The back does not bend at the waist. Severe pain in the lower back. Myofascial pain syndrome when bending the back

The health of your spine Andrey Viktorovich Dolzhenkov

Why does lower back pain occur when straightening?

Many patients turn to doctors with this question. This is a completely natural question. But the appearance of pain of varying severity in the lower back during extension is a completely natural phenomenon.

Did you wash while standing at full tilt or weed on summer cottage a bed of carrots, or washed the floors in anticipation of guests... In a word, they worked. And if you worked for a long time, you probably got tired. But the work did not happen by itself. At the same time, the vertebrae, ligaments, muscles - your entire musculoskeletal system - worked. He too was tired, supporting your body in a semi-reclining position. And now he is experiencing some difficulties when straightening. Especially if the body was in a fixed position.

– What is a fixed pose? – another patient will ask.

A person being in a position resembling the letter “G” without support for more than 15–20 seconds can be considered a fixed pose for this position. After this time, in a person of average physical development, the deep back muscles begin to experience significant difficulties. It's all about the peculiarities of the movement of the spine in the sagittal plane. If you have forgotten what it is, let’s put it simply – when bending forward and extending. Remember when we compared the spine to a pillar? You can compare our spinal column to a tower. Is it possible to imagine a tower bent almost in the middle at an angle of 90°? It’s possible to imagine, but this is already a disaster - the building is about to collapse under the force of its own gravity.

The spine is structured much more perfectly: it is held in a semi-inclined position by the deep muscles of the back. However, in this position their energy capabilities are quickly depleted. Prolonged half-bending is a very unfavorable position from the point of view of spinal biomechanics. Long-term tense muscles are less well supplied with blood; biologically active substances accumulate in them, irritating the nerve endings of muscle fibers. This manifests itself in painful sensations with muscle tension. The stabilizing capabilities of the muscles are rapidly decreasing.

Here you should straighten up - no serious problems have arisen yet. But no: the laundry has not yet been washed, the carrots have not been weeded, the floor has not been washed... And you continue to work, leaving your spine at a disadvantage. This is where the danger arises: the longer a fixed position is maintained, the less strength the muscles have for the subsequent action - extension.

And finally his turn came. By this time, the extensor muscles have long experienced difficulties with blood supply.

Remember: the first signs of fatigue of the musculoskeletal system appeared within 15–20 seconds, and washing, weeding, and cleaning lasted and lasted! Vertebrae that have largely lost muscle support become ready to shift - overworked muscles seem to “let go” of them; As a result, the pressure of the vertebrae on the discs becomes dangerously uneven. In addition to all other troubles, there is also pain from overstretched ligaments. spinal column– there is aching, stringy pain that accompanies the entire process of extension.

Reading these lines, you can get scared. But, unfortunately, it can be worse. If, with severe fatigue of the extensor muscles, you begin to move out of a fixed position, holding a significant load in your hands (even a wet duvet cover, even a bucket filled with soil or water), sad consequences may well arise in the form of persistent pain and the need for long-term treatment.

Ligament tears may occur. Then you will feel a sharp pain in the lower back - we call this sudden blow in everyday life a lumbago. A disc may rupture or even completely rupture, and there may be pain or weakness in one or both legs.

So what – don’t wash, don’t weed, don’t clean? No, you can do all this. Just follow some of the rules that we offer you to eliminate dangerous consequences and maintain a vigorous working state. These recommendations are simple and easy to implement.

First of all, you need to learn to avoid keeping your spine in a bent state for a long time without a safety support. This advice only sounds complicated, but in fact it is completely elementary: when bending, rest your hand on something - on your knee, on a nearby object, on anything.

“But there are absolutely necessary actions,” the patient will exclaim, “in which both hands must be used!” The same washing, for example. There's no getting around it...

One cannot but agree with this. But it is possible and necessary to find a way out of the situation. Try to straighten up more often, at least for a short time, so that the back muscles constantly change their mode of operation and do not experience excessive tension. And if you feel the accumulated tension in your lower back, then it would be a good idea to lean forward deeply, remembering that half-bends cripple, but deep bends heal. Washing, cleaning, weeding will be interrupted for a minute or two - but you will be able to do them much longer without unpleasant consequences for yourself.

