Pain in the Lower Back: Lumbar back pain, commonly referred to as lower back pain, is the most common spine ailment. Due to it, it is impossible to maintain the correct body posture. This type of pain should not be underestimated under any circumstances, as it often indicates one of the diseases of the spine. Find out the causes of back pain in the lumbar region and how to treat them.

The causes of Pain in the Lower Back

There are many causesof back pain. They usually appear between the ages of 30 and 50 – they are the result of both physical and mental health problems. Lumbar back pain often comes on suddenly and can last up to several weeks. Identifying the cause is not always a simple task, even with tests and imaging studies. There are direct and indirect causes of pain.

Direct causes of lower back pain

The immediate cause of damage to the lumbar spine is mechanical damage – then the joints, nerves, ligaments, vertebrae and intervertebral discs are injured. It often results from excessive overloading of the muscles stabilizing the spine, incorrect posture of the body, degenerative changes, bone tissue defects in the vertebrae, acquired and congenitalspine defects.

The direct cause of back pain are often injuries – e.g. falling from a height,lifting weightsor improperly performed physical activity. Lower back pain can also be caused by a traffic accident. It can also result from injuries to the intervertebral disc. It’s also important to know that lower back pain can be genetic.

Indirect causes of Pain in the Lower Back

A sedentary lifestyleis one of the leading causes of back pain in the lumbar region. The advancement of technology has meant that many people, both adults and children, spend most of the day in front of the computer. This makes unconscious adopting a bad posture cause back pain over time. When sitting, the load is as much as 140 kg, and when you lean forward, the load increases by as much as 45 kg!

Poor sitting posture puts pressure on the nerves – the results areheadaches, numbness in the upper limbs and dizziness. The more incorrect the posture is, the more work the muscles have to do. Prolonged bad posture causes the muscles to tire and as a result pain ailments appear, e.g. humping is the cause of the abolition of lumbar lordosis.

Lack of exercise – Lack of exercise is a common cause of back pain. A sedentary lifestyle weakens the muscles and ligaments, so physical activity to strengthen the deep muscles is always good forthe spine. For help in this matter, it is worth asking a physiotherapist or movement therapist. Properly selected exercises will strengthen the muscles that will stabilize the spine.

It is also worth doing functional training with your own body weight. It is also recommended to use resistance bands and aerobic exercises. You can also use additional accessories, e.g. kettlebell. Stretching exercises will also help. Functional training makes you more mobile and eliminates muscle imbalances.

Lower back diseases

The surroundings of the spine are strongly innervated, so it is not difficult for pain phenomena to appear in it. Pain in the lumbar spine most often affects both professional and amateur athletes. The second group of patients are people who work for many hours in sitting positions. The most common lower back conditions are:

1. Discopathy

These are degenerative changes in the intervertebral disc caused by overload of the spine, degenerative changes or age. Discopathy causes severe pain in the spine and most often affects the elderly, although it affects more and more people between 30 and 50 years of age. It is caused by a lack of exercise resulting from a sedentary lifestyle or an excess of exercise.

In people with discopathy, the nucleus pulposus protrudes or falls out as a result of a rupture of the fibrous ring. The disc protrusion puts pressure on the spinal meninges, spinal cord, ligaments and nerve roots. The pain is mild at first, but it gets worse over time. In the advanced stage of the disease, it becomes acute and impedes movement.

Lumbar discopathy is usually treated conservatively. The goal of the orthopedist is to relieve pain – therefore, he can administer, for example, non-steroidal anti-inflammatory drugs to the patient. In addition to them, he may also order the taking of muscle-relaxing drugs that reduce the tension of the paraspinal muscles. Patients with severe discopathy are recommended to sleep on a hard surface.

1. Degeneration of the spine

They are caused by a lack of synovial fluid in the joints – it is quite common in the elderly and people who do not move much. As a result, the articular cartilage becomes weaker and unevenness forms on it. The total absence of synovial fluid in the joints causes the bone to rub against the bone and thus severe pain – pain occurs when trying to make a movement. The strained parts of the vertebrae later become covered with osteophytes, which causes the joints to lose their original shape.

Initially, degeneration of the lumbar spine is hardly felt, so many patients ignore it. The first symptoms are a feeling of stiffness in the lower back – most noticeable when you wake up and sit in one position for a long time. As a result, the back becomes less mobile and the patient may have trouble touching the floor with his hands.

To slow down the development of degenerative changes in the lumbar spine, you should practice various exercises, e.g.swimming, swimming, walking, and aerobics. Proper rest is important – it is recommended to sleep on a comfortable mattress and orthopedic pillow. Avoid abrupt extending from a flexed position. When the defect is found by a doctor, it may be necessary to purchase an orthopedic insole. It is also advisable to change positions frequently so as not to burden the spine.

