Low back pain is a symptom, not an independent disease. There are many reasons for low back pain, most of which are known, but there are still a few unknown reasons. The common causes can be summarized into four categories: ① diseases of spinal joints and their surrounding soft tissues. Such as local injury, bleeding, edema, adhesion and muscle spasm caused by contusion and sprain. ② Caused by spinal cord and spinal nerve diseases. Such as low back pain caused by spinal cord tumor and myelitis. ③ It is caused by visceral diseases. Such as uterus and its accessories, tumor infection can cause lumbosacral pain, and such patients are often accompanied by corresponding gynecological symptoms. ④ It is caused by mental factors. For example, hysteria patients may also complain of lumbar diseases, but there are no objective signs, or diseases that cannot be explained by physiological anatomy and pathological knowledge through objective examination and subjective narration. This kind of low back pain is often a manifestation of hysteria.

Can patients with low back pain wear high heels?

In daily life, many people like to wear high heels, especially young women. The height of high heels is generally about 4 ~ 6 cm, or even higher. After wearing high-heeled shoes, the height of the heel will increase the center of gravity of the body accordingly. In order to stabilize the original balance lost due to the change of the body's center of gravity, the muscle tension of the body, especially the muscle tension of the back, will be readjusted to create a new balance state.

After people wear high heels, because the pelvis leans forward, the gravity line passes through the back of the pelvis, which increases the burden of supporting the weight of the waist, and then the back stretches and lasts for a long time, which will lead to low back pain due to excessive contraction of the back muscles. Every time the heel height increases 1 cm, the extension of the lumbar spine and the contraction of the back muscles will increase exponentially, and the probability of low back pain will also increase.

It can be seen that patients with low back pain should not wear high heels. In order to prevent low back pain, ordinary people had better not wear high heels often. So should patients with low back pain wear flat shoes? In fact, flat shoes are not necessarily absolutely beneficial, and it is more appropriate to choose a heel height of about 3 cm. Therefore, patients with low back pain may wish to change a pair of suitable shoes, which may relieve low back pain.

Can "walking backwards" treat chronic low back pain?

"Walking backwards" means walking backwards continuously. We often see some people "walking backwards" in the morning exercise crowd. Chronic low back pain is caused by insufficient muscle strength and ligament strength of the waist and poor stability of the lumbar spine. The exercise of "walking backwards" can strengthen the strength of back muscles and enhance the stability and flexibility of lumbar spine. When walking backwards, the waist muscles contract and relax rhythmically, which can better improve the blood circulation of the waist and improve the metabolism of the waist tissue, and has a certain therapeutic effect.

Walking backwards is easy to learn. Middle-aged and elderly people can master activities according to their personal situation. Here are two specific methods for your reference:

(1) akimbo posture: stand up straight, hold your chest out, with your hands akimbo, your thumb behind and the other four fingers in front. Press the "Shenshu point" on both sides of the waist with your thumb. (This point is under the spinous process of the second lumbar vertebra, and it is open laterally 1.5 inch). Action: When walking backwards, start from the left leg, raise the left leg as high as possible, move backwards, and move the center of gravity backwards. First, the left foot touches the ground, then the whole foot touches the ground, and the center of gravity shifts to the left leg, then the right leg is changed, and alternately walks backwards. Every time you step back 1, press Shenshu with your thumb 1 time.

(2) Swing arm type: preparation posture: stand up straight, hold out your chest, look straight at your eyes, and your arms naturally droop. Action: The action of legs is the same as that of hips. When walking backwards, your arms swing back and forth with the movements of your legs.

Walking backwards can be done every morning and evening 1 time, 20 minutes each time. Generally speaking, after each exercise, you should take a short rest, and the fatigue will gradually disappear. The site should be flat and barrier-free. Try to hold your chest out and raise your thighs as much as possible when exercising.

Is cold weather related to low back pain?

Some people will have low back pain or its aggravation because of the weather change, and some patients' low back pain symptoms will be as accurate as the weather forecast. Cold is one of the causes of low back pain. Cold mainly causes low back pain through the changes of blood circulation such as vasoconstriction, ischemia, congestion and edema in the back. Most patients have low back pain because they stay in cold areas for a long time, or sleep on the cold ground or at the air outlet. Cold can cause muscle contraction, which affects body movements to some extent. Besides, in order to keep out the cold, people wear more clothes and are not flexible. If the waist is violently exercised, it is easy to cause waist injury.

Can playing mahjong cause low back pain?