This is the ABC of health: initial back pain – muscle pain – occurs due to fatigue and is determined by the duration of work in a fixed position! As vertebrologists say, “the intensity of pain is directly dependent on the degree of muscle fatigue.” Therefore, the more often you unbend, the less reason there will be for discomfort in the lumbar region. After all, extension, with good muscle support, does not pose any difficulty for the spine - unless, of course, there is significant damage to its supporting structures. And yet, just in case, be on the safe side: when straightening the body, even quite often, it will never be superfluous to have the help of a hand resting on the knee or any nearby object.

Follow our advice for at least two weeks, adhering to a movement regime that is reasonable for the spine - and, probably, your problems will be resolved. During this time you will learn to move correctly. Time will pass, and it will become a habit for you.

However, it also happens when discomfort in the lower back remains even when all these rules are followed. This means that your extensors, for one reason or another, are not doing their jobs well enough. Wear an orthopedic belt while working, remembering, of course, to follow the above recommendations.

It is important to understand: is the pain experienced during extension a natural reaction of the body to being in a semi-bent position for a long time or a consequence of a spinal disease? In the first case, you only need caution and basic exercises: such pain is natural, like rapid breathing when running or tired legs after a long walk. In the second case, we are dealing with a disease, and then safety net with an orthopedic belt is necessary so as not to unnecessarily load the weak support-bearing parts of the spinal column.

And if straightening your torso from a half-tilt position ends in a lumbago in the lower back, it’s better to go to bed and call a doctor at home! Be attentive to yourself: lumbago is a very unpleasant phenomenon, and it is better for you to strictly follow all the doctor’s recommendations.

Not long ago, one incident happened to a friend of mine. By nature, he was an active and energetic person; among other things, he was distinguished by good health and almost never got sick. One evening he calls me at home and in a frightened voice full of suffering reports that he had a “lumbago” in the lower back, and how inopportune it was, and how much he had to do... I calmed him down as best I could, advised him to take an aspirin tablet, since He had nothing else, and insistently recommended that he go to bed. In the morning next day, on Monday, I visited him and examined him. The incident, in general, turned out to be trivial, and according to my forecasts, the acute pain should have gone away in three or four days. Knowing his desire for work and his dislike for wasting time, I ordered him as strictly as possible not to get out of bed until Friday and, leaving some medicine and saying goodbye, I left with a calm soul.

For some reason I had to leave town until next Monday. On the day of my return, I immediately called my friend, confident of his full recovery. Imagine my surprise when, instead of a cheerful voice on the telephone receiver, I heard the voice of a man exhausted by pain. Recognizing me on the phone and expressing sincere joy, my friend complained about his ill health and, casually mentioning some reasons that prevented him from recovering, began to beg him to come urgently. A little annoyed at what had happened, I immediately went to him. “Did I make a mistake in my diagnosis?” – I tormented myself all the way with this question. What I heard at the meeting caused rather mixed feelings: a sigh of relief because my diagnosis was correct, and sincere sympathy for my sick comrade. It turned out that on the third day, feeling better, our patient left for work. But, before lunch, he was forced to return home with severe pain in the lower back.

This is the story that happened to my friend. He, of course, recovered. But it cost him at the cost of much greater moral and physical suffering. Not to mention the prolonged recovery time due to the fault of the patient himself.

This text is an introductory fragment.

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Why does lower back pain occur when straightening? Many patients turn to doctors with this question. The appearance of pain of varying severity in the lower back during extension is a completely natural phenomenon.

You did laundry while standing in a semi-tilted position, or weeded a carrot bed at your dacha, or washed the floors while waiting for guests... In a word, you worked. And if you worked for a long time, you probably got tired. But the work did not happen by itself. At the same time, the vertebrae, ligaments, muscles - your entire musculoskeletal system - worked. He too was tired, supporting your body in a semi-reclining position. And now he is experiencing some difficulties when straightening. Especially if the body was in a fixed position.

In this case, a person being in a position resembling the letter “G” without support for more than 15-20 seconds can be considered a fixed pose for this position. After this time, in a person of average physical development, the deep back muscles begin to experience significant difficulties. It’s all about the peculiarities of the movement of the spine in the sagittal plane, i.e. when bending forward and straightening.

