What is Low Back Pain?
Backache; Pain can be felt in the form of pain, stiffness, burning or stinging, sharp or blunt, in and around the waist. It can spread to the legs, hips and heels in the form of pain, burning, pricking, numbness.
We first question the character of low back pain. Inflammatory states with pain that increases with rest and at night; We think of mechanical conditions with standing and daytime pain.
Pain; It may originate from bone, cartilage, muscle, joint capsule, ligament, disc, nerve membranes or vessels, and the exact cause may not always be revealed.
Acute Low Back Pain:
Pain that has been present for less than 6 weeks. It may start after a specific activity or accident, or it may be completely independent of the activity. 80% of people experience severe back pain at least once in their lifetime. Most of the time, the pain subsides on its own. Nearly half will fully recover within 2 weeks. In 6 weeks, back pain is completely relieved in 80% of people. 30% of pain will become chronic and will have a new attack. In acute low back pain, the patient's greatest expectation is to relieve the pain as soon as possible.
Chronic Low Back Pain:
Low back pain that has been present for more than 3 months. In chronic pain, the possibility of tumor must be excluded. If there is pain at rest and at night, and weight loss is observed, the tumor should definitely be considered. It is important to define radicular pain radiating to the lower extremity and localized pain in the lower back. If the pain does not go below the knee, degenerative diseases are considered if it is in front of the hip and thigh. However, if the pain extends below the knee, back of the calf, or foot, the nerve is under pressure.
What are the Causes of Low Back Pain?
- Herniated disc: Heavy lifting, bending over for a long time or staying in the same position, overweight, prolonged stress, multiple births, etc. It occurs when the protective outer part of the disc between the vertebrae ruptures and the disc changes its shape and compresses the nerves as a result of sudden or continuous severe stresses in the lumbar region due to reasons.Back pain or leg pain may be more prominent in the location and type of the hernia. It can cause restriction in mobility, shortening of walking distance, difficulty in sitting, incontinence and impotence.
- Stress Fracture and Lumbar Slip
- Lumbar Narrow Canal: The spinal cord passing through the spine carries sensation and strength to the legs. It controls urine and stool retention. Conditions such as decreased disc height, thickening of the bones, capsules or ligaments of the intervertebral joints, and lumbar slippage may cause spinal stenosis, ie narrow canal, by narrowing the diameter of the canal through which the spinal cord passes.Typical complaints are loss of strength or sensation in the legs, or numbness and tingling after walking a certain distance. Since leaning forward and sitting increases the canal diameter, complaints may decrease or disappear. But it will repeat after walking a certain distance.
- Scoliosis: Spinal curvatures are S or C shaped. Injection application (prolotherapy) is performed together with appropriate exercises. Surgical treatment can be applied to scoliosis patients according to their age, the degree of scoliosis and if it is compressing, these findings.
- Rheumatic Diseases
- Metabolic Conditions
What is the Treatment Protocol for Low Back Pain?
In the treatment of low back pain, cause-oriented treatment is performed:
- * Hot and cold applications
- * Correction of posture
- * Healthy eating and reducing excess weight
- * Choosing the right shoes
- * Regular sleep
- * Physical Medicine and Rehabilitation practice
- * Appropriate exercise programs (Lumbar Hernia, Scoliosis, Postural and Mechanical Disorders)
- * Prolotherapy, PRP, Neuraltherapy, Ozone Injections
Dextrose serum solutions and PRP (Plapellet Rich Plasma solution obtained from blood by centrifugation) are used in prolotherapy injections. It is a method that strengthens the ligament structure of the lumbar region and allows the herniated disc to be pulled in. It allows the hernia to shrink or disappear. It can be applied to any hernia patient. It is a method that must be applied before the decision of surgery is made.
In neuraltherapy injections (neuroprolotherapy injection), physiological saline or 5% dextrose solution is used. In neural therapy, we get very fast and successful results in acute low back pain with superficial injections that we mix with local anesthetics and make superficial injections around the muscles parallel to the spine, nerve projections on the skin, and around the nerves that pierce the fascia. Neuroprolotherapy is an effective injection treatment method for chronic and acute low back pain, which is applied with similar techniques.
Ozone Injection Treatments are also an additional treatment method applied for low back pain.
Here, we evaluated low back pain in terms of rehabilitation methods. If patients have progressive muscle loss, low feet, numbness, and persistent pain due to severe nerve compression, surgical treatment methods will be used.
Dr. Lecturer Elif BERBER
Physical Medicine and Rehabilitation Specialist
+90 545 569 46 55