Low Back Pain

Low back pain is a very common condition in the society, and studies have shown that the probability of people suffering from low back pain at least once in their lifetime is around 80%. Most of the patients with low back pain get better with rest, medication or other treatment methods. However, in some patients, this low back pain complaint recurs and turns into chronic low back pain. First of all, let’s talk about what we should pay attention to in order to prevent our back pain from becoming chronic, that is, to protect it from low back pain.

Golden Rules We Should Pay Attention To To Avoid Low Back Pain

The most important rule to avoid back pain is to protect yourself. The less you disrupt the normal upright position of your back in your daily activities, the less likely you will have low back pain.

Let’s talk about what we should pay attention to, so that you don’t have low back pain.

  1. Do not smoke

  2. Reduce your daily tension and stress as much as possible

  3. Exercise regularly and daily

  4. Brisk walking, swimming and running are the most suitable sports for you to avoid back pain.

  5. Do not keep your legs stretched while lying down

  6. If necessary, reinforce your waist with a pillow that fits your waist curve.

  7. Keep your back straight and lean back while sitting

  8. Prefer hard and orthopedic mattresses when lying down

  9. If you are going to carry weights, keep the weight as close to your body and above your waist as possible.

  10. If you must turn, turn with your body, not with your waist.

  11. Divide the loads you will carry equally on both hands.

  12. Never lift heavy objects

  13. Do not bend over when picking things up, bend your knees and squat

  14. Lift with your legs, not your waist

To summarize, the most important point we need to pay attention to in order not to have low back pain is to keep our normal body posture, that is, not to disturb our posture as much as possible. To put it simply, if we disrupt the posture of our back, which is straight and upright, with the movements we make during the day, it is inevitable that we will have low back pain. The answer to this question is actually very simple.

Let me explain this to you with a few examples; For example, we tie our shoes every morning. Beware, most people tie their shoes by leaning forward. This is a very wrong move, because when we bend forward, too much load is placed on our back. Instead we have to squat on our knees, or rather use a riser. Or when we lift an item, notice that most people do this by leaning forward, and then some of them get stuck.

These examples can be multiplied further, but the main message I want to give you here is the most important rule to protect from low back pain. is to protect yourself.

Let’s talk about why some people suffer more from low back pain, that is, personal risk factors for low back pain.

Personal Risk Factors in Low Back Pain

  1. Age: The first attack is usually observed between the ages of 25-30 and is more common around the age of 55.

  2. Gender: Low back pain is more common in men up to the age of 60. After the age of 60, the incidence of low back pain is higher in postmenopausal women.

  3. Race: The incidence of low back pain in Caucasians is higher than in other races.

  4. Genetic Predisposition: Since our muscle mass is genetically inherited, the incidence of low back pain is higher in people whose parents have low back pain.

  5. Body weight (Obesity): People who are overweight (especially those with a body mass index greater than 30) have a higher incidence of low back pain.

  6. Tobacco Use: According to studies conducted in smokers, the incidence of low back pain was 13% higher than in non-smokers.

  7. Psychosocial Factors: The incidence of low back pain was found to be 17% higher in stressed and depressed individuals compared to studies.

  8. Low Socioeconomic Level: In countries with low socioeconomic level, the incidence of low back pain was found to be much higher than in studies.

 

Yes, my dear patients, if you pay attention to these factors, the probability of having low back pain will be greatly reduced. These factors are personal risk factors.

If you notice, some of these conditions I have mentioned are unchangeable factors, for example genetic predisposition. However, some factors can also be changed, such as losing weight.

It has been observed in studies that modifiable risk factors cause lower back pain much more. Then let’s look at these factors together.

 

CHANGEABLE RISK FACTORS

  1. Bus and truck drivers who go long distances constantly: If drivers who have to sit in the same position for a long time do not pay attention to their posture, it is inevitable to have low back pain. These people must use ergonomic cushions with lumbar support that keep their backs in an upright position. They also need to take breaks and do stretching exercises at certain intervals.

  2. Heavy industry and construction workers who lift weights incorrectly: It is inevitable that people working in these work groups, which have to lift heavy weights, will suffer from low back pain if they do not pay attention to lifting things in the right position. The most important thing that these people should pay attention to is to be careful not to disturb their upright posture. If they are going to lift a heavy item from the ground, they should squat down on their knees and lift them instead of bending over from the waist.