The spine is held in a semi-inclined position by the deep back muscles. However, in this position their energy capabilities are quickly depleted. Prolonged half-bending is a very unfavorable position from the point of view of the biomechanics of the spine. Long-term tense muscles are less well supplied with blood; biologically active substances accumulate in them, irritating the nerve endings of muscle fibers. This manifests itself in painful sensations with muscle tension. The stabilizing capabilities of the muscles are rapidly decreasing.

You should straighten up here - no serious problems have arisen yet. But no: the laundry has not yet been washed, the carrots have not been weeded, the floor has not been washed... And you continue to work, leaving your spine at a disadvantage. This is where the danger arises: the longer a fixed position is maintained, the less strength the muscles have for the subsequent action - extension.

And now, finally, his turn has come. By this time, the extensor muscles have long experienced difficulties with blood supply.

Remember: the first signs of fatigue of the musculoskeletal system appeared within 15-20 seconds, and washing, weeding, cleaning lasted and lasted! Vertebrae that have largely lost muscle support become ready to shift - overworked muscles seem to “let go” of them; As a result, the pressure of the vertebrae on the discs becomes dangerously uneven. In addition to all the other troubles, there are also painful sensations from unrestrained ligaments of the spinal column - aching, viscous pain occurs that accompanies the entire process of extension.

But, unfortunately, it can be worse. If, with severe fatigue of the extensor muscles, you begin to leave a fixed position, holding a significant load in your hands (a wet duvet cover, or a bucket filled with earth or water), sad consequences may well arise in the form of persistent pain and the need for long-term treatment.

So what - don't wash, don't weed, don't clean? No, you can do all this. Just follow some of the rules that we offer you to eliminate dangerous consequences and maintain a vigorous working state. These recommendations are simple and easy to implement.

But there are absolutely necessary actions in which both hands must be used! The same washing, for example. You can't help yourself here?

This is the ABC of health: initial back pain - muscle pain - occurs due to fatigue and is determined by the duration of work in a fixed position! As vertebrologists say, “the intensity of pain is directly dependent on the degree of muscle fatigue.” Therefore, the more often you unbend, the less reason there will be for discomfort in the lumbar region. After all, extension, with good muscle support, does not pose any difficulty for the spine - unless, of course, there is significant damage to its supporting structures. And yet, just in case, be on the safe side: when straightening the body, even quite often, it will never be superfluous to have the help of a hand resting on the knee or any nearby object.

A. Dolzhenkov

“Lower back pain during extension” and other articles from the section

All of these exercises will allow you to significantly improve your body flexibility. Some of them are much easier to do than others. We recommend starting with them. This will allow you to gain self-confidence and move forward without dwelling on what you can’t do.

Many of us are not flexible. Any exercise that requires you to bend causes pain in your muscles and joints. Today we will talk about 5 exercises that will help in this case. Even if you didn’t succeed before, you will easily master them and feel better. All of these exercises will allow you to significantly improve your body flexibility. Some of them are much easier to do than others. We recommend starting with them. This will allow you to gain self-confidence and move forward without dwelling on what you can’t do.

Exercises for flexibility: 5 options

Child's pose

Downward facing dog

Pigeon pose

Standing forward bend

1. Child's pose

These exercises seem quite simple. However, you will see over time how they improve your flexibility. All you need to do is not quit training. Be careful not to use excessive force, as you may injure yourself.

This is one of the main exercises if you feel like your joints are “wooden”. It is usually done at the end of a session to relax the muscles.

Despite its apparent simplicity, this exercise is very important. It will help stretch the muscles in your hips, legs and ankles and relieve back pain.

2. Downward facing dog

This is a triple exercise, and if your body is not flexible or you haven't exercised in a while, it may cause slight discomfort at first. Stand up straight, and then bend forward and lean on your hands so that your head is between your hands and your body is in an inverted V shape.

To get into this pose correctly, make sure your feet are completely flat on the ground. If you are not flexible, you will have to lift your heels off the ground.

However, don't worry. Don't give up and eventually you will be able to touch your heels to the ground.

This exercise improves blood circulation and stretches the muscles of the body. It's ideal for warming up.

3. Bridge

This exercise is also difficult to repeat correctly if your body is not very flexible. But, as with the previous exercise, over time you will be able to do it much better.

