Low back pain - symptoms, causes, therapies

What to do in case of low back pain?

Low back pain is a widespread phenomenon in the population that can be caused by a variety of causes. Overall, joint and back pain are still one of the most common reasons for sick leave in Germany. Lower back pain is commonly referred to as pain in the lower end of the spine. Although mostly older people are affected, the symptoms are also more common in young people. Posture injuries, long sitting, lack of movement and wear and tear are common causes.

contents

• What to do in case of low back pain?
• Low back pain - a quick overview
• First aid for low back pain
• definition
• anatomy
• symptoms
• Possible causes
• Risk factors for low back pain
• diagnosis
• Treatment options for low back pain
• Naturopathic therapies
• prevention

Low back pain - a quick overview

When lumbar spine pain occurs, there can be many causes. Often, however, lack of exercise and stress are the reason for the complaints. Here is a brief overview of the symptoms of low back pain:

• definition: Painful symptoms that manifest in the area of ​​the lower back, ie between the last thoracic vertebra and the tailbone. The terms lumbar vertebrae and sacral pain are also used medically.
• symptoms: Low back pain, tension, numbness, abnormal sensation, pain in movement, diminished reflexes.
• Possible causes: Injury, malpractice, lack of exercise, overuse, tension, contusion, fracture, lumbago, herniated disc, infection, osteoarthritis, inflammatory diseases, Lyme disease, kidney disease, osteoporosis and psychosomatic causes.
• therapy: Physiotherapy, manual therapy, heat treatment, medication, in some cases surgery.
• Naturopathy: Progressive muscle relaxation, yoga, autogenic training, acupuncture, active stress reduction, osteopathy.
• prevention: Avoid physical activity, active stress reduction, bed rest outside of sleep, observe good ergonomics in the workplace, avoid overweight or reduce.

First aid for low back pain

Because tension and malposition in many cases trigger painful lower back complaints, there are a number of immediate and home remedies for back pain that can relieve the pain. Danger: If symptoms such as paralysis or urinary and fecal incontinence occur in addition to the low back pain, this could be a sign of a medical emergency. This should be clarified immediately in a hospital.

Otherwise, the following measures can be tried, but also applies here: If there is no improvement within a short time, a doctor should be consulted:

• Muskelentspannungsbad: Add ethereal thyme or rosemary oil to the bath water (about 10 to 15 drops) and relax in warm water for about 15 minutes.
• Fast heat wrap: Carefully pour hot but not boiling water from above into a rolled terry toweling. Use only enough water to keep the cloth dry outside. Then lay the wrap on the lower back for about 30 minutes.
• walkEven if you're in pain, you should not lie down. Instead, a walk can be helpful in many types of back problems. Back muscles are loosened and vertebral joints mobilized.
• step positioning: Lay your upper body flat on the floor and place your legs in an elevated position (for example, a bed, exercise ball or a couch). The angle in the hip should be around 90 degrees.
• salve: Before sleeping, apply an oil containing camphor essential oil, or apply a heat ointment to the painful area and massage in.

More and more people suffer from back problems such as low back pain. Many modern office activities and increasing life expectancy favor the appearance. (Image: SENTELLO / fotolia.com)

Low back pain - an increasing problem

The "German Back Pain Study" of the Robert Koch Institute (RKI) comes to the conclusion that up to 85 percent of the population suffer from back pain at least once in their lives. Around 25 percent of women and one-sixth of men reported in a survey by the RKI that they had suffered from chronic back pain in the last 12 months. Although low back pain is not basically synonymous with back pain, but clarify the figures how widespread the symptoms in the population. As the likelihood of back problems increases with age, demographic change is likely to increase the number of treatment cases.

definition

Low back pain is common suffering in the lower end of the spine. Colloquially, the term is often used synonymous with the more general term back pain. The low back pain in this article, however, as a painful discomfort in the section between the last thoracic vertebra to the coccyx to understand. In the medical community, this is also often referred to pain in the lower back, pain of the lumbar spine and sacral pain.

anatomy

The pain in the lower back takes place in the area of ​​the sacrum or lumbar spine. The individual lumbar vertebrae are connected via the intervertebral discs. The sacrum is connected to the pelvis via the sacrum of the sacrum (also called the sacroiliac joint). The cross-iliac joints connect the sacral bone with the ilium (ilium) via rigid ligaments underneath the lumbar spine. Together with the hip legs (Os coxae), the sacrum forms the pelvic girdle.

