Lower back pain
introduction
Lower back pain is one of the most common reasons for seeing a doctor these days. They put the patient under great stress, but are usually relatively easy to diagnose and treat, since in most cases the pain is not caused by a serious illness. Also read Low Back Pain
The causes of pain in the lower back can be very different, which is why it is always important to carry out a detailed examination in order not only to be able to treat the pain, but also to recognize a possibly existing underlying disease of back pain or to avoid secondary damage .
You might also be interested in this topic: Inflammation of the bone skin on the coccyx
In principle, a doctor first assumes that the complaints originate from the spine or are muscular and then adjusts his examination accordingly. In such cases, the spine often shows bends in the Lumbar region who can explain the pain. Also Herniated discs of the lumbar spine lead to back pain.
Especially when it slipped out Intervertebral disc If a nerve originating from the spine is irritated or even squeezed, the affected person experiences not only severe pain but also a feeling of numbness and / or paralysis in the area of his leg supplied by this nerve.
However, it is more likely that the lower back pain is caused by incorrect posture or a lack of exercise, and both factors are often combined. Because many people sit for a very long period of time and are therefore in the same position, the Lower back muscles heavily and one-sidedly stressed, which leads to tension or cramps and bad posture, which in turn is a trigger for Back pain is. To counteract this, you can make sure that you change your sitting position several times a day or use a sitting ball, which practically forces you to perform compensatory movements at regular intervals.
A lack of exercise is also an option for back pain. If the spine is not stressed enough due to lack of movement, the vertebral bodies can become porous and ligaments slack, which also causes pain. However, excessive strain can also damage the back, such as carrying or lifting heavy objects.
Appointment with a back specialist?
I would be happy to advise you!
Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
But now enough is indicated ;-)
The spine is difficult to treat. On the one hand it is exposed to high mechanical loads, on the other hand it has great mobility.
The treatment of the spine (e.g. herniated disc, facet syndrome, foramen stenosis, etc.) therefore requires a lot of experience.
I focus on a wide variety of diseases of the spine.
The aim of any treatment is treatment without surgery.
Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.
You can find me in:
- Lumedis - your orthopedic surgeon
Kaiserstrasse 14
60311 Frankfurt am Main
Directly to the online appointment arrangement
Unfortunately, it is currently only possible to make an appointment with private health insurers. I hope for your understanding!
Further information about myself can be found at Dr. Nicolas Gumpert
Illustration causes of back pain in the lower back
Lower back pain
- Spinous process - Spinous process
- Gelatinous core - Nucleus pulposus
- Fiber ring - Annulus fibrosus
- Intervertebral disc
= Intervertebral disc (2nd + 3rd) - Facet joint (vertebral joint) -
- Vertebral bodies - Corpus vertebrae
- Healthy bones
- Bones with osteoporosis
- Broad back muscle -
Latissimus dorsi muscle - Gluteus Muscle -
Gluteus maximus muscle - Deep back extensors -
Dorsi proprii muscles - Lumbar spine (lumbar spine)
- Sacrum - Sacrum
Causes:
A - osteoporosis (decrease in
Bone density - old age disease)
B - herniated disc - emergence
of tissue of the gelatinous nucleus of BS
into the spinal canal
(seen from above)
C - spine with osteoarthritis
D - Faccetal arthritis
(of the vertebral joints) too
Spondylarthrosis
E - fracture of the vertebra
(Spinous process, vertebral body)
You can find an overview of all images from Dr-Gumpert under: medical images
Causes back pain lower back
In addition to the "functional" symptoms described at the beginning, that is, back pain caused by impaired interaction between the musculoskeletal system and incorrect loading, back pain in the lower back can also be an indication of a disease of the spine itself. These diseases can themselves cause pain, but also often lead to a reflex-induced relieving posture and tension, which in turn can be the cause of back pain.
Diseases of the spine itself can be disorders in the structure of the individual "components" and can be caused by wear-related, inflammatory, and in the worst case even malignant processes.
Vertebral bodies, the joints between the vertebral bodies and ligament structures, are subject to aging and wear and tear over the years, especially where particularly high loads occur. This is particularly the case at the transitions between the natural curves of the spine - these are also the places where problems caused by signs of wear and tear often arise.
The Bone density the vertebral body takes - as with all bone in the body - with increasing age. This process is particularly pronounced if there is also a disease of the bone metabolism such as osteoporosis present. If this breakdown of substance has progressed further, the edges of the vertebral bodies may break off or the cover plates of the vertebral bodies may collapse. This in turn can lead to Bad posture, Improper loading other structures of the spine and resulting back pain in the lower back.