Lying on your back, lift your buttocks as high as possible.

The feet should be completely pressed to the floor, and the arms should be extended along the body, with the fingers intertwined.

This exercise helps stimulate organ function abdominal cavity and also improves digestion. This exercise also helps women relieve menstrual pain.

4. Pigeon pose

This is the fourth exercise. Like the previous ones, it is ideal for beginners and, over time, improves the elasticity of muscles and ligaments. Pigeon pose is not easy to get into without preparation, so we recommend finding some kind of support first.

This exercise improves posture and aligns the symmetry of the body. Also, if we have a problem like sciatica, pigeon pose will help relieve some of the pain.

5. Standing Forward Bend

The last exercise we want to talk about looks especially difficult. Despite the apparent complexity, performing the exercise is quite simple.

To begin, stand up straight with your feet firmly on the ground. Now bend forward and try to touch your feet with your fingertips.

If you are not flexible, you will not be able to reach your legs, but it does not matter. Stop at a comfortable height for you and clasp your legs with your arms.

The goal is to bring your body as close to your feet as possible and touch them with your forehead. published .

P.S. And remember, just by changing your consciousness, we are changing the world together! © econet

Pain in the lower back when moving and turning the body, while inhaling and exhaling - dangerous symptom neglect of the disease. It is not surprising that in women, pain in the lower back is often combined with a violation menstrual cycle, after all reproductive organs and the lower third of the intestine receive innervation from the lumbosacral spine.

Pain in the lower back when walking or inhaling occurs due to injury to the nerve fibers or their endings by intervertebral hernia, displaced vertebrae, inflammatory changes in the ligaments of the spinal column, and spasmodic contractions of the back muscles.

Since the duration and intensity of muscle contractions are controlled nervous system, any pathological changes in the spinal nerves affect the functionality of skeletal muscles.

Against this background, excessive physical activity leads to persistent hypertonicity of muscle groups (staying in a state of contraction without relaxation). A person cannot bend forward or get up from bed.

What is sciatica in the back

Why does pain occur in the lower back:

Lifting too heavy objects with rupture of the muscular-ligamentous aponeuroses;
Sharp turns of the body at an angle of more than 120 degrees with weakness of the spinal ligaments lead to displacement of the vertebrae;
Strenuous fitness classes without pre-warming create microcracks and muscle tears;
Prolonged “hunched” position of the lumbar spine when sitting gradually leads to weakness muscle corset backs;
Carrying children weighing more than 4 kilograms is often accompanied by damage to the cartilaginous intervertebral discs (osteochondrosis).

In general, any load on the lumbar spine, which leads to damage to the intervertebral discs (osteochondrosis, hernia). In such a situation, there is likely to be compression of the nerve root that exits the spinal cord, therefore.

If the back muscles are damaged, any attempt to make a sharp turn ends in severe pain due to compression of the nerves by inflamed or spasmed muscles (myofascial syndrome). This is why doctors prescribe muscle relaxants for spinal hernia.

If, at a doctor’s appointment, a patient complains: “I can’t bend over because pain occurs in the lower back with minimal flexion and extension of the back,” myofascial syndrome should be suspected. With it, pain sensitivity increases with movement or inhalation, as the strength increases muscle spasm.

May be caused by “banal” muscle weakness abdominals and backs. A sign of the presence of this condition is the presence of aching pain when inhaling, when standing for a long time or frequently bending the body. When trying to bend forward, a “vertebral hump” appears in a person with a weak back muscle corset.

In such a situation, due to weakness of the skeletal muscles, the back muscles are stretched, therefore the spinal nerves are compressed. To avoid pain, it is enough to strengthen the abdominal muscles and the pathology will disappear forever on its own.

When one lumbar vertebra is displaced relative to another (spondylolisthesis), an unstable position of the vertebral axis is formed. When turning the body sharply or lifting heavy objects, the nerve roots are injured during spondylolisthesis.

To find out why your back hurts, you should differentiate between the five most common syndromes: spinal pathology, myofascial syndrome, weakness of the back muscle corset, kidney disease, and metabolic disorders.