Playing mahjong for a long time, the back is straight, and the intervertebral disc and interspinous ligament are in a state of tension and rigidity for a long time. After a long time, it is easy to make your back sore and stiff, and you can't lie flat and turn around. Moreover, sedentary will make the pelvis and sacroiliac joints bear a large load for a long time, and the waist lacks activity. Qi and blood are easy to stagnate in the waist, causing qi stagnation and blood stasis, affecting the blood circulation of lower limbs, and numbness of the legs for a long time will lead to muscle atrophy. In this case, the muscles are stiff, and a little activity may sprain or cause other injuries, leading to low back pain.

Is smoking related to low back pain?

Many smokers are prone to low back pain, and the reasons are not clear. It may be that smoking leads to chronic bronchitis, and coughing leads to the increase of internal pressure of intervertebral disc and spinal canal. Injecting nicotine into animals will reduce the blood volume of vertebral body, thus affecting the nutrition of intervertebral disc and making it easy to degenerate. This may be the reason why smokers are prone to low back pain. In addition, smokers are prone to lung cancer, which often metastasizes to the vertebral body. Because of the tumor on the vertebral body, it is inevitable that low back pain will occur, and it will get worse gradually, and finally it cannot be treated. It can be seen that smoking is related to low back pain, and smoking is harmful.

Must low back pain be lumbar disc herniation?

The lower waist mainly refers to the lumbar vertebrae, sacrum, bilateral sacroiliac joints and their adjacent tissues, and may involve muscles, ligaments, fascia, posterior joints, lumbosacral joints or sacroiliac joints. Everyone has a history of low back pain more or less, either light or heavy. People often say that they have lumbar disc herniation after low back pain. In fact, not all symptoms of low back pain are caused by lumbar disc herniation.

There are many causes of low back pain, which can be roughly divided into the following categories:

(1) Congenital or developmental abnormalities of lumbar spine: including congenital lumbar fusion, hemivertebra deformity, spina bifida occulta, lumbosacral spondylolysis or spondylolisthesis, scoliosis, hypertrophy of transverse process of the third lumbar vertebra, free spinous process, too large or too small spinous process, hooked spinous process, congenital lumbar spinal canal stenosis, etc.

(2) Lumbar degenerative changes: including lumbar hypertrophic spondylitis, senile osteoporosis, lumbar disc herniation, secondary lumbar spinal stenosis, pseudospondylolisthesis, senile hunchback, lumbar degenerative osteoarthropathy, lower lumbar instability, etc.

(3) Lower lumbar inflammation: including lower back fasciitis, lumbar tuberculosis, sacroiliitis, ankylosing spondylitis, rheumatoid arthritis, suppurative spondylitis, bursitis of the third lumbar transverse process, lumbar discitis, etc.

(4) Lower waist injury: including acute lumbar sprain, lumbar muscle strain, lumbar ligament injury, lumbar fracture, dislocation, sacrococcygeal injury, sacroiliac joint sprain, etc.

(5) Lower waist tumors: including primary and secondary tumors ① Primary benign tumors: such as osteoid osteoma, bone cyst, osteoblastoma, osteochondroma and fibrous dysplasia of bone. ② Primary tumors with malignant pathological tendency: chordoma, giant cell tumor of bone, osteoblastoma, etc. ③ Primary malignant tumors: malignant lymphoma, osteoblastoma, lumbosacral sarcoma, etc. ④ When breast cancer, prostate cancer, uterine cancer and other malignant tumors metastasize to lumbosacral region, they can all have symptoms of low back pain.

(6) Diseases of adjacent tissues, such as sciatica and piriformis syndrome; Urinary calculi, pyelonephritis, perirenal abscess, etc. Peptic ulcer of digestive system, chronic pancreatitis, etc. Uterus, adnexitis, uterine prolapse, pelvic tumor, etc. In obstetrics and gynecology; Retroperitoneal tumors that erode the spine can also produce low back pain.

(7) Functional defects: such as poor health, pregnancy, flat feet, unequal length of lower limbs, and insufficient muscle strength of waist and buttocks.

(8) Others: toxic diseases, such as skeletal fluorosis; Nutritional diseases such as osteomalacia; Nervous system diseases, such as hysteria.

What is the difference between low back pain caused by osteoporosis and low back pain caused by lumbar disc herniation?

Osteoporosis refers to a clinical syndrome caused by various reasons, such as the decrease of the number of bones in the whole body, the increase of trabecular space, the decrease of bone matrix and weight, and the decrease of mechanical strength of bones leading to non-traumatic fractures, or the fracture of some parts can occur with a little external force.

