Our waist is the structure that carries the weight of our body and transfers it from the hips to the legs and at the same time enables our body to be mobile. There are 5 vertebrae in our waist and between these vertebrae there are cartilage pads (disc), joint structures and soft tissues that support them. It acts as a protector for the lumbar vertebrae, spinal cord and nerve roots. Pain felt in the lumbar region is called “low back pain”.
Low back pain is a very common problem. Low back pain can be seen in anyone at any stage of life. Although the frequency of applying to a health institution due to low back pain varies from society to society, it is in the first three places in every society. Diseases that cause low back pain affect workers, and it is an increasing problem in the world, such as wages, loss of workforce and treatment costs.
“Acute” (sudden onset) low back pain can last up to 12 weeks. 50% of these pains heal within a week with treatment, rest and various local applications. These pains are generally mechanical low back pain that is frequently seen in the society. “Chronic” (long-term) low back pain is pain that lasts longer than 3 months. It constitutes 5% of all low back pain. Chronic low back pain is usually caused by rheumatic, serious diseases of the abdominal organs and trauma or strain of structures such as muscles, bones, ligaments and discs of the lumbar region.
Basically, low back pain is discussed under three headings;
Mechanical Low Back Pain: Pain that occurs as a result of trauma or strain on structures such as muscles, bones, ligaments and discs that make up the waist. The causes are divided into two groups as musculoskeletal diseases and spine diseases. It mostly occurs with minor damage to the muscles, connective tissue or joints. Other musculoskeletal problems that cause low back pain include bad and faulty body posture, a short leg, and stress. In spine diseases, lumbar hernia (lumbar disc hernia), wear of disc tissue (degenerative disc disease), lumbar slip (lumbar spondylolisthesis), narrowing of the lumbar spine canal (lumbar stenosis) are the most common disorders that cause low back pain. Apart from these, serious diseases of the spine such as tumor, infection, trauma, collapse due to osteoporosis can be counted.
Mechanical low back pain is distinguished from other low back pain causes with some features.
a) Mechanical low back pain is usually pain in which the onset time or initiating event is known clearly.
b) Although it can be seen at any age, these pains are often seen between the ages of 30-50.
c) The location of low back pain is obvious and the patient can show the area of pain with his hand.
d) Low back pain decreases with rest but increases with standing and activity.
e) Most of the mechanical low back pain is accompanied by pain hitting the leg, heel or even the big toe and burning or numbness.
f) When patients lie on their back at night, they wake up with back or leg pain due to stretching of the sciatic nerve, and when they change their position by bending their knees, back pain or leg pain will decrease after a while. In fact, patients start to sleep by bending their knees after a certain period of time.
Rheumatic Low Back Pain: Diseases that cause low back pain are called spondylarthritis. Rheumatic low back pain has an insidious onset. The patient does not remember clearly when the pain started. Low back pain usually occurs between the ages of 20-30. It is rare for it to start over the age of 40-45. Having chronic pain is important. Because there is no rheumatic pain that lasts for a few days. Morning stiffness and pain is one of the most important features of rheumatic low back pain. The patient usually does not immediately wake up in the morning when they get out of bed. After some movement and exercise in bed, she can get out of bed. The patient wakes up at night with low back pain, gets up for a while, goes back to sleep after the pain subsides. He feels pain when turning in bed at night or is unable to turn.
Reflected Low Back Pain: These pains are usually encountered in the internal organs, lymph nodes and vascular enlargements behind the peritoneum. Diseases such as testicular tumors and lymphoma that occur especially in young people can often be confused because spondylarthritis is also seen at this age. The most important feature of reflected low back pain is not affected by rest and movement. While mechanical low back pain decreases with rest and rheumatic low back pain increases with rest and decreases with exercise, the severity of referred low back pain continues in the same way. Patients have an insidious onset of low back pain. They cannot specify the exact start time. The location of the lower back pain is unclear. Structural complaints of diseases such as cancer, such as weakness, loss of appetite, weight loss, and fever accompany low back pain.