However, most often pain in the lower back when walking, as well as when inhaling, occurs due to pathology of the spine. To confirm the “vertebral” cause of pain at home, a number of tests are used:

Touch your chin to your chest;
Tighten your abs;
Take a vertical position, rising from a horizontal position, but without bending your legs;
Raise your legs up, first one and then the other;
Feel the points along the spinal column with your fingers.

If, when performing the exercises described above, you feel an increase in pain in the spine, the likelihood of having a spinal pathology with irritation of the nerve endings is quite high. X-rays of the spine, as well as magnetic resonance imaging, will help confirm this assumption.

A common kidney pathology leading to pain on the right and left of the spine is urolithiasis disease. Pain syndrome occurs due to irritation of nerve endings urinary tract large concretion (stone).

Metabolic diseases with pain in the lower back include severe osteoporosis (loss of bone structure due to a lack of calcium). This condition leads to deformation of the osteoarticular system of the spine and limbs.

Considering the seriousness of the diseases described above, which lead to pain when walking in the lumbar region, we recommend that you do not try to treat them yourself, but consult a doctor. If there is a pathology, it is important not only to get rid of it, but also to conduct a thorough diagnosis of the person’s condition in order to prevent dangerous complications.

Spinal hernia - common reason back pain

Back pain can be divided into primary and secondary.

Primary pain syndrome occurs against the background of changes in the spinal column, nerve endings, and ligamentous-muscular structures.

The intensity of primary pain can be cumulative or acute. The cumulative pain is aching in nature and intensifies over time with any careless movement or sudden turn of the body. With acute pain in the lower back, a person feels sharp pain when getting out of bed or trying to put on a shirt.

If the cause of the primary syndrome is a narrow spinal canal, the person is almost always in pain. He cannot spend time standing quietly, but when sitting, the symptoms of the pathology are alleviated.

Secondary lower back pain occurs when:

Tumors of the spinal column;
Pelvic infections;
Spinal injuries.

Secondary pain in the lower back during inspiration is an alarming signal that requires a thorough diagnosis of the health condition. If it intensifies when bending forward, briefly standing, straightening or bending the upper limbs, this is an unfavorable sign of cancer.

When a patient tells the doctor: “I’m standing still, but my lower back hurts a lot,” most likely the cause of this situation is weak back muscles. With it, conservative drugs are usually not prescribed, and treatment is carried out with the help of physical therapy.

It’s a completely different matter when the aching pain sharply intensifies when turning the body, while inhaling or exhaling. In such a situation, doctors already prescribe local or systemic anti-inflammatory drugs, since the likelihood of myofascial syndrome or damage to the spinal cartilage is high.

If pain in the lower back appears while lying on your back, in a state of flexion or extension, but disappears on the stomach and when getting out of bed, this is a sign of mild spinal pathology. It is treated with conservative methods.

If the pain is not caused by a pathology of the spine, but only by a muscle spasm (does not disappear while lying on the stomach), vertebrologists believe that the best treatment is the return of a person to moderate physical labor after intramuscular injection muscle relaxant (mydocalm).

If the pain is so severe that it occurs with the slightest movement, you should not get out of bed. An intervertebral hernia is possible, in which the person must be transported to a hospital hospital in a stationary state. After the x-ray, the doctor will apply a plaster splint or the patient will undergo emergency surgery.

Manual therapy as effective means treatment of lumbar myalgia has a right to exist, but in the treatment of spinal diseases it can only be used to stimulate blood supply along the spinal column.

Valery ALEXEEV, Candidate of Medical Sciences,
Associate Professor of the Department of Nervous Diseases of the Moscow Medical Academy named after I. M. Sechenov

One of the most common pain syndromes is associated with the lower back. According to some experts, pain in the lower back is a kind of retribution of humanity for upright walking, when heaviest load falls on the lumbar spine, which bears the main burden of the human body's weight. Physical inactivity, poor nutrition, obesity, and stress also have a detrimental effect. For many, lower back pain (lumbodynia) is such a common occurrence that it becomes part of the Everyday life. It can appear only once and disappear without a trace, or it can return again and again, causing considerable suffering. As a rule, most patients recover within 2~3 months; only a small number of patients with complaints of lumbodynia develop serious illnesses.

Problem on both sides

Back pain can be divided into primary and secondary. As you know, the spine is a series of vertebrae interconnected by elastic tissues - muscles and ligaments. They (except for bone tissue) contain nerve endings and can become a source of back pain.