The etiology and pathogenesis of osteoporosis are not fully understood. At present, the more recognized causes of the disease mainly include the following aspects:

(1) Endocrine disorder: As we all know, this disease is more common in the elderly, especially in postmenopausal women. This shows that sex hormones are directly related to bone metabolism. Hyperadrenocorticism can cause osteoporosis, which is not only the main feature of Cushing's syndrome, but also the result of long-term use of adrenocortical hormone in clinical treatment. This shows that adrenocortical hormone can accelerate the process of osteoporosis. Sex hormones can inhibit pituitrin and indirectly inhibit adrenocortical hormones. Therefore, the elderly, especially postmenopausal women, have decreased sex hormone secretion and are more prone to osteoporosis.

(2) Calcium metabolism disorder: There is no doubt that calcium deficiency is one of the causes of adult osteoporosis. The daily calcium intake of normal people is about 10mg/kg body weight, of which a small amount is used by human body, and most of it is excreted with urine and feces to maintain the metabolic balance of calcium. If the intake of calcium is reduced, or the intestinal absorption function is impaired, or the excretion from urine and stool is increased, it is easy to cause osteoporosis caused by calcium deficiency. At this time, if combined with the influence of endocrine disorders, it is more likely to cause osteoporosis.

(3) Waste factor: Under normal circumstances, due to the relaxation and contraction of muscles and various stresses, bone tissue is stimulated to maintain normal calcium metabolism balance. However, once the limbs or the whole body lose physiological activities and physical labor or exercise, it will easily cause a series of changes in bone tissue, which will lead to decalcification and increased urinary calcium excretion, leading to osteoporosis. Long-term bedridden patients show systemic osteoporosis, and limb plaster splint fixation or neurological disuse shows local osteoporosis.

Osteoporosis is more common in the elderly, especially in women over 60 years old. Patients often complain of general fatigue, preferring to stay in bed or lie on their back rather than exercise; Whole body ache, especially waist ache, can dissipate from the waist to the buttocks and lower limbs, or from the back to the ribs and abdomen. The patients themselves feel that their height is getting shorter and shorter, which is not only related to intervertebral disc degeneration, but also related to the compression fracture easily caused by vertebral osteoporosis. In the same way, humpback deformity can also be gradually aggravated.

X-ray manifestations: spinal osteoporosis, trabecular reduction, central depression of vertebral body, fishtail shape.

The course of pain caused by osteoporosis is far less serious than that caused by lumbar disc herniation, and the X-ray manifestations are quite different. After treatment with sex hormones, high protein and high calcium, the symptoms of low back pain can be alleviated.

What is low back pain? What visceral diseases can lead to low back pain?

Involved low back pain refers to the clinical symptoms of low back pain caused not by lumbar vertebrae but by diseases of internal organs. Because the cause of low back pain is not the spine itself such as bones, joints, muscles and ligaments, it is also called non-spinal low back pain. Specifically, visceral diseases that may lead to low back pain symptoms are:

(1) Urinary system diseases: such as acute and chronic pyelonephritis, renal tumor, kidney calculi's disease, ureteral calculi, renal tuberculosis, nephroptosis, perirenal abscess, prostatitis and prostate tumor.

(2) Diseases of digestive system: such as digestive tract ulcer, chronic cholecystitis, gallstones, pancreatic cancer, rectal cancer, etc.

(3) Gynecological diseases: such as adnexitis, metritis, retroversion of uterus, pelvic tumor, uterine prolapse, pelvic congestion, menstrual tension, etc.

(4) In addition, subphrenic abscess and retroperitoneal tumor can also cause low back pain. Just like a headache, the cause of a headache is not necessarily in the head. Some low back pain is just a symptom of an organ or systemic disease. The causes of low back pain caused by visceral diseases are mainly in the following two aspects: ① The lesions involve the waist or its adjacent tissues: when the lesions of visceral diseases involve the tissues around the spine and retroperitoneum, the waist can feel pain, and it is often accompanied by back muscle spasm. Such as low back pain caused by retroperitoneal tumor and perirenal abscess. (2) Reflexively causing low back pain through nerve fiber conduction: Because the pathological changes of some organs stimulate sensory nerve fibers, they are introduced into the posterior root or a certain stage of the spinal cord, and the stimulation spreads to the tissues dominated by the spinal cord and nerve roots, resulting in low back pain.

For the treatment of low back pain, that is, non-spinal low back pain, symptomatic treatment should be given according to its pathogenesis. To be exact, we must first understand the primary disease. On the basis of treating the primary disease, Chinese medicine, acupuncture, physical therapy, massage and other methods can be properly selected to exercise the function of back muscles. All these methods can be effective.