Those are particularly affected by the signs of aging Band washersthat lie between the vertebral bodies and buffer them against each other. They consist of a gelatinous core that is surrounded by a ring of firmer connective tissue fibers. This outer ring becomes more and more brittle with increasing age, so that - especially in connection with incorrect loading - it can tear and parts of the intervertebral disc core emerge. If this happens in such a way that the bulging gelatinous mass presses on the spinal nerves emerging from the spine, this corresponds to the widespread and sometimes extremely painful "Herniated disc of the lower back“.
Even without the core of the intervertebral disc emerging, the intervertebral discs can cause lower ones through wear-related changes Back pain become: the height of the intervertebral discs decreases with age because the connective tissue they are made of can store less fluid.
This decrease in height causes the taut ligaments that run along the vertebral bodies Spine Connect with each other and stabilize the spine over its entire length, loosen up. This means that the Back muscles do a considerable extra work in compensatory movements in order to correct the posture, which can lead to pain caused by overload - In the loosened combination of ligaments and vertebral bodies, vertebral slippage can also occur, individual vertebral bodies slipping out of their original position.
The degenerative processes also include the intervertebral joints that connect two adjacent vertebral bodies ("Facet joints“), All the more so if the structure of the individual building blocks has already loosened. Local overloading leads to excessive wear Articular cartilage and bony additions to the articular processes, which lead to the very painful "Facet syndrome" being able to lead.
For mechanical reasons, these are degenerative changes in the intervertebral joints in the area of the Lumbar spine especially often.
A rarer cause that comes with the clarification of lower Back pain but should also be considered are Inflammation of the vertebral body („Spondylitis") And the intervertebral disc ("Spondylodiscitis"). These are caused by the sowing of infectious agents from other sources of infection in the body via the bloodstream, but can also be caused by the spread of germs from the body surface, e.g. B. when injecting Painkillers arise near the spine. The risk of an inflammatory disease of the spine is v. a. increased in people who like in the context of a chronic general illness Diabetes mellitus have a reduced resistance to infection.
A Inflammation of the renal pelvis can also manifest itself in back pain. Due to the anatomical location, kidney pain is projected onto the region of the transition from the lower to the middle back. It is often an oppressive and very strong one pain. The back is then very sensitive and reacts with pain even to light pressure. The pain is mostly one-sided and is from fever and accompanied by painful urination.
Cold drafts can also lead to tension in the back muscles and thus to pain in the lower back. Such pains are mostly not of long duration and can be relieved well with warm compresses or heat pillows. A warm bath is also very effective against this type of back pain. You can support a light painkiller, for example Ibuprofen from the pharmacy. The pain reliever helps against acute pain, making it easier for the muscles to relax.
Finally, if there is a suspicion, it must be clarified whether the back pain is a Tumor disease underlying. While malignant degeneration of the bone tissue is rare, there are some cancers that spread particularly frequently to the spine.
These settlements can lead to bone loss or overbuilding and lead to back pain, either by themselves or by collapsing the vertebral body. Various malignant diseases of the blood cells also take place at the place of origin of these cells, in the Bone marrow from.
Since the vertebral bodies are rich in blood-forming bone marrow, the spine is a common site of these diseases. The fact that the degenerate bone marrow displaces normal bone tissue can lead to back problems and instability of the vertebral bodies, which can lead to vertebral collapse.
Localized lower back pain
Below are the causes and symptoms of back pain in specific locations in the lower back.
Back pain lower right
Lower back pain is not uncommon. Those affected often complain of the pain for weeks or even months. Both acute events, such as a broken bone or a sports injury, as well as creeping processes can lead to back pain in the lower back. What is meant by the "lower back" is the Lumbar spine area. Due to its location, this is exposed to the greatest stress in everyday life: it has to carry the greatest weight. Right-sided lower back pain suggests that the cause of the pain is also on this side. A lateral disc herniation is a common cause of right-sided lower back pain. This means that part of the intervertebral disc slips out of its original position to the right and there Pinching nerves.
Read more about the topic here: Herniated disc of the lumbar spine
In the lumbar spine, the location between lumbar vertebrae 4 and 5 is particularly often affected. The pain feels pulling and can also result in that radiate right leg. Also nerve irritation by Joint wear (Spondyloarthropathy) in the lower back lead to unilateral back pain on the right side. The pain is similar to that of a herniated disc, as the nerve irritation causes the pain here too. Acute injuries on the right side, such as bruises, falls or the like, can of course also cause unilateral pain. Other diseases of the spine such as the Osteomyelitis or the Spondylolisthesis usually do not lead to one-sided back pain.
Lower left back pain
For lower back pain on the left side, basically the same applies as for the right side. Unilateral pain can express one lateral disc herniation or one Joint wear (Spondyloarthropathy) on the affected side. A nerve or nerve root irritation on the left side is the reason for the sharp, one-sided pain. The Radiate into the left leg is typical for it. Parasitic sensations or a tingling sensation are also possible.
