Causes of lower back pain – in 90% of cases, pain is caused by problems with the spine and back muscles; in 6%, the cause of pain is kidney disease; 4% – diseases of other internal organs (genitourinary system, intestines).
Most often, back pain is associated with the following diseases:
- Compression of the nerve root, which causes symptoms of sciatica and is most often due to a herniated disc. As a rule, with compression of the nerve root, the pain is acute, has irradiation and sensitivity disturbances in the zone of innervation of the nerve root. A herniated disc occurs mainly as a result of degeneration of the disc. There is a protrusion of the gelatinous part of the disc from the central cavity and pressure on the nerve roots. Degenerative processes in the intervertebral discs begin at the age of 30 and older. But the very presence of a hernia does not always lead to an effect on the nervous structures.
- Spondylosis – degenerative changes occur in the vertebrae themselves, bone growths (osteophytes) appear, which can affect nearby nerves, leading to pain.
- Stenosis of the spinal canal may occur due to degenerative changes in the spine (spondylosis and osteochondrosis). A patient with spinal stenosis in the lumbar region may experience low back pain radiating to both legs. Lumbar pain can occur as a result of standing or walking.
- Cauda equina syndrome. This is a condition requiring emergency medical attention. Cauda equina syndrome occurs as a result of compression of the elements of the cauda equina (terminal part of the spinal cord). A patient with cauda equina syndrome may experience pain and dysfunction of the intestines and bladder (incontinence and bladder atony). This syndrome requires emergency surgery.
- Pain syndromes such as myofascial pain syndrome or fibromyalgia. Myofascial pain syndrome is characterized by pain and tenderness at certain points (trigger points), decreased muscle movement in painful areas. The pain syndrome decreases with the relaxation of the muscles located in the painful zones. In fibromyalgia, pain and soreness is distributed throughout the body. Fibromyalgia is not characterized by tightness and pain in the muscles.
- Non-communicable inflammatory diseases of the spine (ankylosing spondylitis) can cause stiffness and pain in the spine (including the lower back itself), which is especially worse in the morning.
- Inflammation of the nerves and, accordingly, pain manifestations (in the chest or in the lumbar region) may be due to damage to the nerves themselves (for example, with herpes zoster)
Given the variety of causes of symptoms, such as acute or subacute low back pain, it is very important to fully examine the patient and perform all necessary diagnostic procedures.
After establishing the diagnosis and confirming the vertebral origin in lumbago and lumbalgia, a specific treatment for low back pain is prescribed.
In acute pain, rest is necessary for 1-2 days. Bed rest allows you to reduce the load on the muscles and reduce muscle spasm. In most cases, when the pain syndrome is due to muscle spasm, the pain syndrome decreases within a few days without the use of drugs, only due to rest.
Medicinal pain relief. For pain syndrome, drugs of the NSAID group (Meloxicam, Ibuprofen, Diclofenac) are used. COX-2 inhibitors, such as Celecoxib (Celebrex), have fewer side effects, but long-term use of these drugs also has certain risks. Considering that all drugs of this group have a lot of side effects, taking drugs of this group should be short and under the obligatory supervision of a doctor.
Muscle relaxants (baclofen, dantrolene, and tizanidine) can be used to relieve spasm. But the use of these drugs is effective only in the presence of spasm.
Steroids may be used to treat pain, especially when there are signs of sciatica. But due to the presence of pronounced side effects, the use of steroids should be selective and short in time.
Manual therapy. This method can be very effective in the presence of muscle blocks or subluxations of the facet joints. Mobilization of motor segments can reduce both muscle spasm and lower back pain.
Physiotherapy. There are many modern physiotherapy procedures that can both reduce pain and reduce inflammation, improve microcirculation (for example, electrophoresis, cryotherapy, laser therapy, etc.).
Simple, but effective method Lumbarest therapy. At the end of the twentieth century, the German scientist K. Kinlein developed a technique for safe traction (stretching) of the spine and comfortable relaxation of the back muscles. It should be said that the professor himself suffered from severe back pain after a compression fracture of the spine. With the advent of that system, many “hopelessly” ill patients have a chance to return to normal life.
Using his technique in the United States, we made the Lumbarest system, which is a special rib mattress that best meets the natural curves of the body. The structure is made of a special material that has unique abilities to adapt to a specific organism and find the most comfortable position for the spine.
Lying close to the body and supporting it with ribs, Lumbarest allows you to evenly distribute the load of the spine in a different state (on the side, back, on the stomach). This neutral position of the body helps to relax the muscles of the back, relieve tension from the intervertebral discs and slightly stretch the spine itself.
Stretching the spine frees up the discs, allowing them to once again receive the fluid and nutrients they need, as well as the ability to increase their height. Thus, gentle stretching and relaxation of the spinal muscles allows you to completely regenerate damaged discs, improve and stabilize the condition of the spine, and correct posture.
Important note! Due to the beneficial effect of Lumbarest therapy on the spine, the general condition of the patient also improves. This is due to better sleep, improved circulation of the spine and the release of pinched nerve roots, and hence the establishment of the work of all body systems.
Therapeutic exercises. For acute pain in the lower back, exercises are not recommended. Connecting exercise therapy is possible after reducing the pain syndrome. In the presence of chronic pain, exercise can be very effective in strengthening the core muscles and improving spinal biomechanics. Exercises should be selected only with an exercise therapy doctor, since often independent exercises can lead to increased pain manifestations. Systematic exercises of exercise therapy, especially in the presence of degenerative changes in the spine (osteochondrosis, spondylosis), can preserve the functionality of the spine and significantly reduce the risk of pain syndromes.