Here is an antomic overview of the area of ​​the hip and the lumbar vertebrae. (Image: bilderzwerg / fotolia.com)

symptoms

Low back pain can occur on the left, right and center. In many cases, the pain radiates to other areas such as the legs or the buttocks. In addition, many sufferers complain about tensions and movement pains. You may also experience additional symptoms such as numbness, discomfort, difficulty walking to paralysis and diminished reflexes. If signs of urinary or fecal incontinence in combination with back pain are detected, it could be an emergency requiring immediate medical attention.

Possible causes

As a trigger of low back pain numerous factors are considered, which may range from more harmless complaints as a result of a bad load on lumbago and herniated discs to rheumatic and tumorous diseases.

wear

The elderly, in particular, suffer from low back pain caused by signs of wear. Lack of exercise, poor posture, constant overloading, obesity and obesity can contribute to the fact that wear complaints arise earlier.

Infections of the vertebral bodies

Spinal infections, such as osteomyelitis and spondylodiscitis (inflammation of the cartilage slices), can cause pain in the lower spine.

Bad posture, long sitting, lack of exercise and one-sided stress are often to blame for the pain. The left two seating positions should be avoided over a longer period, whereas the right seating position should be preferred. (Image: Africa Studio / fotolia.com)

Arthrosis and constrictions

Likewise, arthritis of the vertebral joints (spondylarthrosis) or of the intercostal joint (sacroiliac joint) as well as narrowing of the spinal canal, the so-called spinal canal stenosis, may underlie the painful discomfort.

Inflammatory diseases

In addition, inflammatory diseases such as Crohn's disease, Scheuermann's disease or ankylosing spondylitis must be considered as potential causes of the complaints.

Lyme disease

In addition, the borreliosis transmitted by a tick bite sometimes causes migratory back pain.

Kidneys, intestines and pancreas

Furthermore, kidney stones, pyelitis, urinary tract infections as well as various diseases of the intestine and the pancreas may be mentioned as possible causes of low back pain.

Sacking of the aorta

So-called aortic aneurysms (aortic outgrowths) may also lead to severe stabbing pain in the back.

Bruises and fractures

Of course, bruises and fractures as a result of falls or accidents can cause pain in the lumbar spine and the sacrum and coccyx.

Congenital or acute illnesses, bruises, fractures and psychosomatic causes can trigger lumbar pain even in younger people. (Image: Africa Studio / fotolia.com)

Psychosomatic causes

Permanent negative stress (distress), often due to work, but also mental illnesses such as depression or anxiety disorders can be manifested by low back pain. In addition, suppressed feelings of aggression, anger or sadness burden the psyche. This can also lead to low back pain.

Naturopathic approaches

The naturopathic procedure of osteopathy assumes that the back pain can also be caused by blockages, especially in the lumbar spine and the sacroiliac joints.

Other causes

In low-back pain of the lumbar spine, not infrequently tension of the hip flexor muscle (psoas muscle) is the trigger. Furthermore, anatomical features such as a difference in length of the legs can cause the backache. Also, osteoporosis and associated loss of bone can cause discomfort. Since the pain in the lower back may be due to a serious illness under circumstances and the restraint can lead to an increase in the symptoms, in case of low back pain a doctor should urgently be consulted.

