Low back pain, most people have experienced, the pain can be described as sitting up, seriously affecting our life and work.
So what's with the lower back pain? Why does the pain keep coming and going? How to check? How to treat?
Today, we are going to talk about 6 problems related to lower back pain.
1. The causes of low back pain
01. Lumbar facet joint syndrome
Lower back injury, unusually severe lower back pain immediately after injury. Patients often lie on their side, the waist can not be straight, dare not move, afraid of being touched by others, often misdiagnosed as acute lumbar muscle sprain. In fact, the exact diagnosis should be the lumbar joint synovial incarceration, or lumbar facet joint disorder, commonly known as facet joint syndrome.
02. Low back myofascitis
Back myofascitis refers to a series of clinical symptoms caused by cold, damp and chronic strain causing edema, exudation and fibrodegeneration of back myofascitis and muscle tissue. People said back pain again, it is likely to be caused by back myofascitis.
Wet and cold climate environment, is one of the most common reasons, wet and cold can make the back muscle blood vessels contraction, ischemia, and eventually form fibrositis, chronic strain is another important pathogenic factor, the back muscles, fascia damage after fibrosis changes, resulting in small tearing damage, squeezing local capillaries and peripheral nerves appear pain. Others such as often sitting in one position, lack of corresponding activities, sitting in front of the computer for a long time and virus infection, rheumatism muscle allergy, etc., are triggers.
Main manifestations: diffuse dull pain in the low back, especially on both sides of the psoas muscle and above the iliac crest. Local pain, chills, skin numbness, muscle cramps and movement disorders. Pain in the morning, light in the day, heavy in the evening, long-term inactivity or excessive activity can induce pain, a long course of disease, and due to fatigue and climate change.
03. Lumbar disc herniation
Lumbar disc herniation is a common disease, mainly because after the aging and degeneration of various parts of the lumbar disc, under the action of external factors, the fibrous annulus of the disc is ruptured, and the nucleus pulposus tissue is protruded from the rupture to the rear or within the spinal canal, resulting in irritation or compression of adjacent spinal nerve roots, resulting in lumbar pain, numbness and pain of one or both lower limbs and a series of clinical symptoms.
2. What tests can you do for low back pain?
01. Imaging examination
A plain X-ray can show whether there is a bone problem, a CT can more accurately measure the distance between bone structures, and an MRI can more accurately show the soft tissue. One or more tests should be selected according to the patient's condition.
02. Laboratory examination
For patients with fever accompanied by low back pain, the cause of fever should be identified first, and routine blood and urine tests plus sedimentation rate, as well as necessary imaging examinations. In patients suspected of having rheumatoid arthritis, three tests for rheumatism are required.
03. Bone density examination
For elderly patients with low back pain, bone density examination can be performed depending on the situation.
The choice of examination method needs to be determined by the doctor according to the patient's condition. Only through the necessary examination can we understand the cause of low back pain and avoid misdiagnosis and mistreatment to the greatest extent.
3、How to treat lumbago ?
01. Lumbar muscle strain
Conservative treatment: mainly bed rest, can be combined with medication (oral non-steroidal anti-inflammatory drugs, plaster), physiotherapy, acupuncture, etc. In daily work and life, it is necessary to improve bad posture, more activities, and strengthen the exercise of lumbar and back muscles.
Surgical treatment: psoas muscle strain generally does not require surgical treatment, but if there is numbness in the hands and feet, pain, weakness, difficulty in defecation, numbness around the anus and other conditions, you need to go to the hospital as soon as possible, at this time may need minimally invasive surgery.
02. Lumbar disc herniation
Conservative treatment: About 90% can be improved by conservative treatment. Conservative treatment methods include: bed rest, physical therapy, lumbar muscle exercise, etc. In addition, intraspinal injection is feasible.
Surgical treatment: The symptoms of severe conservative treatment can be treated surgically. Surgical methods include open surgery (full cone plate decompression, half cone plate decompression, and other fenestration procedures) and minimally invasive surgery (foraminoscopy). The advantages of minimally invasive surgery are: precision, small incision (only 7mm), short operation time, and fast recovery.
03. Lumbar spondylolisthesis
Conservative treatment: the degree of slip is mild, symptoms and signs are not obvious, can be conservative treatment, conservative treatment mainly includes: strengthening lumbar muscle exercise, bed rest, hot compress, physical therapy, the application of non-steroidal anti-inflammatory drugs, weight reduction, waist circumference or support to increase lumbar stability.