1. Osteoporosis

Osteoporosis bones, in this case those at the bottom of the spine, are less durable and therefore more prone to fractures. This is due to decreased bone mineral density. A person with osteoporosis may not experience symptoms for many years until the bones become weak at some point. Pain is felt during movement, mainly when sitting down and standing up, and in the acute phase during any activity.

Osteoporosis can be caused by genetic factors – it is usually inherited from your mother or grandmother who also had osteoporosis. This does not mean, however, that everyone who has had it in the family will also get sick – each person inherits features differently. Nevertheless, it is worth realizing it at some point and examining yourself in this respect. Another risk factor is a weak physique and a small amount of exercise.

Drugs used in the treatment of osteporosis arebisphosphonates, denosumab, teriparatide, raloxifene. Sometimes doctors also recommend hormone replacement therapy. The most popular drugs in the treatment of osteporosis in men and women are bisphosphonates. Other drugs, such as denosumab, inhibitbone resorption– it is used in the treatment of osteoporosis in postmenopausal women.

Pain in the lower back – treatment

There are several types of physiotherapy that are used to treat lower back pain.

1. Manual therapy according to IFOMPT standards

It is a physiotherapeutic method aimed at treating dysfunctions of the neuromuscular and skeletal system. Before starting any activities with the use of this technique, the physiotherapist conducts an interview with the patient and orders tests to be performed – after the initial analysis, he proceeds to assess the patient’s health and establish the therapy.

Manual therapy according to IFOMPT standards uses various therapeutic measures. They also include various types of exercises, but they are always selected individually for the patient. Each patient is treated individually – the criteria for selecting exercises are even the patient’s interest and the profession. Due to the holistic view of the patient, manual therapy is used both in the treatment of diseases of the lumbar spine and other diseases.

1. Mc Kenzie method

The McKenzie method was created by Robin McKenzie in the 1950s. It is the best documented method of rehabilitation of the spine and sciatica. The main goal of therapy is to reduce pain and enable the patient to recover as quickly as possible. It is used in the treatment of patients with mechanical injuries, e.g. discopathy.

High efficiency in the treatment of diseases by the Mc Kenzie method is due, among others, to from an interview conducted by a doctor or physiotherapist with the patient at the first stage of treatment. Thanks to the collected information, he assigns the patient to one of the groups. In addition to the interview, clinical trials and additional tests are also carried out. Thanks to this, the doctor /physiotherapistknows all the pain ailments of the patient.

The Mc Kenzie method is recommended for patients with chronic spinal hernia, lumbar discopathy (also thoracic and cervical). Exercises to support the treatment of the lumbar region depend on the topography of pain. Contrary to appearances, they are not only hyperextensions – during treatment, combinations of flexion and extension mechanisms are used. Mc Kenzie therapy often avoids surgery.

1. Manual therapy by Brian Mulligan

Its creator is a New Zealand physiotherapist Brian R. Mulligan. The Mulligan method is a manual method consisting in the treatment of diseases of the peripheral joints, the spine and sacroiliac joints. Before starting the therapy, the physiotherapist conducts an interview with the patient and orders tests to be performed to locate the source of the pain. Patients feel the benefits of treatment immediately.

When the Mulligan Method is applied to the lumbar spine, therapy is initiated at the site of pain. Thanks to the method, it is possible to combine the passive movement of the physiotherapist and the active movement of the patient. Within the spine, physiotherapists use NAG and SNAG techniques. The NAG technique is an oscillating slide; the SNAG technique is an extended natural oscillating slide.

The Mulligan method is recommended for people including with dysfunctions within the spine and peripheral joints, for patients with intercostal disc disease and suffering from dizziness resulting from spinal injuries. The therapy, when properly performed, is painless and safe. However, in order for it to be effective, the patient should strictly follow the individual recommendations of the physiotherapist.

1. Orthopedic method according to Cyriax

The Cyriax orthopedic method, developed by the English surgeon James Cyriax, is a diagnostic and therapeutic system that focuses on the treatment of people with musculoskeletal disorders. In this way, it is possible to treat spinal injuries in the lumbar, cervical and thoracic spine, as wellas tendinitis, muscle contusions anddisc hernia.

The Cyriax orthopedic method is aimed at patients with problems with the locomotor system. The largest group of patients using it are patients with back pain – this is the type of pain that as many as 85% of people struggle with once in their life. There are many athletes among the patients treated with this method. Therapeutic measures are used in the therapy, such as: transverse massage, mobilization, traction and tightening the bag.

1. Soft tissue therapy

Soft tissue therapy is a set of manual techniques aimed at reducing tension and dysfunction within muscles, ligaments, joint capsules, muscle attachments, tendons and fascia. Physiotherapists use, among others with the techniques of muscle energy and active relaxation. Soft tissue therapy, although it can sometimes cause pain, is completely safe for the patient. Its effectiveness is supported by scientific research.