The causes of primary lower back pain are due to pathology of the spinal column - dystrophic and functional changes in the joints of the vertebrae, intervertebral discs, muscles, tendons, and ligaments.

Secondary pain syndrome in the lower back is associated with traumatic lesions of the spine, tumor and infectious processes, diseases internal organs, osteoporosis and other pathologies. This is a kind of alarm signal about problems in the body. Particularly common causes of constant lower back pain are benign and malignant diseases of the pelvic organs (endometriosis, uterine fibroids, dysmenorrhea, damage to large vessels, kidneys, chronic prostatitis, some diseases of the nervous system).

5 reasons for suffering

Osteochondrosis (dorsopathy) is the most common source of pain in the lower back. During the examination, degenerative diseases of the spine are detected - osteoarthritis, osteoarthritis, osteoporosis. The height of the intervertebral discs decreases, which leads to disturbances in the mechanical balance between the structures of the spinal column - hence the constant, quite tolerable, but periodically increasing pain in the lower back,
Muscle spasm. When performing intense and excessive physical activity that is unusual for you, did you experience acute pain in the lower back? A predisposing factor is a long-term static incorrect position of the body (at the computer, squatting, bending in half during dacha work). As a result, muscle spasm develops, limiting the mobility of a certain part of the spine. Tight muscles become a source of suffering, triggering a vicious circle of “pain - muscle spasm - pain.” This condition may persist long time and causes a lot of unpleasant moments.
A herniated disc, which compresses the roots of the spinal cord, is especially common in men over 40 years of age. The first symptom of trouble is lumbodynia in combination with a number of additional signs: pain along the spine from the buttock to the foot when coughing, sneezing and laughing, difficulty bending and straightening the spine in the lumbar region (this is especially evident when putting on socks and shoes), increased unpleasant sensations when raising a straight leg while lying on your back. This pain is often called the outdated term “sciatica” or the colloquial word “lumbago”. The pain intensifies in a vertical position and subsides in a horizontal position.
Spinal instability - typical problem middle-aged women. Manifested by back pain, which intensifies with prolonged physical activity and standing. At the same time, there is a feeling of fatigue and a desire to lie down. The disease is caused by damage to the disc or intervertebral joint and often occurs against the background of moderate obesity. It is difficult for such patients not to bend over, but to straighten up and make “extra” movements.
Narrow spinal canal. The most common symptom is pain at rest combined with pain when walking. It spreads along the root from the buttock to the foot, and it always hurts, even lying down or sitting, to the point that it is impossible to sit on the “sick” buttock. Narrow spinal canal syndrome is a consequence of degenerative changes, proliferation of bone and joint structures of the spine, which leads to pinching of the spinal nerve roots.

Your actions.

Whatever the cause of lower back pain, it is impossible to determine it yourself. If your back gives you no rest either day or night, it is better to consult a specialist in a timely manner who will suggest treatment tactics.

Rest for 2-5 days. As a rule, we are talking about bed rest on a hard, flat surface.
Wear a special bandage if necessary.
Take painkillers and anti-inflammatory medications - non-steroidal anti-inflammatory drugs. The most effective are ketoprofen and diclofenac. ibuprofen and others. They are available in tablets, injection solutions and ointments.
The specialist may prescribe muscle relaxants to relieve muscle spasms, as well as diuretics and vascular drugs to reduce swelling of the nerve root and improve blood circulation in the affected area. IN Lately Doctors now have dual-action drugs at their disposal - painkillers and muscle relaxants (muscle relaxers), which is very important in the treatment of pain due to pathologies of the musculoskeletal system and muscle spasms. This is Catadolop (flupirtine), which has a triple effect - analgesic, muscle relaxant and neuroprotective (protection nerve cells from damage). In fact, we are talking about a fundamentally new approach to the treatment of back pain.
Resort to local therapy with ointments and gels containing analgesic, anti-inflammatory or warming components.
Take a course of physical therapy to strengthen positive effect when your health improves. Physiotherapeutic procedures (magnetic therapy, electrophoresis, phonophoresis), as well as massage and physiotherapy relieve muscle tension, improve blood circulation and stop the inflammatory process.