Pain in the lower back is familiar to almost everyone. It restricts traffic, it is difficult to move around with public transport, to carry bags and long to sit at the office table. She interferes at home, at work, on the road and even in bed, not always manages to curl up into a painless pose. The first desire of a person with a sick lower back is to find such a pose and stay in it until the pain disappears by itself. But, it seems that this is just the worst option of all possible. Doctors insist on the opposite.
Pain in the lower back: what is it about?
Pain in the lower back is usually understood as pain in the lower back. In their life, 80 to 100% of people are faced with them, and if there is a person in the world who did not suffer from back pain – he will still not be able to avoid getting to know her.
Medical statistics say that 6-9% of all adults in the year go to the doctor about this. True, this does not at all mean that they address immediately, as soon as they began to suffer from lower back. According to doctors, only 18% of citizens say that the pain worries them recently and continues right now. 31% of patients suffer about a month at home before finally getting to the doctor. And 39% inform the doctor that the pain in the waist periodically occurs in them already within a year.
This is one of the main causes of disability in the world (10%), and the older a person, the higher the probability of his disability due to back pain.
And this is one of the most mysterious and ambiguous pathological states of the human body. It is not always possible to find out the cause of the pain, while many people it passes by itself within 6 weeks. Two of the three sufferers are still suffering from back pain three months after its appearance. It happens that the pain lasts more than a year, but the intensity of it decreases. Pain in the lower back can go away and come back – sometimes for no apparent reason. It can become chronic, affecting a person’s well-being, poisoning the joy of life, limiting his abilities.
Pain in the lower back is a lottery. It is impossible to immediately be sure that it will soon pass and will not return. According to observational data, 60-80% of patients suffering from acute low back pain experienced discomfort and relapses of pain attacks during the year. If a person due to lower back was unable to work, in 40% of cases it happened again.
Pain acute and chronic
If back pain lasts less than 6 weeks, it is considered acute. If the duration of the pain syndrome has passed for 12 weeks – talk about chronic pain. The gap between these values is designated as the period of subacute pain.
In 80-90% of cases, doctors speak of nonspecific pain, caused by injuries to muscles and ligaments, sacro-podzvdoshnogo joints, etc. In 1-5% of cases, the pain develops as a result of squeezing the spinal nerves with herniated intervertebral discs.
It should be noted that in these cases of examination using MRI methods nothing new about back pain will be said, but they are expensive, and the number of coupons for them in budget medical institutions is limited. At the same time, the unwillingness of a neurologist to write out a voucher for an unnecessary examination in this case often becomes an occasion for a conflict between the doctor and the patient. Moreover, quite often the patient, unsatisfied with the refusal, makes an MRI in a paid clinic. Discovering intervertebral hernias (which from a certain age there are practically all people), a person panics, which often leads to deterioration due to psychic reasons.
Back Pain Treatment: Basic Steps
In Denmark, the United Kingdom and the United States, as first-line therapy and with acute and chronic low back pain, it is recommended that the patient continue to lead a lively lifestyle, and also provide training to patients who will benefit from back exercises. In chronic pain, a course of cognitive-behavioral therapy is also prescribed.
The second line of therapy includes manual therapy (practiced in Denmark, the United Kingdom and the USA), massage (recommended by UK and US doctors) and acupuncture (USA) for acute pain. With chronic low back pain, yoga, participation in the MBSR program (Mindfulness-Based Stress Reduction), etc. are added to these items.
Finally, only the third line of therapy includes the use of non-steroidal anti-inflammatory drugs in acute pain, and chronic selective norepinephrine reuptake inhibitors and, in extreme cases, surgical treatment, are added to them.
It should be added that studies have repeatedly confirmed that manual therapy and massage have a stronger and more lasting effect than other drugs.
Physical activity is the main drug
Many patients, facing pain in the back, believe that it is necessary to lie down, wait until the pain passes. Even while continuing to move, they begin to do this cautiously, trying to maximally protect the lower back, limiting all types of physical activity.
And this is their main mistake. Neither in acute, nor in chronic pain is not recommended to do so. Moreover, moderate physical activity is included in the list of different types of therapy that are prescribed for back pain. This is confirmed by a number of studies.
For example, in a 2006 study, scientists compared two groups of physically active people who suffered from chronic low back pain. One group spent 4 weeks on Pilates equipment, the second group (control group) received usual medical appointments. Reduction of pain was more significant in the first group, the effect lasted for 12 months.
In 2011, the impact of tai chi classes on the health of patients with chronic low back pain was studied. After 10 weeks of training, the participants in the experiment were significantly less likely to suffer from back pain and had a higher self-esteem than those receiving normal medical care.
Scientists also indicate that the mechanism of development of chronic pain involved different levels of the nervous system. This is not only the concentration of neurotransmitters that change the strength of the pain pulse, but also the sensitization of the nerves involved in its transmission. It is also a person’s psychological reaction to constant pain. Physical activity reduces the level of emotional stress, which almost doubles the effectiveness of traditional methods of therapy in the treatment of chronic pain.
The list of various types of physical activity, recommended for back pain, includes:
- yoga;
- tai chi;
- aerobic exercise – walking, swimming, cycling;
- coordination exercises;
- exercise, focused on the restoration of muscle skills, and others.
Conclusions:
- Back pain should be referred to a doctor. It is possible that the cause of the pain will be found, especially since the list of causes looks menacing: infections, injuries, cancer.
- If the cause of the pain remains incomprehensible, you can not relax. In the first place – physical activity, a flexible way of life, but not a soft sofa. Drug administration is possible only as directed by a physician.
- It is also necessary to minimize the impact of such developmental risk factors as obesity, smoking, specific work, in which a person must constantly be in an uncomfortable, painful posture.
- Doctors recommend: as far as possible, continue to lead the usual life – go to work, maintain previous social contacts.
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