leverage when carrying and lifting loads on one side increase the stress that occurs during certain movements. The intervertebral discs often support our body weight many times over.
Spinal Canal Stenosis
Spinal stenosis is a narrowing of the spinal canal. The spinal cord flows through the spinal canal. In spinal canal stenosis, bony and/or soft tissue growths, such as an intervertebral disc, press on the spinal cord. The pressure on the nerves, which no longer have enough space, causes symptoms.
The consequences of spinal stenosis are pain radiating to the arms or legs, gait disturbances, or fine motor disturbances. Patients experience an increasingly limited range of motion in their daily life. Spinal canal stenosis often occurs in the lumbar spine between the L 4/5 vertebrae or in the cervical spine (cervical spine).
Lumbago
It is a sudden, often stabbing pain in the lower back, lumbar spine. The vertebral joints are blocked, the muscles are tense and the nerve endings are irritated. Pain and symptoms arise from an interrupted interaction of all the structures involved.
Lumbago is a back problem that makes a person barely able to move due to sudden and severe pain. Fortunately, severe back ailment, such as a herniated disc, rarely occurs behind this. However, many patients walk hunched over. The good news: low lumbar back pain usually goes away on its own.
Misalignment of the spine (Scoliosis)
Spinal misalignment can be congenital or occur due to degenerative processes in old age (scoliosis in adults). These include, for example, diseases such as osteoporosis or facet joint osteoarthritis.
Lateral curvature with simultaneous twisting of the spine can affect the area of the thoracic spine, the lumbar spine, or the transition between these two sections. Advanced misalignments are often very painful and manifest through muscle tension.
The choice of therapy depends on the cause of scoliosis, the age of the patient, and the extent of the scoliotic deformity. An incipient disease is usually treated conservatively with strengthening exercises and physical therapy. Those affected usually wear a corset that stabilizes the spine.
Only very severe cases of scoliosis are treated surgically. The deciding factors here are the degree of curvature and physical deterioration.
Muscular Imbalance
Unequal muscle relationships, which cause pain in the lower lumbar spine. An example of this is weak abdominal muscles with normally strong back muscles. Lifting or carrying unusual loads usually precedes the pain 1 or 2 days before the pain begins (eg, unfamiliar gardening, etc.)
Unfortunately, muscle tension (for example, in the area of the abdominal muscles or in the area of the hip flexor muscle) cannot be seen on either X-ray or MRI. Consequently, when looking for the cause of pain, treatment is often incorrectly focused on the intervertebral discs and small vertebral joints, while functional muscle imbalances are often ignored as the cause of the pain.
Rheumatism
Rheumatism has many faces, it is not an independent clinical picture. More than 100 different diseases belong to it. This includes all “unexplained” pain in the musculoskeletal system: tendons, muscles, ligaments, joints, or connective tissue. Morning joint stiffness, in particular, worries many sufferers. In addition, there is a painful inflammation of the joints or soft tissues. But rheumatism may not only play a role in musculoskeletal disorders. Almost all organs in the human body can be affected. Because there are many different types of rheumatism, this will delay the diagnosis occasionally.
The course of rheumatic disease is highly dependent on the intensity and quality of care. Early diagnosis and consistent treatment are key. Optimal use of all available measures requires special knowledge and experience. With special laboratory tests and X-rays, the rheumatologist will reduce the type of rheumatism.
Osteoporosis
Osteoporosis (bone loss) is a bone disease that often occurs in old age. It decreases bone mass and bone becomes more prone to breaking (fractures). The bone structure also changes. The skeleton (including the lumbar region) becomes unstable due to the less bearing capacity of the bone. In women, the disease usually appears after menopause. Therefore, the risk of developing osteoporosis is significantly higher for women aged 50 and over, at approximately 24%, compared to men, who are affected by only about 6%.
Other causes like broken bones, tumors, and metastasis in the lumbar spine.
What to do with lumbar back pain?
Treatment for lumbar back pain depends on the cause of the pain. First, general therapeutic approaches, such as hot or cold treatments, physical therapy, manual therapy, electricity applications, and traditional pain therapies, can relieve or even cure pain. In addition, the patient must design his daily behavior in a back-friendly manner. Half an hour of exercise a day prevents poor posture and can counteract lumbar back pain. If these applications do not lead to the desired success, special pain therapies, for example, an operation to correct the cause of the back pain and help the patient.
Treatment modalities for lumbar back pain:
1- Physical Therapy
2- Back Exercise (like Back Bridging)
3- Back Support (like Back Braces)
4- Chiropractic Therapy (Manual Therapy)
The physician experienced in chiropractic therapy can release the joint blockage (that causes lumbar back pain) with specific movements or a small twist. Consequently, these movements will interrupt the nerve stimulus briefly, which will decrease muscle tension, and release the joint. The doctor exerts only a minimal force impulse on the joint. However, there may be a clearly audible crack in the connections of the joints when handling. Similarly, a chiropractor treats pain that radiates from the knee, elbow, or hip joint.
5- Pain Killers (Drugs)
Many people with lumbar back pain adopt a relief position to avoid movements that cause pain. However, due to the unnatural posture, this leads to increased stress on the surrounding muscle groups. Non-steroidal anti-inflammatory drugs (NSAIDs) can help break the vicious cycle of lumbar back pain and ease posture. These include, for example, active ingredients such as ibuprofen or diclofenac. You can get it without a prescription in the form of tablets, ointments, or gels at the pharmacy.
6- Transcutaneous Electrical Nerve Stimulation ( TENS )
Transcutaneous electrical nerve stimulation (TENS) is a method of electro-medical therapy that is used primarily for pain management and muscle stimulation.
The electrical stimulation of the skin areas is carried out by means of surface electrodes with the aim of inhibiting the perception of pain through stimulation. The electrical stimulus prevents the nerves from transmitting pain between the brain and the place where the pain originated (like the lumbar region). The process also stimulates the formation of endorphins (which are the body’s own substances that help relieve pain).
7- Surgery (in some certain circumstances)
How should one lie with lumbar back pain?
A distinction is made between people who sleep on their back, stomach, and side. The worst position for people with low back pain is the prone position. Since you are lying on your hollow back for several hours, the surrounding muscles tighten and start to ache. If you still don’t want to give up your favorite sleeping position, you can place a flat pillow under your belly.
In general, it is important to pay attention to a suitable mattress. It should be neither too soft nor too hard for the spine to have adequate support. You should also form a straight line when you sleep.
Conclusion
Lumbar back pain is rarely due to a damaged disc or a herniated disc. Muscle overload is the reason for this much more often. Consequently, the treatment will focus on this cause.
If pain persists after conservative therapy, doctors should do more investigations to detect the specific cause of the pain. At the latest when neurological deficits appear, such as tingling, a feeling of heat or cold without external causes or numbness, disc damage or damage to the spinal nerves must be considered. Appropriate targeted treatment is then more effective.
References
https://www.nhs.uk/conditions/back-pain/