Muscular Tension The back muscles or the leg muscles on the left are also possible reasons for left-sided lower back pain. Other diseases of the spine usually do not show strictly one-sided pain. Another cause of unilateral pain on the left is one Pelvic inflammation the left kidney. The pain feels rather dull and oppressive. However, it is a pain that can be very strong even when the skin is touched. Accompanying symptoms of the infection such as fever, painful urination, and general fatigue are typical.
Back pain in the middle below
Many different diseases and conditions can cause pain in the lower back area. Central back pain in the lumbar spine is not uncommon. Muscle tension, Joint wear and Herniated discs represent the top 3 causes of back pain in the lower back. Joint blockages and the stress on the important supporting structures such as ligaments, tendons and fascia are also possible causes of back pain in the central area of the lower spine.
Often hires Sedentary lifestyle or incorrect stress on the spine are important factors in the development of such conditions. Also Obesity has a negative effect and stresses the central area of the spine in particular, as it has to absorb most of the weight. Wear and tear in the sacroiliac joint can lead to both central and unilateral pain in the lower back and buttocks. Other specific diseases of the spine such as Inflammation (Osteomyelitis, spondylodiscitis) or a ankylosing spondylitis as well as rheumatism are a little rarer, but definitely to be considered as causes.
Read more about the topic here: rheumatism
Back pain laterally below
Lateral lower back pain suggests a cause that is also on a specific side of the back. The skill lateral herniated discs, Signs of wear on joints, ligaments or tendons, Muscle tension, Joint blockages or injuries to various structures. A lack of exercise for many years and being overweight are often decisive factors in the development of herniated discs and joint wear. Nerve root irritations that arise in the course of this lead to stabbing pain on the side, which can be accompanied by tingling sensations and a reduction in strength in the affected side. Furthermore are Inflammation of the renal pelvis a possible cause of pain on the side of the lower back.
Lower back pain with pulling in the leg
A pull in the leg is particularly typical of one Radiculopathy. This is the irritation of a nerve root. Causes for it can Joint wear in the sacroiliac joint or in other areas of the lumbar spine as well Herniated discs be. The segment between lumbar vertebrae 4 and 5 is most commonly affected. An entrapment or crushing of the nerve root in this area typically results in a Radiation of pain into the leg the affected side. An entrapment or irritation of the sciatic nerve typically leads to a so-called Lumboischialgia. This term describes the pain in the lumbar spine in the lower back as well as pain in the area supplied by the sciatic nerve. This includes the buttocks and the leg. The pain is pulling and pulling from the buttocks to the leg. The resilience of those affected is often through this highly limited. Also discomfort like a tingle in the leg can occur.
Figure back pain
A - neck pain
B - upper back pain
C - lumbar spine pain
Lumbago (lumbago)
D - lumboglutealgia
(Radiating into the buttocks)
E - Lumboischialgia
(Radiating into the leg)
- First cervical vertebra (carrier) -
Atlas - Seventh cervical vertebra -
Vertebra prominent - Trapezius -
Trapezius muscle - Broad back muscle -
Muscle latissimus dorsi - First lumbar vertebra -
Vertebra lumbalis I - Fifth lumbar vertebra -
Vertebra lumbalis V - Sacrum - Sacrum
- Tailbone - Os soccygis
- Iliac crest -
Iliac crest - Gluteus Middle -
Muscle gluteus medius - Gluteus Muscle -
Muscle gluteus maximus - Big Dresser -
Adductor magnus muscle - Two-headed hamstrings -
Biceps femoris muscle
a - Disc prolapse -
Nucleus pulposus prolapse (from above)
b - vertebral fracture
(Vertebral fracture)
c - spinal osteoarthritis -
(Joint wear)
You can find an overview of all Dr-Gumpert images at: medical illustrations
Lower back pain in certain positions
Below are the causes and symptoms of low back pain that occur in specific body positions.
Lower back pain while sitting
People who are one predominantly sedentary work often experience lower back pain. A classic example of this are office workers. Often times, sitting for a long time leads to one Sedentary lifestyle as well as a lack of strengthening of the back muscles. Tension and shortening of the back and leg muscles increase the pain and lead to Bad posture. Also nerve stretching pain, for example, as part of a Lumboischialgia or one Herniated disc can be reinforced while sitting.
Lower back pain when lying down
Many people with lower back pain find lying on their flat back uncomfortable. There are several reasons for this. Most of the lower back pain is on Bad posture, Muscle tension or Joint wear traced back. Different factors are often involved in the development of the pain. Shortened or tense muscles are not relieved when lying down, but often lead to the development of one Hollow back. This can lead to painful conditions in the morning after getting up, which usually improve with movement.
