Back pain lower back – causes, treatment and prevention

Back pain is a common ailment. Medicine distinguishes between acute, subacute and chronic back pain. Acute back pain is pain that occurs suddenly. They last no longer than six weeks. However, if the back pain exceeds this period, it is the subacute form. Chronic back pain is when the patient suffers from the symptoms for more than 12 weeks.

But the position of the pain is also important for the doctor. The most common type of back pain is lower back pain. The pain occurs in the lumbar spine or between the sacrum and the coccyx. This can be attributed to the fact that this section is the most stressed part of the back. For this reason, muscle tension and herniated discs are particularly common there.

Back pain in the lower back accounts for about 60 percent of all back disorders. Doctors then also speak of lumbar syndrome or lumbago. In some cases, the pain radiates from the lower back to the legs . In the worst case, signs of paralysis are also possible.

causes

Low back pain occurs for a variety of reasons. In most patients, irritation of the nerves, tense muscles, overstressed joints , signs of wear and tear or poor posture are the causes of the painful symptoms. Another common reason is a herniated disc. This results in part of the disc being squeezed out between two vertebral bodies.Other conceivable causes of lower back pain are injuries, rheumatic-inflammatory diseases, vertebral or nerve inflammation due to infections or malformations of the lumbar spine. One of the most common triggers for back pain in the lower back section is impairment of the sciatic nerve (Nervus ischiadicus). Sciatica originates in the lower lumbar spine, where its roots begin. The sciatic nerve travels further down the leg and branches out there. If there is mechanical irritation of the sciatic nerve due to a herniated disc, tension, overload or injuries, this results in pain in the lower back section, which can radiate into the leg.

Not infrequently, a lack of exercise is also responsible for the complaints in the lower back. Too little movement of the spine leads to slackening of the ligaments, which in turn leads to pain. Excessive strain on the back, such as lifting or carrying heavy loads, can also result in pain. Another possible cause of back pain in the lower back area can be osteoporosis (bone loss), which leads to the breakdown of bone substance. If the deterioration continues, there is a risk of the edges of the vertebral body breaking off, which in turn triggers incorrect loading and incorrect posture of other spinal structures, causing pain in the lower back.

Diseases

• disc prolapse

• Lumbar syndrome

• lumbago

• rheumatic inflammatory diseases

• nerve inflammation

• vertebral inflammation

• Ischiassyndrom

When to the doctor?

Although low back pain can be severe and severely restricts mobility, it is not always an emergency. They usually subside quickly with a stepped positioning and relaxation of the back muscles.

However, if the pain persists for more than three days or if the intensity of the pain increases very quickly, a doctor’s visit is unavoidable. Even if pain in the lower back increases and changing posture or positioning no longer changes the pain, it is necessary to have the cause clarified. In connection with a poor general condition and fever , back pain also belongs in the hands of a doctor.

Emergencies include lower back pain when accompanied by numbness or paralysis. The same applies if breathing difficulties or functional disorders of the intestines and bladder occur. A quick search for the cause is necessary here. Various examination methods are available to the doctor for this purpose. Depending on the findings, he will initiate appropriate treatments to eliminate the disorder.

diagnosis and course

During an examination of the back, the doctor looks at the patient’s medical history. It is important for further treatment to find out the exact cause of the symptoms. He therefore asks the patient whether the pain is acute or chronic, how severe the symptoms are, whether there are previous illnesses and other symptoms.

Local complaints in the cross region are also important. If the pain radiates into the thighs, this is considered an indication of a nerve blockage, which can be caused by degenerated vertebral bodies or herniated discs, among other things. Nerve involvement is most commonly present when the patient suffers from neurological symptoms such as tingling, numbness , movement disorders, or incontinence. The doctor receives information about degenerative changes in the spine using imaging methods such as an X-ray examination, computed tomography (CT) or magnetic resonance imaging (MRI) .. Since the back pain in the lower back usually subsides after a few days or weeks, the course of the symptoms is usually positive. In some cases, however, it can lead to chronic back problems.

complications

Back pain in the lower back is a major impairment of general well-being. Emotional distress increases and mood is depressed. They are often associated with incorrect muscle strain or one-sided movement. The muscle fibers are damaged and trigger the symptoms. Severe cases can result in herniated discs or nerve damage. In addition to physiotherapy and specific sports exercises to strengthen the muscles, surgical interventions are often necessary to permanently relieve the pain.

Back pain causes bad posture. The musculoskeletal system is restricted and everyday activities cannot be carried out as usual. Sitting or standing activities are no longer experienced without symptoms. Bone damage to the spine, pelvis or hips can occur. Osteoarthritis , gout or rheumatism are possible chronic diseases that can occur. circulatory disordersare other complications that can arise from back pain. The muscles and nerves are no longer sufficiently supplied with the necessary nutrients and messenger substances. Sensory disturbances or numbness in the back can occur. Back pain in the lower back is considered a symptom of psychosomatic illnesses. A general overload or persistent stress are the most common triggers. Taking painkillers leads to other health problems for many people. The mucous membranes are attacked, resulting in gastrointestinal problems.

treatment and therapy

Usually, conservative methods of treating low back pain are sufficient. The therapy focuses on relaxing and strengthening the muscles, physical therapy that includes the application of cold , heat or vibration, and movement therapy. These measures can usually have a positive influence on the symptoms, so that freedom from pain is achieved again. In addition, the patient has the option of taking local painkillers .

In the case of degenerative low back pain , preparations containing vitamin D or calcium can also be given. However, if there are pronounced symptoms, the nerve blockage must be removed quickly. This is usually done by surgical intervention on the intervertebral discs. The surgeon removes the substance that has escaped from the intervertebral disc, which reduces the pressure of the disc substance on the nerve. Relieving the nerves, in turn, prevents chronic damage to the lower back. In addition, pain and symptoms of paralysis subside again. After the disc operation, the patient has to rebuild his muscles through physiotherapy.

prevention

Strengthening the back muscles is a good way to prevent lower back pain. In addition, the back should be relieved by movement. Suitable sports are Nordic walking and water aerobics. It can also be helpful to lose excess weight that puts a strain on your back.