Lower Back Pain
Lower Back Pain is one of the most common reasons why a doctor visits . The reasons for this are generally stress levels in everyday life caused by sitting too long in the office or doing heavy physical work. If lower back pain occurs, itaffectsthe lumbar spine, which is the lowest part of the spine.
While lower back pain often used to be due to overwork and overuse after physical work, lack of exercise and poor posture, such as when working on the computer, are often the causes of lower back pain , which can also be felt as pulling or burning in the lower back pain . If the person does not move sufficiently, stable muscles are not formed around the spine, resulting in instabilities.
The lower back is exposed to high loads because it has to carry a high percentage of body weight. If the muscular musculoskeletal system is insufficiently developed, numerous diseases can develop that cause pain in the lower back.
In the following, common diseases are presented:
Muscle tension is the most common reason for lower back pain. They arise when the musculature in the spine is overloaded or irritated by malposition and are a protective mechanism and warning signal of the body. Often they also occur due to stress, as stress is associated with increased muscle tension. Due to the pain that the tension brings, the body takes on an unnatural posture, which in turn leads to tension and pain, so that the patient is drawn into a vicious circle.
Therapy of muscle tension
In therapy, it is important that the vicious circle of pain is broken through consistent action. Helpful in this case are the intake of anti-inflammatory analgesics such as ibuprofen or diclofenac for a few days. By inhibiting the pain, a natural posture can be taken again and movements can be carried out. Lower back heat treatments can also relieve tension and relieve pain.
Other physical treatments like massages are also helpful. Especially stress-related tensions can be treated with targeted relaxation exercises . In the long term, it is advisable to operate muscle in the area of the spine. This helps to make the spine support more robust and less likely to cause tensions due to bad posture.
Lumbago ( lumboischialgie )
The lumbago, also called lumbosia, is characterized by a sudden onset of lower back pain. In addition, the pain is transmitted to the leg. This pain is caused by the irritation of nerve roots, which emerge between the vertebral bodies . The reason for this is often a tense back muscles. The tense muscles can put pressure on the nerves and thus cause a mechanical irritation.
The pain radiating into the leg is also due to such irritation, it usually affects the sciatic nerve on the back of the leg. In addition to tight muscles can also have a bulging disc (see below) or degenerate intervertebral joints ( Facet joint osteoarthritis , see below). Nerve roots in the lower back irritate and lead to a lumbago.
Therapy of lumboischialgie
Basically, it is important to determine the cause of the symptoms and then to specifically treat them. For muscle tension, the therapies presented above are helpful. Important for severe pain that occurs in the context of a lumboischialgie is that a sufficient drug pain therapy is done so that the patient can move and does not remain in restraint.
It is also important in this context that the chronification of the pain can be prevented. In order to avoid a recurrence of lumbago in the long term, it is important to build muscle. A stable lower back spine is essential for long-term symptom relief.
Spinal disc bulging of the lumbar spine and herniated disc herniation
The intervertebral discs lie between the vertebral bodies and serve as a shock absorber for the human body, in addition they give the spine their mobility. They consist of a jelly-like core, which is surrounded by a fibrous cartilage ring. With increasing age, the flexibility of the intervertebral discs decreases and they become less stable, which can lead to problems.
Disc problems are more common in the lumbar spine, which can lead to lower back pain . With each movement, the discs are subjected to high pressures. If an intervertebral disc can no longer withstand this pressure, an intervertebral disc protrusion or an accident may occur.
In the protrusion, the fiber ring of the disc is pressed only slightly towards the spinal canal. During the incident, the fiber ring breaks and parts of the core emerge into the spinal canal. Both conditions can cause lower back pain due to nerve entrapment. These pains are often sudden and shooting and radiate into the leg. In the leg it can also lead to sensory disturbances and diminished strength or even paralysis , in severe cases, urinary and fecal incontinencemay occur, this requires immediate medical attention to seek to prevent permanent damage to the nerves.
For a reliable diagnosis, a magnetic resonance imaging (MRI) of the lumbar spine isperformed, which images the conditions around the disc.
Therapy of the disc protrusion and the herniated disc
Therapy should initially be conservative. Surgery should be considered only if there is a disc herniation and unsuccessful conservative therapy for at least six weeks or severe paralysis. Conservative therapy is provided with analgesics, physiotherapy , physical applications and the like. Also helpful may be local injections of the irritated nerve roots with painkillers or anesthetics .
In the context of choosing surgery, it is important to consider carefully whether or not the disc problems are actually the cause of the pain. Studies have shown that a high proportion of the population has a herniated disc without feeling pain. Conversely, this means that in case of pain not necessarily diagnosed herniated disc must be the cause. In this case, an operation is useless.
Facet joint osteoarthritis
With increasing age, there is progressive wear of the spine, a facet joint arthrosis may be the result. This is the joint wear of the facet joints, which connect the individual vertebrae with each other and are also called intervertebral joints. The degeneration of these joints is accelerated by poor posture, increased burden of obesity and degenerative disc disease.
Facet joint osteoarthritis manifests itself symptomatically with lower back pain, which can radiate into the buttocks and leg. It is important for the treating physician to locate the leg pain to differentiate the facet joint arthrosis from a herniated disc. Emotional disorders usually do not occur in facet joint osteoarthritis. Lower Back pain can be aggravated by movements such as hyperextension of the spine. In addition, an X-ray or MRI image is helpful diagnostically.
Treatment of facet joint osteoarthritis
Especially in the early stages of the disease heat applications relieve the symptoms. In addition, cortisone and locally acting painkillers can be injected into the environment of the facet joints for pain relief . This process is called facet joint infiltration and is done under X-ray control to ensure that the right structures are met.
In order to avoid a facet joint osteoarthritis or to stop its aggravation, it is advisable to build up a good spinal support musculature, as this relieves the joints. If there is an overweight, it should be tackled, because with each kilogram removed, the burden on the spine decreases.
Many conditions that cause lower back pain can be avoided or alleviated if consistent muscle building is performed. The following are simple examples of simple exercises that can be performed at home. For a positive effect, strengthening exercises should be done three to four times a week. There should be some effort in the muscles. In addition to strengthening, it also makes sense to consistently perform stretching exercises , so that ligaments and tendons remain flexible.
Quadruped stand with arm and leg raises
For this exercise, take the quadruped stand, hands and knees on the floor. First, the right arm is raised horizontally and stretched forward and held, as is moved with the left leg. This position is held for about 15 seconds (increase if necessary), then arm and leg are turned off again. Then come the other arm and the other leg. This exercise is done several times in succession for both sides.
In this exercise you lie on your back, your legs are bent so your feet can stand on the floor. Now push the pelvis into the air, so that the thigh and upper body form a line, after a short stay in this position, the pelvis is slowly set down again. Repeat this exercise ten times and then take a short break after which another 10 repetitions are performed twice.