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Lower back pain - causes, symptoms, treatment

 Lower back pain - causes, symptoms, treatment

Lower back pain - causes, symptoms, treatment


Lower back pain (back pain / lumbago) are common disorders of the back muscles and bones. It is one of the most common health problems today, and it is estimated that 80% of the population have at least once pain in the back or lower (lower) spine during their lifetime
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Chronic pain is acute if less than 6 weeks and chronic if more than 12 weeks.

 

The risk group for the development of lower back pain consists of all persons doing difficult physical work or vice versa, persons working in hours of non-physiological position (long sitting), persons with osteoporosis or other spinal anomaly, persons who have had injury or spine surgery, and older people who have experienced degenerative processes.

 

Back pain is one of the most common reasons for going to the doctor. It is also a major public health problem because it is the most common cause of absenteeism and a large number of sick days.

 

Radiologic examinations, and in particular modern radiological diagnostics (CT, MR, DSA and Doppler ultrasound), as a rule, are aimed at proving suspicion of disease due to possible adverse effects such as radiation.

 

This is why, except when really necessary, people with back pain avoid being diagnosed with imaging tests (RTG).

 

It is of particular importance that an increasing number of people develop chronic forms of disability. According to a 2007 Eurobarometer survey "Health in the European Union", almost one third of respondents felt musculoskeletal pain that impaired the quality of daily life.

 

Lower back pain - causes

The spine is a complicated anatomical assembly of the vertebrae (7 cervical), 12 thoracic (thoracic) and 5 lumbar movable and 5 sacral spines that have grown into the sacral bone, cartilage of the intervertebral discs (which allow the spine to move), and is associated with many muscles. , nerves, blood vessels and ligaments, forming the main supporting body assembly.

 

Due to its multifaceted function, the spine is exposed to constant mechanical action or loading (pressure, train, shear, bending, twisting, torsion) and may overstress and wear out.

 

More than a hundred different causes of back pain are listed. Most low back pain does not have a clear cause, but it is assumed to be minor muscle or bone injury, ligament or muscle stretch, and joint sprain.

 

The most common cause is excessively irregular and over-exertion that exceeds the strength of the back muscles, ligaments and intervertebral discs - heavy physical work, hours of irregular body posture (such as sitting in a car for long periods), and problems regularly caused by relaxed or overstretched muscles.

 

Tissues that are excessively strained can contract and turn into a very hard and painful region with sudden severe and severe pain.

 

Back pain can also occur gradually, with a feeling of discomfort that gradually gets worse (increasing pain).

 

Certain factors can contribute to lower back pain, such as obesity, smoking, stress, poor posture, and poor sleep.

 

Causes can also be:

 

osteoarthritis,

rheumatoid arthritis,

osteoporosis,

disc degeneration,

congenital spinal distortion (kyphosis, scoliosis),

congenital developmental disorders of the vertebrae,

disc herniation,

vertebral fracture,

feet lowered,

infections (tuberculosis, infectious spondylitis) or

spine tumor.

 

In older people, back pain is often caused by degenerative changes in the vertebrae and intervertebral discs (spondylosis, spondylarthrosis). Spondylosis is a chronic inflammatory rheumatic disease that makes the spine less flexible and results in hunched posture. Spondylarthrosis is the onset of degenerative changes on the intervertebral joints.

 

Women may suffer lower back pain due to endometriosis, cysts, ovarian tumors, or uterine fibroma. Due to changes in posture and center of gravity, every other pregnant woman experiences lower back pain.

 

Lower back pain - symptoms

The main symptom is lower back pain. It may occur abruptly or gradually, be localized in the lower spine or extend into one or both legs, and of the waist type, forward.

 

Lower back pain usually occurs after a certain movement, when bending, bending, or lifting. Pain can occur immediately after movement or the next morning.

 

In certain positions, it can increase significantly and even spread along the leg (sciatica).

