Pain is actually a complaint of all of us. There should be no distinction between men and women, young and old. In this issue, we will talk about low back pain, which concerns a large part of society. Pains such as lower back pain negatively affect social and business life for various reasons. We sit and cannot stand, or we stand and cannot sit. Even while sitting, we need to maintain the correct posture so that we do not get sore during the conversation. We are actually talking about a situation that extends throughout the day, so it is very important. Although it does not seem to be a big inconvenience, it reduces our quality of life.
How often is low back pain encountered?
Low back pain is the most common type of pain after headache, seen in 50% of urban areas and 80% of rural areas in our country. . It is also the most common problem we encounter among spine problems. Almost 1 in 2 people experience back pain at some point in their lifetime. And its frequency is increasing with the aging population. The complaint of low back pain is the second most common reason for consulting physicians and the fifth among inpatients. For this reason, it creates an economic burden.
What are the causes of low back pain?
The majority of low back pain is caused by overuse of the spine and surrounding structures, accounting for 97% of cases. It causes mechanical pain that occurs after straining or straining. The cause of most of this type of pain cannot be determined. Tensions in the muscles around the spine, disc wear, wear in the joints, wear and tear in the ligaments and soft tissues and sprains are held responsible for the pain. In this type of pain, there is a pain that decreases with rest and increases with movement. Morning stiffness lasts for short periods of 5-10 minutes. And we see that heat application reduces pain.
What conditions cause low back pain other than mechanical pain?
The conditions that may cause low back pain are mainly inflammatory, that is, rheumatic. diseases, some infectious diseases such as brucellosis, tuberculosis, cancers or malignancies that everyone fears, fractures and pain reflected from various organs such as bladder, kidney, liver, ovaries, psychosis. It may cause pain due to social reasons.
Can there be a serious disease or condition underlying lower back pain? What should you pay attention to in order not to miss these diagnoses? What is important in your evaluation?
It is very important to take a good history before examining the patient. There are some findings that will alarm us, especially those that the physician should question carefully. We call these red flag symptoms in low back pain. These can be generally described as follows. Pain located in the upper part of the waist, towards the chest cavity, occurring with high fever, unexplained weight loss and weakness in the patient, night sweats, nausea, vomiting, increasing numbness in the legs, loss of sensation and strength, impaired walking, pain that does not ease with rest. , especially the pain that wakes us up at night should warn us. Apart from this, incontinence of urine or defecation as a result of deterioration in bladder and bowel control, or a feeling of saddle-shaped numbness around the anus, and pain that begins after trauma such as an accident or a fall, can be described as warning symptoms. In other words, all these symptoms are red flags.
How to relieve lower back pain, what should be done to protect waist health, what should be paid attention to after it is caught and overcome?
Of course, we are in a constant rush during the day and we often neglect our health. However, if we follow certain rules to protect our waist health and make this our lifestyle, we can reduce the possibility of getting back pain in the future by 3 quarters.
I can explain these as follows; For example, we are looking at an object or object, and we need to turn to that object completely with our whole body front, not with a certain body part. We need to look so that the head, neck and body are on the same plane.
We need to be careful not to stay in the same position for a long time. We need to make sure that sitting and standing time does not exceed 45 minutes. If we have been standing for 45 minutes, we should sit for 5 minutes; if we have been sitting for 45 minutes, we should stand for 5 minutes.
When we sit, we should use a pillow that supports the lumbar arch. We should bend it into a k position and sit in an upright position.
In jobs that require picking up something from the ground, we should take care to do the work by squatting from our knees rather than bending from the waist.
We should use a spring orthopedic mattress to lie down. This bed should be neither hard nor soft.
When going to bed, we should first come to the edge of the bed and sit down, get support from the arms, first lie on our side, and then turn over on our back. When we want to get out of bed, we must first lie on our side and sit down with support from the arms, then stand up.
Bending forward in the side position and pulling the legs towards the abdomen is the most suitable position for waist health.
Avoid air conditioning or air flow. We must take precautions to avoid direct exposure.
Is every back pain a hernia? Do all back pain require surgery?
Patients usually apply to us in panic. In fact, hernias account for the least portion of back, neck pain and spine problems. Most of the back pain in young ages is caused by muscle problems. Muscle-related spasms or muscle tightness, which we call trigger points, popularly referred to as cramps, are frequently seen. As we get older, we frequently encounter conditions commonly referred to as calcification, which are deteriorations in the spinal joint structure due to abuse. At very old ages, we see herniations less frequently as there is water loss in the cartilage structure between the vertebrae, which we call discs.
What are the symptoms of a herniated disc?
There is definitely pain in a herniated disc, and the pain is accompanied by limitation of movement. For example, patients generally express difficulty in turning left and right, bending forward, putting on shoes, or taking off socks. In the mornings, our patients usually experience a feeling of stiffness, that is, when they get out of bed, they express that they have difficulty in changing my clothes or washing my hands and face. They say I can't open up for 5-10 minutes. If the patient has these complaints, we can attribute the low back pain to a herniated disc, mechanical problems of the spine or muscle problems. However, if this process, which we call morning stiffness, lasts more than 1 hour, and if the patient still cannot open up after at least 1 hour, then more We often think about whether we have inflammatory rheumatism. Apart from that, if it is already a hernia, the problem is not only in the lumbar region, but the radiating and reflected pain also accompanies it.
Where is the pain reflected in a herniated disc?
Pain may be referred to the right or left hip. It can be reflected in the calf along our entire leg. It may be reflected in our fingertips, and in hernias, which are less common in the upper lumbar region, pain may be reflected in the front of the thigh. At the same time, some symptoms such as numbness, burning, and tingling may occur if the pressure on the nerve continues due to the hernia and its nutrition is impaired. And even in the last stage, problems such as muscle weakness, falling in our feet and fingers, and not being able to move the ankle upward may be accompanied by problems. If the event is too advanced, an unpleasant condition called cauda equina syndrome may occur, which is very rare.
Why is swimming important?
Swimming is very important because especially during swimming, our muscles that carry the loads on the spine surrounding the spine become extremely strong. If our muscles are strong, we can carry loads that can increase up to 30 kilos when we gain 1 kilo, without straining the spine. That area is under stronger protection and becomes healthier.
Why is low back pain common during pregnancy, what should be done?
One of the most common complaints of pregnant women is lower back pain. We encounter low back pain in at least 60-70% of pregnant women. There are several causes of lower back pain. One of these is that with the advancing weeks of pregnancy, the load on the vertebrae increases and the lower back muscles work more. Another cause of lower back pain is some problems in the spine such as a herniated disc that started before pregnancy. For example, if there is such a thing, there may be pain in the leg. Another cause of lower back pain is the growing uterus. As the uterus grows, pain in the groin and lower back may be observed due to the displacement of internal organs. In these cases, supporting the waist area while sitting or massaging the muscle areas in the waist with circular movements with baby oil will reduce these pains. At the same time, paracetamol is used for back pain that has become unbearable. Simple painkillers can be used.
What should pregnant women pay attention to in order to protect themselves from low back pain?
To protect against low back pain during pregnancy, women It is very important that they do not gain excessive weight. This may be possible with a proper nutrition and exercise program. For this reason, great importance should be given to exercises such as walking, swimming and pilates during pregnancy. They need to pay attention to their posture in daily life, that is, they need to exhibit the correct posture.
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