What do you need to know about lower back pain?
Lumbar spine pain (lower back pain)
- It is common among athletes
- It can often be the end of a career or cause a serious setback
- There is often no correlation between pain and imaging findings
- MRI does not cure lower back pain
- Most athletes have a degenerative damage in the lumbar spine that can be proven by imaging, but it is often asymptomatic
- Psychosomatic origin
- Pain can be prevented and controlled with care and proper exercises
Causes of lower back pain
- Often disproportionate structure of the core musculature
- Excessive curvature of the spine at the lumbar spine
- Inadequate warm-up
- Overloading, in elite athletes the load on the spinal disc can reach 8600N.
RED FLAGS
If you have the following symptoms in addition to back pain, you should seek medical advice as a matter of urgency:
- Muscle weakness in the lower limb
- Difficulty holding urine or stool
- Pulsating pain at night
- Impotence or persistent erection
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For the correct diagnosis it is important to know
- The description of the injury, when and how the pain occurred, what were the circumstances
- The location and radiation of the pain
- Pain while bending backwards shows injury to the small joints and damage to the back of the vertebra.
- Pain while bending forwards may indicate an injury to the intervertebral disc and vertebral bodies, while pain on rotation may indicate an injury to the capsule of the small joints.
- Pain radiating to the lower limb may indicate disc injury.
What are the most common tests to perform for lower back pain?
- A thorough physical examination
- X-ray from two directions, from the front and side. The X-ray will show bony injuries, slipped vertebrae and abnormal spinal curvatures, and can also give an indication of the condition of the discs. When the gap between two vertebral bodies is narrower than between the others, there is probably a degenerative damage to the disc.
- MRI The so-called Gold Standard scan is very informative and can show the condition and abnormal changes in the vertebrae, joints, ligaments, discs and surrounding muscles and tissues. It often shows abnormalities even in the absence of complaints, and over the age of 60 100% of MRI scans show signs of disc degeneration. It is important to treat the complaint and not the radiological findings.
Treatment and common diagnoses in athletes
The most common diagnoses for lower back pain in athletes are
- Tension of the muscles around the spine
- Spondylolysis, Spondylolysthesis
- Disc degeneration (discus degeneration, discus protrusion, discus hernia)
Treatment for lower back pain
- The treatment depends on the exact diagnosis, the most common solution being conservative therapy, i.e., physiotherapy, massage and physical therapy.
- Depending on what is causing the pain, it may be necessary to immobilize the spine, especially in cases of so-called fatigue injuries of the vertebrae (spondylolysis, spondylolysthesis).
- Core-training is a gymnastics exercise that strengthens the stabilizing muscles of the spine and compensates for any lateral or anterior-posterior asymmetries, thus ensuring proper stability of the spine and helping to distribute the load on the vertebrae and discs.
- Surgical intervention may be necessary for certain problems.
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