  3. Those who work by leaning forward: Especially cleaners or farmers are affected by this situation. The most important thing that these people should pay attention to is that they should be careful not to disturb their posture, which is upright. If they are going to lift a heavy item from the ground, they should squat down on their knees and lift them instead of bending over from the waist.

  4. People who work in jobs with inappropriate posture: People who sit for long periods of time, write, use computers, work in tailoring or car mechanics are highly affected by this condition.

  5. Smoking: According to studies conducted in smokers, the incidence of low back pain was 13% higher.

  6. Sedentary (sedentary) life: Compared to studies conducted on sedentary people, the incidence of low back pain was found to be 8% higher.

  7. Obesity (Overweight): According to studies, the rate of low back pain was found to be much higher especially in people with a body mass index higher than 30.

I tried to tell you about the most important points to prevent low back pain. Now I will try to give you clues about the causes of low back pain and which complaints may be the cause of low back pain.

Let me explain to you the most common causes of low back pain.

  1. Nonspecific low back pain: It describes pain localized only to the low back region. There is no nerve root symptom (numbness, tingling, muscle weakness). Included in this class are mechanical low back pain, facet joint pain, osteoarthritis, muscle sprain and muscle spasm.

  2. Sciatica (Lumbar Disc Herniation): This is the situation we call herniated disc. In the radicular type, there are complaints such as numbness and tingling in the lower extremities along with the waist and waist.

  3. Spine Fracture (Compression Fracture): It should be considered if there is a history of trauma, osteoporosis (bone loss), localized pain on the spine.

  4. Malignancy (Cancer): If you have unexplained weight loss, fever, or a history of cancer, the cause of your back pain may be malignancy.

  5. Infection: If you have fever, intravenous drug use, a history of tuberculosis, the cause of your back pain may be infection.

  6. Ankylosing Spondylitis: If you have low back pain that increases with rest, decreases with movement and especially at night, the cause of your pain may be rheumatic diseases such as Ankylosing Spondylitis.

There are many reasons for low back pain, but I tried to tell you about the most important ones.

Most of the low back pain is relieved with rest. However, in some cases, it is absolutely necessary to see a specialist. Now let me tell you about when to go to the doctor in low back pain.

 

IN WHICH SITUATIONS SHOULD I VISIT THE DOCTOR EMERGENCY FOR LACK PAIN?

Try to see a specialist in the situations I will list below.

1- If you have low back pain after the age of 50, you should see a specialist doctor as soon as possible.

2- If you have a history of cancer, the cause of your low back pain may be due to the re-activation of this cancer and spreading to your waist region (metastasis).

3- If you have unexplained weight loss, the cause of your low back pain may be a serious systemic disease.

4-If you have long-term steroid use or intravenous drug addiction, try to see a specialist doctor as soon as possible.

5-If you have a urinary tract infection along with your lower back pain, see a specialist doctor as soon as possible.

6-If your low back pain still does not improve even after resting, the cause of your low back pain may be a serious systemic or rheumatic disease.

7-If you have a fever along with your low back pain, the cause of your low back pain may be a serious infection.

8-If you can’t hold your urine or large toilet, you may need emergency surgery due to herniated disc.

9-If you have difficulty urinating, this may indicate a serious illness.

I tried to tell you briefly in which situations you should take your back pain seriously.

Unfortunately, in our country, a large amount of imaging tests are requested for our patients who go to the doctor with low back pain. Before examining the patient, direct lumbar (waist) MRI is requested instead of a direct X-ray, which is a simpler imaging examination. Is that so true?

Now, I will try to briefly talk about the situations in which direct radiography, that is, x-ray examination, should be requested.

 

IN WHICH SITUATIONS SHOULD A DIRECT X-RAY BE TAKEN FOR WAIST PAIN?

 

In the following cases, it is absolutely necessary to see a specialist physician and perform an imaging examination (direct X-ray if possible).

1- >50 years: At this age, if you haven’t lifted heavy weights or made any adverse movements, the possibility of low back pain is not very high. For this reason, if you have a low back pain complaint that starts at this age, you should definitely try to see a specialist.

