This article circulates around this topic. It does not aim to remind you of your pain, rather it aims to inform you of why this occurs and in what ways to reduce the pain.
Nearly 8 out of 10 people have lower back pain which implies it is really common. The symptoms vary from person to person. There are many reasons as to why lower back pain even occurs that happens normally in the lumbar spine area.
The main reason is due to bad posture. For instance, not sitting or standing, lifting or bending correctly and/or for long periods of times. Other causes include over-stretching and over-using the muscles where the latter can occur during sport known as repetitive strain injury.
This is why all NHS staff have an annual training known as Manual Handling to lower the incidence of lower back pain.
Being stressed, pregnancy, smoking, overweight and long-term use of medications are other reasons. In relation to pregnancy, carrying the baby can add strain.
In relation to smoking, smoking can cause tissue damage in the back.
In relation to overweight, being overweight can add pressure.
In relation to medications, an example are corticosteroids that is normally prescribed for anti-inflammatory conditions such as asthma, allergic rhinitis (hayfever), inflammatory bowel disease (IBD) and others. When it is used for a long-term period of time, it can weaken the bones.
These causes can lead to:
- The large paired lower back muscles known as erector spinae can have been damaged.
- The bones, ligaments or the joints can have been damaged.
- Intervertebral disc may be degenerating.
- Irritated small nerves.
- Back muscle spasms
- The large nerves in the lower back that goes to the legs are irritated
A problem with the bones, nerves, spinal muscles, tendons or discs in the lumbar spine area can cause lower pain that can radiate to other areas of the body.
Moreover, the symptoms that one gets can imply for a particular medical condition. For instance, sciatica which is a slipped disc. It can cause lower back pain, numbness and a tingling feeling down one leg are the main symptoms.
Another condition lower back pain can be related is due to arthiritis. Having joint pain especially in the back whilst walking are one of its symptoms.
Furthermore, back pain can also be due one of the symptoms of whiplash that can occur following an accident. It is very rare that back pain can be due to a more serious condition of the spine such as cancer, infection or fracture.
Additionally, it is important to seek medical attention urgently if you have back and one of the following as this could be a sign of a serious problem:
- Hyperthermia (high temperature)
- Chest pain (angina)
- After an accident
- Weight loss.
- Unable to urinate
- Constant pain
- Uncontrollable bladder movement
- Numbness in your private area (front/back), bottom
- Worse at night
What’s the lumbar spine?
Lumbar is derived from the Latin word ‘lumbus’ defined as lion. The role of the Lumbar spine is for flexibility (lifting, bending, twisting) and strength. The lumbar spine is where the spine curves inward towards the abdomen. This is known as lordosis.
The lumbar spine connects the thoracic spine with the sacral spine (sacrum) as shown in the image below. It has five vertebrae (L1-L5) providing support of the weight of the whole back. However, L4-L5 and L5-S1 carry most of the weight. Thus, they are more prone to injury.
The lumbosacral joint (L5-S1) allows one to rotate, for instance when running or walking, the pelvis and hips can swing.
The spinal cord initiates from the base of the skull through the spinal column and ends at T12-L1. T12-L1 is where the thoracic spine links with the lumbar spine. The nerves then branch out like roots forming ‘caud equina’ that extend to the bottom, legs and feet.
Thus, it is very rare that the cause of the lower back pain is due to nerve damage or paralysis as the spinal cord does not run via the lumbar spine.
- Try to sit, lie, lift and stand properly as all these factors can influence the back.
- Do not place too much pressure
- Walking and swimming are two recommended ways to prevent lower back pain.
- Yoga can aid in improving flexibility and strengthening back muscles.
Releasing inner endorphins
- Massage therapy, meditation and aerobic exercise aids in releasing endorphins. Endorphins are hormones made in the body whose role is to prevent pain signals recorded with your brain.
- Another role of endorphins is to help remove stress, anxiety and depression that are all linked with chronic back pain and can help make the pain worse.
- The muscles in your abdomen and back helps supporting the lumbar spine and needs to be targeted.
- Stretching the hamstrings of your legs twice daily also aids in alleviating lower back pain.
- Tight hamstrings can increase stress of the lower back and sacroiliac joints which leads to more pain.
- Below is a link for lower back pain exercises.
There are skills that the patient can develop to lower or ignore the pain signals which therefore influence how you perceive the pain. Pain specialists are able to help in this manner.
- Acts as an anaesthetic by slowing the nerve impulses causing the pain.
- Lowers inflammation
- This can be in any form such as hot packs, water bottle, hot bath etc.
- Inhibits pain signals reaching the brain
- Stimulates blood flow allowing nutrients in the blood reaching the affected area.
Despite pain can cause difficulty sleeping or staying awake, having less sleep can make the pain worse.
Do activities that make you happy
Having pain can influence your life whether that be the ability to get stuff done or relationships and can affect your mood and sleep. Thus, distracting yourself by doing something you enjoy can help.
As earlier stated, stimulating the blood flow allows nutrients to enter the affected area. This aids in healing the damaged area as it supplies cells with energy and recovery. When having problems with the back especially the lumbar spine, the discs do not receive good blood flow.
Hijama therapy (wet cupping) is effective as it can promote good blood flow in the area and remove toxins. When negative pressure is applied on the skin, endorphins are released which is needed to trigger for recovery.
Other therapies such as chiropractic, massage, and CBT also helps.
Acupuncture is another therapy that can help massively. It began in China centuries ago and involves inserting thin needles at certain points on the body. Traditional Chinese medicine is known for its strength and improving health. There are 2000 points connected by pathways to create an energy flow known as Qi (Pronounced as Chee). Stimulating these points allows the imbalance energy flow to be corrected which helps to relieve pain. Moreover, acupuncture also allows:
- Release of chemicals in the brain, muscles and spinal cord which can affect the pain. For instance natural opioids are released in the brain which reduces pain and promotes sleep.
- It alters the release of neurotransmitters that can stimulate nerve impulses.
- It alters the release of neurohormones which can affect the function of an organ.
- It speeds relay of electromagnetic signals which increases the flow of endorphins and release of immune cells.