Lower Back Pain: the Causes, and 5 Ways to Prevent and Relieve
Many people have had to experience it. Lower back pain. Low back pain can cause severe discomfort and even affect your quality of life.
How does this happen? Which group is most likely to experience back pain? Dr. Joshua Li is an associate professor at University of Virginia’s Department of Biomedical Engineering. spine A surgeon who is a doctorate holder in bone mineral research gave a detailed explanation of the causes and presented treatment options for lower back pain.
Anatomy of Spine
Lower back pain can be understood by understanding the anatomy and tissues of the spine. The spine is made up of four components: the vertebrae and intervertebral discs as well as nerves and muscles.
The spinal column is divided into four areas: the cervical, thoracic and lumbar regions, as well as the sacral. Seven vertebrae make up the cervical spine. The curvature curves to the front and is convex. Twelve vertebrae make up the thoracic spinal spine. The curvature curves to the rear and is concave. Five vertebrae make up the lumbar. It is crucial to consider the curvature that results from the alignment of your spine. Poor posture and difficulty standing can be caused by an excessively inward or outward arched.
Between the vertebral bodies are the intervertebral disks. They are circular and flat in shape and approximately one to three mm thick. The intervertebral disk is composed of two components: an inner jelly-like nucleus, and an outer elastic annulus fibrusus. Intervertebral disks are designed to absorb shocks that can be generated by movement.
The spinal cord is protected by the canal formed by the connecting vertebral bodies. Each vertebra connects to a vertebral arch. The arrangement of the arches creates the intervertebralforamen, from which the spinal nerves extend. This modulates sensory and motor information in both the extremities.
Muscles surround the spine. Strong muscles can relieve the pressure from the vertebrae and support the spine to maintain its correct position.
Lower back pain can be caused by problems in the intervertebral discs, vertebrae, muscles, and nerves.
Which group of people is most likely to experience lower back pain?
Low back pain is more common in three groups.
1. People whose profession involves carrying
Heavy loads are often carried by delivery people or construction workers.
2. Driving is a job for people who are in the driving profession.
Vertical vibrations are common for taxi drivers and truck drivers. This pressure can lead to deformation of intervertebral discs.
3. Office worker
These people are likely to have poor posture and sedentary habits, which can lead to an excessive load on the spine and gradual flattening intervertebral discs. This results in lower back pain.
Four Causes of Lower Back Pain
1. Acute lumbar spinal injury
This is especially common in young people who are more likely than others to engage in vigorous sports like volleyball or badminton.
People frequently stretch out their backs and turn during strenuous exercise. This could lead to muscle strain, muscle fiber injury, microvascular rupture and other conditions that can cause muscle spasms.
2. Disc herniation
The intervertebral disk herniation occurs when the outer annulus fibrusus of the intervertebral disk loses its strength and elasticity.
The structure of the entire intervertebral disc is similar to a common snack—a jelly donut. The nucleus pilosus is jelly-like, and the annulus fibrus is jelly-like. A herniated disc can be compared to jelly being squeezed from a donut.
After the nucleus pulposus herniates, the intervertebral disc becomes thinner and loses its cushioning function—then vertebrae are more likely to collide with each other during activities, causing lower back pain.
If it presses on a nerve, a protruding nucleuspulposus can cause lower back pain. A herniated disc can compress the sciatic nerve, causing numbness and pain in lower back and lower legs. It can also cause muscle weakness.
A herniated disk can also cause inflammation.
The intervertebral Discs do not have a blood supply so the immune system doesn’t recognize it. The immune system will therefore recognize the protruding Nucleus pulposus and send immune cell to attack the intervertebral Disc, causing inflammation. An inflammation that causes nerve irritation can cause pain.
Surprisingly, herniated disks are more common among younger people.
This is due to the fact that younger people tend to lift heavier objects, and thus have a greater chance of being injured. The second reason for this is that the nucleus pulsus of young people is more fluid and water-rich, and therefore is more likely protrude. However, the nucleus pulsus of older people is less solidified and has a lower water content, and is less likely protrude.
3. Spinal stenosis
Degeneration can cause the intervertebral spine discs to lose enough strength. The surrounding tissues will then proliferate to protect the nerves.
The growth of facet joints and ligaments around the spine can lead to a narrowing of the spinal canal which will further compress the nerves.
The most common sign of spinal stenosis in the elderly is “intermittent claudication”—the patients’ legs and lower back will hurt after walking for a short distance, and they have to sit down and rest for a while to relieve the pain before continuing to walk.
One sign that spinal stenosis can cause is difficulty standing up. When a person is standing straight up, the spinal canal volume shrinks. Patients with spinal stenosis prefer to lean forward because it increases the volume of their spinal canal, reduces nerve compression, and can reduce pain. Senior citizens often hunch over and use crutches.