2- Suspicion of Ankylosing Spondylitis:If your back pain is inflammatory, that is, unlike normal low back pain, it increases with rest, decreases with movement, and if you have pain especially at night, the cause of your low back pain may be a rheumatic disease.

3-Serious Trauma and Suspicion of Fracture:If you have experienced a high-energy trauma such as a serious fall or impact, see a specialist as soon as possible.

4-Urine and stool incontinence: If you are incontinent or incontinence, seek medical advice immediately. A large lumbar hernia may occur under this situation.

5-Progressive Neurological Deficit:If you have progressive muscle weakness, try to see a specialist as soon as possible.

6-Unexplained weight loss:If you have weight loss along with your low back pain, this may be due to a serious systemic disease such as malignancy.

7-Fever:If you have a fever along with your lower back pain, it may be due to a serious infection in your lower back, such as tuberculosis.

8-Corticosteroid Usage:If you are using cortisone for a long time (more than 3 months), you should definitely see a specialist for your low back pain.

9- If your back pain does not improve despite one month of treatment:Try to see a specialist for pain that does not go away despite rest, medical or physical therapy methods.

Yes, my dear patients; I tried to give you general information about when you should take your back pain seriously and go to the doctor.

Now let’s take a look at the most frequently asked lumbar hernia.

What is herniated disc and what are its symptoms?

First of all, let me try to answer the question of what is hernia and how it occurs, my dear patients.

The lumbar spine consists of five vertebrae and discs. The vertebrae surround the spinal cord, preventing it from being damaged. Lumbar hernia occurs when the cartilage between the vertebrae slips and ruptures after severe stress (heavy lifting, staying in the same position for a long time, being subjected to strain, falling, overweight) and the nerves coming out of the spinal cord are compressed.

The waist region is the region that bears the body weight the most, and therefore, herniated disc is very common in our society.

 

Yes, my dear patients, after answering the question of what is hernia and how it occurs, let’s try to answer this question, what are the symptoms of herniated disc.

The first symptom of herniated disc is usually low back pain. There is also spasm, tension and stiffness in the paravertebral muscles in the waist region. Due to this spasm, lower back movements are painful and limited. The most important difference of lumbar hernia from other causes of low back pain is that there is leg pain along with low back pain. In addition, due to nerve compression, complaints such as numbness and tingling in the legs and feet can be seen. Herniated disc pain increases with standing, walking, leaning forward, coughing and straining.

Yes, my dear patients, the most important message we should take out of this article is that if you only have pain in the lumbar region and this pain does not hit your legs and feet, it is very unlikely that the cause of your low back pain is herniated disc. In addition, if you do not suffer from numbness and tingling in the legs and feet along with your low back pain, it is very unlikely that you will have a herniated disc.

If you have the complaints I have mentioned, you may indeed have a herniated disc. My advice to you is to consult a doctor who listens and examines you as soon as possible.

After briefly talking about herniated disc, let’s talk about the treatment methods in low back pain in general.

 

TREATMENT METHODS FOR LACK PAIN

 

There are many treatment methods when you have low back pain. Let’s list them now.

  1. Rest: Rest is the most important treatment step in low back pain.

  2. Medications: Medication is frequently prescribed for low back pain. The important thing here is to know that the drugs will create a temporary relief.

  3. Physical Therapy: In general, physical therapy methods are preferred for chronic low back pain.

  4. Waist Corset: Corset can be used for acute and severe low back pain, provided that it is used for a maximum of 3 days. If a corset is worn all the time, the waist muscles become weak because they do not work, and the patient becomes dependent on the corset.

  5. Exercise: Exercises are very important in terms of maintaining the normal posture of our waist. The important thing here is that you should not exercise in acute low back pain. Because if you exercise when you have pain, your pain will increase even more. After your back pain is gone, exercise should be done, especially swimming.

  6. Local injections: Local injections can be used for pain that does not go away with medical treatment.

  7. Manipulations: Manipulations performed correctly by a specialist help to bring our lumbar region to the correct anatomical position.

  8. Surgical treatment: If you have drop foot or urinary incontinence, you should have surgery within 72 hours. Situations other than that (having very severe back pain and numbness) are not a definite reason for surgery.

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