Lower back pain in pregnancy / early pregnancy
Over half of pregnant women suffer from back pain during their pregnancy. Often it is pain in the lower back. The increasing Weight during pregnancy, Sedentary lifestyle as well as the natural loosening of important ligaments in the lower back and pelvis can lead to pain. Often, however, the pain was already present before the start of pregnancy. Perform in late pregnancy Labor pains and the increasing strain lower back pain in the pelvis.
Even in pregnancy are easy Gymnastics or yoga exercises, Massages and warming envelopes the most effective measures for lower back pain. If the pain comes from the pelvis, it can strengthen the Pelvic floor muscles specifically help against the pain. Get advice from your gynecologist and a specialized physiotherapist. Guided training measures are often easy to carry out and are very helpful. Light sports such as walking or swimming are also very back-friendly and help you stay fit during pregnancy.
Read more about the topic here: Back pain in pregnancy
What to do / what helps with lower back pain?
Back pain is not only annoying for most of those affected, it also severely restricts everyday life if it persists over a long period of time. Chronic pain isn't just that physically, but also mentally stressful. What can you do about it now? First of all, it is advisable to analyze your own behavior: Was there an acute one trigger, for example, a fall? Did the pain develop suddenly or over several weeks? Where is the pain localized and are there any accompanying complaints? What is your everyday life like? Do you move around a lot or do an activity that puts a lot of strain on your back?
These are all questions that are also important for the doctor in the conversation to find the cause. Try to formulate your complaints as precisely as possible in order to actively contribute to finding the cause as quickly as possible. Depending on the cause, there is then one appropriate therapy searched. Often those affected can do a lot against the pain themselves: Various Exercises, Back training and Relaxation techniques are easy to learn and are more effective than for many ailments Painkiller. Consult your doctor for advice. Whenever you are in pain, try to breathe calmly and deliberately. Do simple exercises that stretch and relieve your lower back. Warm compresses and heat packs can also help relieve the pain in the acute situation.
Read more about the topic here: Back training
Exercises
A variety of exercises can be effective for Relief from pain contribute in the lower back. Factors such as a lack of exercise, obesity or incorrect loading of the back are often involved in the development of back pain. Due to its position, the lower back in particular has to carry a lot of weight and cushion loads. Through the upright gait this part of the back is particularly stressed. Back pain in this area is therefore all too common. A few simple exercises can already go a long way and help your back too relieve. Below are two simple exercises that can help if you are experiencing acute lower back pain. For long-term training, which is highly recommended, you should consult an experienced one Physiotherapists or a specialized one Gym turn:
- 1st exercise: The starting position for the following exercise is the four-footed position. Keep your back straight and your head extended. Take a few breaths in and out calmly. Now come into a cat's hump with your inhalation. Put your chin on your chest. As you exhale, straighten your back again. Repeat the exercise as often as you are comfortable. You can do this every day.
- 2nd exercise: Lie loosely with your back on a mat or other comfortable surface. Breathe calmly and evenly. Now pull your knees towards your chest and clasp them with your arms. Let the neck and head slack. Remain in this position for half a minute. This exercise stretches the often shortened muscles in the lumbar spine and helps against acute pain.
Kinesio tapes
Taping the lower back with Kinesio tapes is possible and should help with pain. The effect has not been scientifically proven, but there is Physiotherapists and athletes who are convinced of kinesio tapes. You need four strips of tape to tape the lower back. There are different techniques that are suitable for taping the lumbar spine. A technique is to be explained here as an example:
To put on the tape, the person concerned has to bend forward so that the back becomes rounded. Now a second person applies the first strip of tape. For this technique, all tape strips are attached with maximum tension. The first strip of tape is affixed from top to bottom along the length of the lumbar spine. The pain point is in its center. The second strip is now attached to the center of the first strip at a 90 ° angle so that a cross is created. The strip must be reattached with maximum tension. The last two strips are attached diagonally to the cross, so that ultimately all strips overlap in the middle. When straightening the spine, the tapes form slight waves. This indicates the correct position.
Read more about the topic here: Kinesio tape
Home remedies
Warming envelopes are arguably the best home remedies for lower back pain. Warm a cherry stone or spelled pillow and place it on the affected area. Also a hot bath can be very helpful for lower back pain. Small amounts of are suitable for additional relaxation essential oils like for example Thyme oil in the bath water. The pleasant smell will help you relax and relieve pain. The following rule applies to home remedies: do what is good for you! Some sufferers also massage healing earth or essential oils into the affected area and find this very beneficial for the back.
Read more about the topic here: Homeopathy for back pain