 

It is important to understand the existence of similar problems earlier and other health disorders of the spine, general medical condition and pain characteristics (pain localization, causal link with load and relief, spread of leg pain and involvement, tension pain - coughing, sneezing, laughing, stool, changes in skin sensitivity, pain periods, and pain relief).

 

The first low back pain usually occurs between the ages of 20 and 40, and often the pain continues to persist throughout the life, with recurrent episodes becoming more painful.

 

Back pain very often affects the quality of sleep, as well as daily functioning.

 

It is important to note that the incidence of low back pain in children and adolescents is also on the rise, becoming one of the common reasons for going to the doctor. Most back pain can be described as "nonspecific" and linked to lifestyle changes, reduced movement and longer sitting, and "overload" of the spine and trunk muscles, according to the 2013 study, which deals with new insights when it comes to back and back pain children and adolescents.

 

Treatment of lower back pain

If medical history and physical examination do not indicate a specific spinal injury or disease, imaging diagnostic methods such as X-ray, CT, or MRI are often accessed.

 

To make an accurate diagnosis, an X-ray of the spine (standard back and forth direction) and functional imaging of the maximum forward and backward inclination are performed. Also, a thorough clinical or physical examination of a specialist doctor is required.

 

Researchers have concluded that massage can have a positive effect in the treatment of people with chronic low back pain and that massage therapy has similar results to non-steroidal anti-inflammatory drug therapy.

 

The purpose of treatment is to eliminate the cause of the disease - the surrounding harmful stimuli, suppress the pain and prevent the recurrence of pain.

 

Conservative methods of treating low back pain are:

 

rest - during the first 7 days until the pain subsides, rest in a comfortable position and careful movement is recommended. Prolonged lying down is not recommended, even in severe pain. Careful movement is required, that is, an easy walk in a safe environment. After the pain subsides, a workout plan still needs to be worked out to prevent a recurrent episode of back pain.

physical activity - light walking, stretching, Pilates, yoga, swimming and gymnastics in water have proven to be an effective way to prevent lower back pain. For people with chronic pain, special exercises have been developed that reduce the level and frequency of long-term pain, however, in order to be effective, they need to be practiced regularly with the advice of physiotherapists. Strengthening of the muscles of the back and abdominal muscles will strengthen the torso and reduce the pressure on the spine, which will subsequently relieve pain.

medications - paracetamol is usually prescribed for pain relief, and non-steroidal anti-inflammatory drugs can be prescribed in case of severe acute pain. However, they carry a higher risk of side effects, since they can have adverse effects on the kidneys, stomach and heart. If these two types of drugs do not prove effective, opioids (such as morphine) may also be used, but only in the short term and for severe pain or concomitant complications, as they carry the risk of causing addiction and may have negative interactions with other drugs. Injection into the intervertebral joints can be effective in people with sciatica.

surgical treatment - surgery can be useful in people with severe mechanical damage, such as disc herniation, with pain spreading to the leg and causing leg weakness, bladder problems, or loss of bowel control.

corsets and orthopedic supplies - although individuals experience improvement while using corsets and / or orthoses, their use in the long run is not recommended as they weaken the back and abdominal muscles, which again leads to spinal overload and pain. They should be used and worn for a maximum of 4 hours a day, only during the activity, not at rest.

alternative medicine - science is still moving towards proving the effectiveness of specific types of therapies in eliminating back pain. Some people testify that in their case there was a reduction in pain after practicing massage, acupuncture and chiropractic. Acupuncture has in some cases proven to be as effective as analgesic therapy. Massages combined with physical activity can give excellent results, as can chiropractic if treatment is performed by a skilled person.

 

Lower back pain - warning signs

If you experience any of the following symptoms with lower back pain, you should seek medical attention immediately as it may be a serious medical condition:

 

unexplained weight loss,

loss of control of the bladder or intestines,

considerable weakness of the lower back and / or abdominal muscles,

reduction of sensation in the legs, back or buttocks,

severe pain after surgery,

fever,

urinary tract infection.



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