Surgical treatment: Patients with severe symptoms and no obvious relief after conservative treatment should consider surgical treatment. There are many surgical methods for lumbar spondylolisthesis, such as posterior reduction of spondylolisthesis, pedicle screw fixation, and interbody bone graft fusion. The principle is to restore the spondylolisthesis by a certain method, and then fuse the adjacent vertebrae to prevent the spondylolisthesis again and restore the stability of the lumbar spine. If there are symptoms of nerve root compression, it is also necessary to decompress the nerve root and spinal canal to eliminate the symptoms of lower limb pain and numbness caused by lumbar spondylolisthesis.
04. Lumbar spinal stenosis
Conservative treatment: Mild conservative treatment, including bed rest, oral medications (NSaids, dehydrants, nutraceuticals), physical therapy, rehabilitation exercises, waist circumference or braces to increase lumbar stability.
Surgical treatment: When the spinal stenosis is severe and conservative treatment is ineffective, surgery is needed. The surgery is mainly performed through a posterior incision from the waist to decompress the spinal canal and relieve the increased nerve pressure.
4. What are the characteristics of low back pain caused by osteoporosis?
Osteoporosis is more common in the elderly, especially in women over the age of 60, patients with systemic fatigue, like bed or sitting position and do not want to activity;
General pain, especially in the lower back, may radiate from the waist to the buttocks and lower limbs, or from the back to the ribs and abdomen.
The degree of pain caused by osteoporosis is not as severe as that caused by lumbar disc herniation, and symptoms will be alleviated after treatment with sex hormones, high protein, and high calcium.
5. Will low back pain recur?
Long-term poor posture is an important cause of low back pain. Correcting poor posture, coupled with appropriate symptomatic treatment, can achieve long-term relief. However, after relief, attention should still be paid to prevent re-injury and eliminate bad posture. If not, the symptoms are likely to recur and worsen.
01. Sit down
When sitting, the pressure on the lumbar spine is equivalent to 5-6 times when lying flat, especially in the sofa, the back arch, the waist muscles are pulled, and the low back pain is easy to appear for a long time. We should try to take the correct sitting posture to reduce the pressure on the lumbar spine.
Correct posture: Keep your upper body with your neck upright, chin slightly tucked in, shoulders naturally hanging and relaxed, upper arms close to your body, elbows bent, preferably resting on armrests.
Try to keep your wrists horizontal and your waist straight. Naturally bend your knees at 90 degrees and keep your feet on the ground.
02. Sleeping
The soft and hard bed should be moderate, too soft mattress will cause improper bending of the spine, increase the tension of the muscles of the lower back, easy to get back pain.
On the contrary, a strong mattress will let many parts of the body fall into place, which is not conducive to the curvature of the lumbar spine.
The softness and firmness of the mattress should be the best when lying flat, the mattress naturally sinks and can support the physiological curvature of the spine.
03. Move
Some movements, such as bending over to lift heavy objects, are very damaging to the lumbar spine, and it is easy to "flash to the waist".
Correct method: First close the body to the weight, squat down with both hands to hold the item steady, and then slowly get up to lift the item up.
People with bad back should try not to do sit-ups. It puts a lot of pressure on the spine; The lever force generated in the process of sitting up will compress the lumbar disc, and even induce lumbar disc herniation, and patients with chronic low back pain with weak waist strength should pay more attention.
6. What exercises can you do for lower back pain and what can't you do?
Baby Stretch
1 to 2 groups of 10 times a day
Action points: Kneel on your legs, stick your hips to your heels, and stick your chest to your thighs, pushing your body down.
Action: Relax back muscles and relieve muscle spasms.
Reverse the small swallow fly
1 to 2 groups of 10 times a day
Action points: hands forward, chest and thighs slightly off the mat, toes not higher than the hips, remember not too large! Don't go too fast! So you don't get hurt.
Function: Strengthen back muscles.
Alternate leg lifts
1 to 2 groups of 10 times a day
Action points: the waist is close to the ground, the butt is slightly raised, and the leg is alternately lifted, and the height of the leg is not more than 30 centimeters.
Action: Strengthen abdominal muscles.
These three actions, both control recurrence, but also have a preventive effect, you can practice before going to bed.
Exercises not recommended:
Exercise to increase the pressure of the lumbar spine: sit-ups, standing and bending to reach the toes, and some large bending movements in yoga.
Waist fast twisting movement: for example, playing badminton, tennis, golf swing, table tennis, etc., there are many rapid rotation movements in such sports that require the waist to drive the force, which invisibly brings a lot of pressure to the lumbar spine.