It is one of the manual therapies. He uses techniques of the myofascial type, functional massage, deep tissue massage, trigger point therapy and muscle energization techniques. It is appreciated for restoring balance by reducing adhesions and pathological tensions. It also accelerates tissue regeneration. Thanks to it, the patient regains the full range of movements.

Soft tissue therapy, in addition to treating lower back pain, is used in the treatment of various back pain, tension headache, pain in the jaw, groin and perineum. It also helps in the treatment of degenerative and rheumatic diseases and posture defects such as scoliosis and varus of the feet. What’s more, it is used in the case of swelling, scars and after operations when the joints are immobilized.

1. Neuromyblizations

This is one of the methodsof manual therapythat allows direct stimulation of nerve tissues. Neuromobilization is helpful in improving the mobility of nerves and their sliding in relation to the surrounding tissues. At the beginning of therapy, the physiotherapist establishes the pathological process. Treatment involves tightening and stretching the nerve to move its internal and external structures – this is possible thanks to the angular positioning of the joints where the nerve runs.

Patients with diseases such as tears, discopathies, hyperaesthesia,tinglingand tingling often participate in neuromicrobial procedures . It also helps in the treatment of muscle disorders, loss of muscle strength, and abdominal dysfunction and ailments. Neuromoblizations help in the treatment of burning, radiating and stressful pains.

Lower back pain – exercise

Moderate exercise helps to combat pain in the lumbar spine and strengthens the deep muscles. Exercises that can be performed at home include, among others classic cat’s back. Nevertheless, it is worth consulting a physiotherapist in advance so that he can choose a set of exercises and possibly help in their implementation.

The following exercises are not a recipe for back pain, but can be done prophylactically as they improve muscle function. What’s more, if you do exercise regularly, your overall fitness will also improve. In order for the exercises to bring the expected results, they should be performed every day – each of them for about 20 minutes in 3 or 5 series. If exercise hurts you, give it up.

1. Cat’s back

Cat’s back is an exercise that strengthens the thoracic spine and is effective in treating pain in the lumbar spine. Exercise relaxes the spine and warms up and relaxes the muscles. Thanks to it, the muscles are no longer stiff. What’s more, doing the cat’s back also improves blood circulation and protects the spine.

Begin the exercise in a propped kneeling – lean on your arms at the elbows and shift your body weight onto them. Hands should be placed shoulder-width apart; thighs and arms parallel to each other. In the first stage of the exercise, the head should be in a straight line with the spine, so it should not be lowered to the floor or lifted upwards.

In the second stage of the exercise, we perform the cat’s back. When flexing the spine, inhale air through the mouth – the thoracic spine should be pushed upwards and the head tucked between the shoulders. You should persevere in this position for a few seconds, then lift your head up and slowly lower your spine so that the abdomen is low, as close to the floor as possible – the exercise should be repeated about 5 times

1. Other exercises

Exercise 1 – The starting position should be a propped knee. Pinch your shoulder blades together and straighten your back while inhaling. Sit on your heels and stretch your arms out as far forward as you can. The position you perform is also known as the “Japanese bow” – breathe out while extending your arms. Before doing the exercise, you can warm up, thanks to it, the elastic structure of the spine will relax.

2nd exercise – the starting position should also be propped on the knees. Extend your right arm forward and your left leg backward and inhale. Bend your left leg at the knee; Bend your right arm at the elbow and pull it towards your chest. The right elbow should touch the left knee – breathe out at this stage of the exercise. Then come back to the starting position and repeat the exercise.

How to avoid lower back pain?

First of all, you should dophysical activity tostrengthen your back and abdominal muscles – this is especially important when you work at a desk on a daily basis. You should also take care of the correct posture and hygiene at work, e.g. taking breaks for movement and stretching the muscles. It is also worth learning the principles of lifting weights on a straight back – the entire load should be transferred to the legs.

Diet is also important. In order to avoid back pain, it is worth eating foods rich in vitamins, minerals and compounds that build muscle mass andtendons– you should also take care not to be overweight. Preventive actions can help. Thanks to them, the probability of nagging pain will be almost zero.

Lower back pain in a child

A child with back pain, including the lumbar region, should change their daily habits. It is advisable to start exercising and follow a balanced diet. Some pain conditions can be treated with compresses, baths, and mild painkillers to reduce inflammation, but these are temporary measures.

Propersleep hygieneis important . The child should sleep on a hard mattress and place his head on a small pillow – sleep should last continuously for 8 to 9 hours. When the back pain becomes persistent, you should immediately visit a physiotherapist or orthopedist with the child. In the fight against pain, manual therapy, massages and exercises will help. From an early age, it is worth teaching your child good habits to take care of posture and take a lot of exercise.