4. Compression fracture
This is a serious condition which requires extra attention.
In the elderly, especially those who are postmenopausal, compression fractures are quite common. These people are most likely to have osteoporosis and their bones can be quite fragile. Fractures can occur in the front vertebrae from lifting heavy objects and falling forward while leaning forward.
Below is an X-ray image that shows how the front of the first Lumbar vertebra is shorter, while the rear remains at a normal height. Thus, the wedge shape.
How can you tell if there is a compression fracture? It could indicate a fracture if there is crackling sound after an elderly person falls.
It may also be a sign of a compression fracture if the lower back is not hurting after a fall, but there is no neuropathic pain or radiating pain in your legs.
Different Lower Back Pain Conditions Require Different Treatments
• Acute lumbar spinal injury
Rest, medication (medicines to relax muscles) and cold compresses (to lower inflammation can all help.
Most people’s symptoms are relieved with rest, medication, and cold compresses without the need to see a doctor.
However, only 5% of patients will experience persistent or chronic pain that lasts more than 4 weeks. To rule out organic lesions, it is important to visit a doctor.
• Disc herniation
There are five major categories of treatments.
It is possible to use conservative treatments if there is no sign of muscle weakness, persistent numbness in the hands or feet.
- Medication: Use nonsteroidal anti-inflammatory medications such as ibuprofen.
- Physiotherapy: Strengthen your lower back muscles or stretch the nerves to loosen compression.
- Alternative treatments: You can try acupuncture, massage and cupping. If the symptoms of nerve compression or pain persist after the three previous treatments, it’s important to consult a doctor promptly to obtain further treatment.
- Steroid injections – Steroids are injected through the disc using a syringe. This reduces inflammation.
- Surgical treatment: This is not a last resort, and over 95 percent of patients don’t need it.
Some lower back pain conditions must be treated as soon as possible with surgery
The only reason to consider surgical treatment is if your muscles are weak and you feel persistent numbness in your hands and feet.
Rarely, complications like a dural tear can occur after surgery. It is unlikely that it will happen, but it is better to avoid it. Local scar tissue may form following surgery which can increase the difficulty of the next procedure.
However, severe neurological symptoms should be treated as soon possible. The nerve could be irreparably damaged if it is not performed promptly.
Doctors rely on minimally invasive surgery to perform most of their procedures. The incision is usually only 2-3 millimeters. This surgery significantly reduces the pain, and the patient’s symptoms of muscle weakness and skin numbness will gradually improve.
Multiple medical professionals have indicated that patients are able to fully recover after four months of muscle weakness. Patients may not be able fully to recover after four months even if they have had surgery.
How to Care for the Lumbar Spine, Prevent Lower Back Pain.
The five methods below can help you prevent or relieve lower back pain.
1. Maintain a healthy posture
You should sit straight up and not lean forward.
Below is a diagram showing the pressure placed on the lumbar spine by different positions. The blue bars refer to data from a 1999 study.
Both studies found that intervertebral pressure drops when a person lies flat on their back. It increases when they lie on the sides.
If a person sits while leaning forward, the pressure on their intervertebral Discs is twice that of when they are standing. When a person sits back, the pressure on their intervertebral Discs will drop. Standing and leaning forward puts the most pressure on the discs.
Why is it that sitting forward causes more pressure on the intervertebral discs than standing.
Chinese say, “Talking while standing does not hurt your back.” It is true. The support of the upper body comes from three forces: the abdominal muscles, the spine, and the lumbar muscle at the rear. Standing allows for some pressure to be taken off the spine by contracting our abdominal and back muscles.
When we sit or lean forward, our abdominal and back muscles relax, which leaves only the spine and intervertebral disks to bear the pressure. This increases the chance of a herniated disk.
2. When lifting heavy objects, use proper technique
Your spine should be straight. People who lift heavy objects improperly can develop herniated disks.
When lifting weights, be sure to bend your knees while keeping your spine straight. Instead of using your back muscles, use your legs and calves to lift the weight.
3. A firm mattress is best for sleeping.
It can support your spine.
When we sleep on a soft mattress, our hips and back are not supported properly. This prevents the natural curve of the lumbar spine. This causes muscle soreness and tension in the back muscles.
4. Use a lumbar pillow
It can help relax your lower back muscles.
You can place a small pillow behind your waist while you are lying down or sitting to support the natural curve of your lumbar spine. This will help relax the lower back muscles.
5. Stop smoking
Smoking accelerates disc degradation
The nicotine in tobacco products will prevent the body’s nutrients from entering the intervertebral disc, which will accelerate its degeneration, thinning, and weakening. The nucleus pulposus will protrude from the intervertebral disc when this happens.
An X-ray can show whether the patient smokes. A person with many bone spurs (osteophytes), or thinning intervertebral disks, is most likely to smoke.
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