The lower back is the most common place for musculoskeletal pain. It is one of the most common reasons for hospital admission. It is the most common cause of job loss. About 80% of the population suffers from low back pain at some point in their active lives. 90% of patients recover within two to three months. Three or more repetitions in 70% of patients. 10% of low back pain becomes chronic. Low back pain usually occurs as a result of strains due to weak body biomechanics, unidirectional repetitive loads, neglect of physical activity and insufficient muscle tone.
Those who are sedentary in work and social life (desk work, etc.), those who lift heavy loads, those who do work that require repetitive bending, those who drive for a long time, those who have weak waist and abdominal muscles, those who are overweight, those with body biomechanics and posture disorders, those in the last months of pregnancy The incidence of low back pain increases in those who are involved in risky sports such as weightlifting, smokers (smoking disrupts the nutrition of the discs), and those who experience stress and mental tension.
Low back pain can develop due to muscle strain and unilateral loads, postural disorders, calcifications, disc pathologies such as herniated disc, rheumatic diseases such as anclosing spondylitis, traumatic causes, osteoporosis, infectious conditions, tumors, and reflected pain of internal organ pathologies.
Low back pain starts suddenly or increases slightly. Pain is most commonly of mechanical origin, such as strain on bones, muscles, ligaments and soft tissues, or it is due to the influence of nerve roots, which we call sciatica, which develops due to hernias caused by strain and damage in the intervertebral disc. Clinically, lumbar movements are painful and limited. Daily activities such as leaning forward, standing up, washing your face become more difficult. There is detention. In soft tissue pain, the pain decreases at rest and increases with movement. In pain caused by hernias, the nerve root is affected and there is pain at rest. There may be numbness, tingling, and a feeling of weakness.
Appropriate treatment plan is created for patients diagnosed with detailed history and post-examination tests. In the treatment, firstly, a short-term rest is given. NSAIDs, analgesics, muscle relaxants and tranquilizers are started as drug treatment. Superficial heat is applied. Bracing may be recommended. Physical therapy agents such as superficial and deep heaters, traction, and low-frequency currents are used in the treatment. Local injections may also be required. Rehabilitation is essential to avoid recurrences in the chronic period. Muscle strength and tone should be strengthened and flexibility should be provided. Exercises to strengthen the back and abdominal muscles are applied. Regular strength and stretching exercises are given. Activities such as walking, swimming, yoga are recommended. Ergonomics and posture are regulated in daily life activities and working environment. It is recommended to use lumbar supports in a sitting position, to have appropriate desk and monitor levels, to avoid heavy lifting, to carry shopping bags in both hands, not to stay in a fixed position for a long time, and to prefer flexible and comfortable shoes.
Dr. Filiz GENGOR
Physical Therapy and Rehabilitation Specialist
Tınaztepe Galen Hospital