The doctor told about the causes of sudden pain in the lower back
Sudden lower back pain may occur when the child is lifting, bending, or trying to get out of bed. Possible causes include muscle and ligament damage, irritation of the intervertebral disc, and changes in the joints of the spine. However, most episodes pass over time, and prolonged bed rest is usually not required. Why, by the nature of the lumbago, it is impossible to independently diagnose who really needs an MRI scan and what symptoms require emergency help is in the Izvestia article.
Why can your back hurt from regular movement?
Severe pain often finds a person doing everyday things. He reaches for the shelf, picks up the bag, or bends over to the child — and suddenly cannot calmly straighten up. Colloquially, this is called "tearing off the back" or "lumbago". However, such expressions primarily describe the sudden onset of pain, rather than a specific injury.
According to Mina Yu, a specialist in physical medicine and rehabilitation at the Mayo Clinic in Arizona, one of the most common causes is muscle stretching, in which muscle fibers are excessively stretched or damaged. Ligaments can also be affected — dense connective tissue structures that help stabilize the spine.
But the lower back may hurt for other reasons. The doctor names irritation or herniation of the intervertebral disc, arthritis of the small joints of the spine and irritation of the sacroiliac joint at the junction of the spine with the pelvis. Less often, sudden pain occurs when one or more vertebrae are fractured.
Therefore, the statement "I just pulled a muscle" after a sharp tilt remains an assumption. Different conditions can give similar sensations, and one description of the movement, after which it became painful, is not enough for a definitive conclusion. The doctor finds out the circumstances of the symptoms, examines the medical history and conducts an examination.
However, it is not always possible to establish a single anatomical cause. According to the World Health Organization, about 90% of cases of low back pain are classified as non-specific: they cannot be confidently explained by a specific disease or structural damage. This is a medical characteristic of the condition, not a doubt that the person is really in pain.
What does the pain of bending mean?
In one person, the pain resembles a sharp prick, in another — a pulling sensation or pronounced muscle tension. Sometimes it appears only with a certain movement, sometimes it persists at rest. Such differences are useful for a doctor: they help to choose the direction of examination. Min Yu pays attention to movements that enhance the symptoms.
"If the pain increases when bending forward, it may indicate a problem with the disc, such as a herniated disc," explains the specialist.
If the soreness becomes worse when bending backwards, a possible cause may be irritation of the facet joints — the small joints between the vertebrae. They are involved in the movement of the spine.
However, the words "may indicate" are important here. A painful tilt does not confirm a hernia, and unpleasant sensations during extension do not prove that the problem is in the joints. These are the signs that the doctor evaluates along with other data. You should not repeat painful movements yourself, trying to determine the diagnosis in this way.
Why is an MRI not prescribed for everyone
After a severe lumbago, you want to get a picture as soon as possible and see the cause of the pain. But a lumbar examination usually begins with a conversation and an examination. The specialist clarifies when the symptoms appeared, what preceded them and how they change. Past injuries, chronic illnesses, and medications are important. During the examination, the doctor can evaluate movements, muscle strength, reflexes and sensitivity.
Min Yu notes that radiography and other imaging techniques are needed in some cases, but not all patients. The reason for such caution is related, among other things, to the interpretation of the finds. An MRI scan can detect age-related changes or small abnormalities that do not cause ongoing pain. Therefore, the conclusion of the study should be compared with the complaints and the results of the examination. By itself, the presence of changes in the image does not explain why the lower back is sick right now.
If the doctor suspects a serious cause or identifies disturbing neurological symptoms, an examination may be required without delay. The decision depends on the clinical situation. The lack of referral for an MRI scan after the first appointment and the need for urgent examination for dangerous signs are quite compatible with the same approach — prescribe a diagnosis based on indications.
Why you don't need to stay in bed for a long time
When any movement gives way to pain, the natural desire is to lie down and wait for complete relief. Min Yu recommends relative rest: temporarily eliminate actions that worsen the symptoms, while remaining as active as possible.
"Relative rest is recommended. However, this does not mean bed rest, because staying in bed does not always improve the condition," says the doctor.
For example, if pain appears during exercise, this exercise should be suspended until recovery. But this does not mean that a person needs to stop moving completely. The specialist advises to continue gentle movements within the limits of tolerance.
The difference is significant: the temporary abandonment of heavy training or weight lifting leaves the opportunity to walk and perform accessible household activities. At the same time, the recommendation to remain active does not mean that you need to endure the sharply increasing pain and continue practicing at any cost.
Cold or heat — which can alleviate the condition
In the early days, Min Yu allows the use of cold to reduce pain and inflammation. Later, some people find warmth more comfortable. At the same time, he warns that for certain diseases, in particular multiple sclerosis, thermal procedures may be undesirable.
A cold compress can reduce pain and swelling, while a warm compress can reduce stiffness and muscle spasm. It is recommended to wrap an ice pack or a heating pad with a cloth. It is important to distinguish between relief of sensations and treatment of the cause. If it feels better after the compress, it still does not allow you to determine what caused the pain. Both cold and heat remain auxiliary measures.: They are not a substitute for a medical assessment in case of dangerous symptoms or deterioration of the condition.
There is no universal rule that will suit all people with sudden back pain. The choice depends on the tolerance and the state of health. Min Yu considers home remedies as part of the help for most common episodes, but separately identifies situations in which it is impossible to wait for the result of self-medication.
What are the symptoms that require emergency treatment?
Min Yu identifies signs in which sudden lower back pain cannot be waited out at home. One of them is the loss of control over the bladder or intestines. The doctor explains that this may indicate severe compression of the nervous structures and the threat of permanent damage.
Another dangerous sign is pronounced weakness in both legs or numbness in the so—called saddle area. We are talking about the perineum, the inner surface of the thighs, and the areas of the buttocks that would come into contact with the saddle when riding.
A new difficulty urinating can also be a dangerous change. The NHS recommends emergency care for disorders such as numbness around the genitals or anus, or symptoms in both legs. It is also necessary after a serious accident or when back pain is combined with chest pain.
There is no need to wait until all the listed signs appear. A new violation of urination or numbness of the perineum on the background of back pain already requires emergency treatment. There are also situations in which an urgent examination is needed, even if there are no listed neurological disorders. These include sudden severe or rapidly increasing pain, as well as pain with chills, a feeling of heat, or general malaise.
How to reduce the risk of a repeat episode
According to Min Yu, one of the significant risk factors is the weakness of the muscles supporting the spine. Additional stress occurs in people who often lift heavy objects or perform physically demanding work, especially if the movement technique increases the load on the back.
The specialist recommends maintaining the strength and flexibility of the body muscles and paying attention to how a person performs everyday actions. However, prevention begins with a gradual return to feasible activity after an acute episode, rather than an attempt to immediately catch up on missed workouts.
It is impossible to completely prevent each episode, admits Min Yu. But working on strength and flexibility and doing daily work more thoughtfully can reduce the risk of future damage.
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