Risk factors for low back pain

As a common risk factor for low back pain is generally the unfavorable posture in today's office work. Working for hours on the computer leads to incorrect strain on the muscles. Tensions and corresponding pain are the result. Lack of exercise and insufficiently trained back muscles are also often associated with the increased occurrence of low back pain. However, an excess of exercise or stress can cause the back pain, especially in unfavorable movements, such as repeated bending over and lifting heavy objects.

Incorrect lifting of weights or constant overwork due to hard physical work can lead to back pain. (Image: elenabsl / fotolia.com; own editing heilpraxis.de)

Wrong lifting of weights

For good reason, the experts advise not to lift weights from the back, but from the knees. Since the lower back anyway carries a higher weight load than the rest of the spine, stress symptoms are often in this area of ​​the spine. Especially at the interface of the transmission of power between the spine and legs, the sacrum and iliac joint, abnormal strain is often painful.

diagnosis

In order to discuss the causes of low back pain, an extensive medical history takes place at the beginning of the examination in which the patients are interrogated, inter alia, on existing pre-existing conditions and the situations in which the symptoms occur preferentially. In the course of the clinical examination, the examination of possible anatomical features (for example, legs of different lengths) follows. By scanning the spine further evidence of underlying diseases arise. With the help of imaging techniques such as X-rays, computed tomography (CT) and magnetic resonance imaging (MRI), the diagnosis can finally be specified.

Treatment options for low back pain

According to the different causes of low back pain, numerous therapeutic approaches are used in the treatment of low back pain. Basically, the therapy usually aims to alleviate the pain, rather than directly addressing the causes of the condition. In addition to painkillers, alternative methods such as physiotherapy, massage or acupuncture are used here. After treatment of the acute pain the causes of the discomfort should be remedied therapeutically. This is different depending on the trigger of the complaints with difficulty. In the worst case, surgery is required to eradicate, for example, a herniated disc or a potentially existing tumor.

As a rule, non-specific low back pain can be treated well. In particular, activating measures should be emphasized in the treatment. (Image: blackday / fotolia.com)

Which medications are used for low back pain

For the treatment of pain in the lumbar spine, medications are also often used. The type and dosage of the drug treatment is strongly related to the cause. When it comes to nonspecific low back pain, analgesics should be considered as an occasional support rather than a basic therapy. Among other things, the following drugs are used:

• Painkillers - as support for exercise therapy,
• Antibiotics - for infectious cause,
• Cortisone - in rheumatic diseases.
• Dietary supplements such as calcium, vitamin D or calctonin for degenerative causes.

Naturopathic therapies

The often used in non-specific chronic low back pain osteopathy is based on a manual treatment of the symptoms by pressure to release the blockages that cause the pain. Also, relaxation exercises and autogenic training are often part of an alternative pain therapy, especially if a psychosomatic background is suspected. In addition, the progressive muscle relaxation according to Jacobson promises to relieve the symptoms of low back pain. Muscle relaxation is also recommended in the current guideline for the treatment of non-specific low back pain (as of 05/2017).

These measures can help alleviate and prevent low back pain. (Image: alexeyblogoodf / fotolia.com / heilpraxis.de)

prevention

To prevent the pain in the back, in addition to the treatment certain rules in everyday life must be observed. Weights should not be lifted from the back, the workplace should be made as easy as possible on the back and, if in doubt, your back should be strengthened by a few simple gymnastic exercises (back pain exercises). Regular physical activity is considered to be one of the most effective measures for the prevention and alleviation of nonspecific low back pain.

A good exercise for prevention as well as for relieving the back pain, which are triggered by tension and blockages, is the so-called "popo-slides". With your legs outstretched, sit flat on the floor and alternately push the right and left legs forwards so that you move forward piecemeal. Try to slide forward about two meters in this way.

Furthermore, one should refrain from auszubieren back pain in bed. This is rather counterproductive and can aggravate the symptoms. If you are overweight, losing weight can help relieve the symptoms. (fp, vb; updated on August 15, 2018)