Low back pain is one of the most common complaints in society, and 80 percent of people experience low back pain at some point in their lives. Approximately 1% of all low back pain requires surgical intervention. The other part is treated with auxiliary methods called conservative treatment.
Causes of low back pain
1) Muscle origin pains (Mechanical low back pain)
Occurs after heavy activity or seasonal changes. It usually improves with rest and pain relievers. If it persists, exercise therapy is recommended.
2) Herniated disc (lumbar disc herniation)
It is the overflow of disc material between the lumbar vertebrae into the spinal canal. The overflowing cartilage tissue, that is, the hernia, compresses the nerve root coming out of that level. This causes pain called “sciatalgic” or “radicular” pain extending from the waist to the hip and leg. If the hernia protruding into the spinal canal does not compress the nerve root, such pain is not expected. In this case, only low back pain is seen due to the overflowing hernia compressing the capsule.
Most of these pains are relieved by rest, drug therapy, physical therapy and back injection therapy, which is called conservative treatment.
Surgical intervention is required in those who continue to have pain that reduces their quality of life despite all treatments, or who have progressive loss of strength in the muscle group stimulated by the nerve compressed by the hernia.
The main surgical methods are microdiscectomy and endoscopic discectomy.
After surgery, the patient is usually discharged after 1 night of hospitalization, and can return to work after 2 weeks.
3) Low back slip (Spondylolisthesis)
It is the compression of the spinal cord due to the slipping of the lumbar vertebrae over each other. It manifests itself with low back pain, the severity of which increases especially with standing and walking. Displaced vertebrae are treated with screws (stabilization).
4) Canal Narrowing (Lumbar Narrow Canal)- Calcification
It is the compression of the spinal cord passing through the middle with the calcification of the lumbar vertebrae. The main complaint is the feeling of numbness in the legs that increases as the person walks and the need to rest for 5 minutes even for short distances while walking. In its treatment, surgically calcified and narrowed areas are opened microscopically and the nerves are relieved. Depending on the condition of the spine, screwing may be required.
5) Spine injuries
Injuries to the spine due to trauma. They cause severe low back pain, resting with a corset or surgical procedure may be required depending on the type of injury.
6) Bone resorption (Osteoporosis)
They are deformations in the spine due to weakening of the bones. It often causes fractures in the form of collapse of the vertebral bones. It is especially common in women in the menopausal period. It is treated with medication for osteoporosis, conservative treatment for the spine, or surgical methods by filling the bone.
7) Rheumatic diseases
Of the many types of rheumatism, the most common is Ankylosing Spondylitis (AS). Pain lasting 4-5 hours after waking up in the morning, and unlike other types of pain, it is typically relieved by movement. It is mostly familial, and early diagnosis is important in terms of preserving functions. It is treated with drug therapy and physiotherapy determined by rheumatology or physical therapy doctors.
8) Infection
Spontaneous infections, cheese disease (brucellosis), tuberculosis or post-surgical infections (discitis) cause long-term low back pain. Sometimes surgical intervention may be required with antibiotic therapy.
9) Causes originating from other organs
Liver, kidney disorders, urinary tract infections can cause low back pain.