In medical terminology, the lower part of the spine is called the lumbar spine and the lumbago is the colloquial “lower back pain. “The common abbreviation for the lumbar spine is LWS and that of the associated lumbar vertebral bodies LWK. The lumbar spine is located below the thoracic spine and begins with the first vertebral body where no rib can be felt.
The five vertebral bodies of the lumbar spine are followed by the coccyx, whose original vertebral bodies have fused into a single bone in the course of evolution. The individual vertebral bodies are connected to each other via intervertebral discs and the so-called facet joints. Each vertebra consists of a massive vertebral body and the vertebral arches that enclose the spinal canal.
The intervertebral disc connects the vertebral bodies and the facet joint connects the vertebral arches. The intervertebral disc acts as a kind of shock absorber or buffer between the vertebrae and consists of a gelatinous mass that soaks up water and thus absorbs peaks and impacts, giving the spine its enormous mobility. Between the vertebral arches and vertebral bodies, nerve bundles from the spinal cord make their way to distant parts of our body to control muscles or other body functions.
Pain in the spine, i.e. back pain, is one of the most frequent reasons for visiting a doctor in Germany, along with colds. Pain in the area of the lumbar spine can be very different, from pressing to stabbing or even dull. It is also important to differentiate whether the pain is always there, only occurs at a certain load (e.g. only when sitting, standing or lying down) or even only at certain times of the day.
If the pain is present after a short-term event such as a move and disappears again within a few days after the end of the load, then short-term overload can be assumed as the cause. Even short-term pain caused by one-sided strain is usually only of short duration and disappears again by itself. In the case of a violent impact on the back, a fracture of the vertebral body must always be considered and urgently clarified.
In general, a doctor should be consulted immediately if the symptoms do not improve or even become worse. Typical causes are then often lumbago, a herniated disc, the facet syndrome or a degenerative (= wear-related) cause. Lumbago, as the name suggests, often comes suddenly and unprepared from a completely irrelevant movement.
It immediately manifests itself with a strong stabbing pain in the lumbar region, which makes any movement impossible and forces the affected person to remain in this position. The cause of lumbago is the irritation of the nerve tracts that emerge from the spinal canal between the vertebrae. The irritation leads to an immediate tension of the muscles in this area, which finally leads to the inability to move due to a strong tension of the muscles and causes the affected person to remain in this position under strong pain.
But no matter how excruciating the pain, a lumbago is really unpleasant for the person affected but not dangerous for him. The facet syndrome takes its name from the facet joints of the spine that connect the vertebral arches. Due to natural aging, intervertebral discs lose fluid in their interior during the course of life.
On the one hand, their function as shock absorbers and on the other hand, their height decreases continuously. As a result of these changes, the facet joints experience more and more stress and begin to rub against each other, which is associated with severe pain for the person affected. If the vertebral bodies come even closer together, the nerve tracts leaving the spinal canal at this point can still become trapped, which could have greater consequences.
The pain in facet syndrome is caused not only by the joints but also by a reflex tensing of the spinal column muscles, which can end up as a blockage of the spinal column. The most common type of pain and movement restrictions in this area are caused by blockages in the mobility of the joint. These can be treated well by experienced physiotherapists.
In medicine, the ileosacral joint is referred to as ISG. The pelvic bone, which forms the pelvic shovel, is called the os ilium, and the coccyx bone is called the os sacrum. The ileosacral joint is the connection between these two bones.This joint is of particular importance because it connects the pelvis with the spine and ensures that the person can walk upright.
It also serves to transfer the power of the legs to the rest of the body. All these tasks are connected with a load on this joint and can therefore be disturbed, which often ends in pain. This pain is then found in the lower lumbar spine (lumbar spine) and in the area of the coccyx.
In many cases, a herniated disc in the lumbar spine can be detected very clearly by the radiation of the pain into the legs. The lumbar spine (lumbar spine) is highly stressed due to its high load of almost the entire body weight and is most often prone to injuries or age- and wear-related consequences. Anatomical causes of a herniated disc in the lumbar spine are parts of a disc that slip out to the back, left or right.
If this slipping out part presses on the nerve cords occurring at this height, the nerve signals can no longer be transmitted: The muscles can no longer respond to the stimuli and other stimuli, such as those of the skin, can no longer be sent to the brain. The patient notices the disturbance of the nerves through pain, tingling or numbness in the legs. The reflexes in the affected areas of the body also change.
An experienced physician can find out exactly which nerve cord is affected from which height of a vertebral body because of the pattern of where the numbness occurs, where the tingling is, where the reflexes are changed or where the muscles are weak. Causes for this painful prolapse of the intervertebral disc of the lumbar spine are usually to be found in the everyday life of the patients. The most common causes are incorrect lifting and carrying, poor posture (especially incorrect sitting) or extreme stress during sports activities.
Despite many known causes, however, in many cases it is not possible to identify no cause. Wear and tear is a completely normal process in our body. The lumbar spine is particularly often affected due to the great strain and mobility caused by our own body weight.
Due to the natural aging of the intervertebral discs, they lose height due to increasing water loss and the vertebral bodies and joints change their shape due to years of continuous strain. Similar to arthrosis, these changes lead to severe discomfort for those affected. If no cause for the pain can be found, even rarer causes for back pain should be considered and examined.
A very typical diagnosis when the pain improves while sitting is spinal stenosis of the lumbar spine. In this case, bone protrusions narrow the spinal canal and the nerves are put under pressure, which is similar to a herniated disc and can lead to nerve pain and back pain. The fact that the pain gets better while sitting makes this clinical picture very clear, since for most other causes the pain is best tolerated while standing.
Also some rheumatic diseases occur in the spinal column and should be clarified by a blood test. For this purpose, above all those affected come into consideration who have these pains over a period of more than 6 weeks and the complaints occur mainly in the morning and will improve in the course of the day. Older people and women from the menopause onwards should also always consider osteoporosis.
In osteoporosis, the bone structure becomes thinner and more fragile and the bones break very easily and often without external force. It is therefore quite possible to suffer unnoticed bone fractures with osteoporosis. These are then only noticed through the resulting pain.
Osteoporosis affects not only long tubular bones such as the thigh or upper arm, but above all the spine. In addition to osteoporosis, the possibility of a tumor should also be considered in older men with newly occurring back pain. In men, a tumor of the prostate gland is the most likely candidate in this regard, since this type of tumor very often forms its daughter tumors in the vertebral bodies.