What are the characteristics of low back pain caused by gynecological diseases?

Due to anatomical and physiological characteristics, women have some unique diseases, such as metritis, adnexitis, uterine retroversion, uterine prolapse, pelvic tumors and so on. Women with these diseases usually have symptoms of low back pain. In addition, low back pain can also be caused during menstruation, pelvic congestion, menstrual tension and pregnancy. But the low back pain caused by gynecological diseases is not similar to that caused by other reasons. It has the following characteristics:

(1) The pain site caused by gynecological diseases is relatively limited, usually located in lumbosacral region, with fewer symptoms of lower limbs.

(2) The nature of pain caused by gynecological diseases is generally swelling pain, dull pain, acid swelling or dull pain, and there is no obvious radiation pain.

(3) The symptoms of low back pain are closely related to menstrual period or primary gynecological diseases. For example, women with uterine contraction will have symptoms of low back pain during menstrual cramps.

(4) In addition to the symptoms of low back pain, the main symptoms are gynecological symptoms, such as abdominal distension pain, falling pain, increased leucorrhea, dysmenorrhea and irregular menstruation.

(5) There are no positive signs in lumbosacral region, the tenderness is not obvious, the tenderness point is not limited, the straight leg elevation test is negative, the pain at percussion is not obvious, and there is comfort after percussion; Gynecological examination can find positive signs such as uterine retroversion and uterine prolapse.

(6) The pelvic cavity, uterus and adnexa may have imaging changes, but the lumbosacral X-ray examination has no positive signs.

Gynecological diseases can cause low back pain because the nerves of uterus and its appendages originate from pelvic nerves and parasympathetic nerves of the sympathetic plexus of abdomen and ovary, and these nerves originate from the second to fourth sacral nerves. When these nerves are involved in diseases, they can reflexively cause symptoms of low back pain.

What is the difference between lumbago caused by visceral diseases and other lumbago?

Although lumbago caused by visceral diseases in abdominal cavity and pelvic cavity and lumbago caused by lumbar spondylosis itself are generally lumbago, there are still some differences. The differences are as follows:

(1) The nature of low back pain caused by visceral diseases is mostly involved pain: the lesion of low back pain is not in the spine, so the activity of the spine is not affected. During physical examination, it was found that the patient's waist activity was good. What is the proportion of low back pain in all patients with low back pain? At present, there is no statistics on this, but there are many patients with this kind of low back pain.

(2) The low back pain caused by visceral diseases is mostly secondary: it is mainly manifested in the front of the trunk, which is generally secondary, far less serious than abdominal pain. Although in rare cases, some visceral diseases first cause low back pain, it is followed by severe abdominal pain, and the degree is more serious.

(3) Low back pain caused by visceral diseases is generally not the only symptom: in addition to the symptoms of low back pain, there are generally other clinical manifestations of visceral diseases. For example, patients with renal tuberculosis may have low fever, night sweats and emaciation. Patients with pancreatic tumors may have cachexia such as loss of appetite and weight loss. The low back pain attack of digestive tract ulcer is mostly related to diet.

(4) Orthopedic examination of the lower lumbar spine showed no positive signs, such as the tenderness point was not concentrated, the tenderness was not obvious, and the straight leg elevation test was negative. The diseased organ itself may have positive signs.

(5) There is no obvious change in lumbar imaging examination, and the low back pain caused by visceral diseases can have positive results in the organ itself, such as ureteral calculi, stone shadows on X-ray plain films or films, and tumor size on CT or MRI of pancreatic cancer.

What different types of low back pain do different people have?

The incidence of low back pain is very high, and there are many diseases that lead to low back pain, but the types of diseases that lead to low back pain vary from person to person.

(1) Different ages lead to different low back pain diseases.

The common causes of low back pain in children or adolescents are congenital malformations, such as spina bifida occulta and transitional spine. Postural diseases, such as lumbar scoliosis; Inflammatory diseases, such as lumbar tuberculosis.

The common causes of low back pain in young adults are mainly traumatic diseases, such as lumbar muscle strain, lumbar sprain, lumbar disc herniation and lumbar compression fracture. In addition, immune system diseases, such as ankylosing spondylitis, are also common causes of low back pain in young people.

The common causes of low back pain in middle-aged and elderly people are mainly degenerative changes, such as lumbar proliferative spondylitis, lumbar spinal stenosis and osteoporosis. Followed by various tumors in the lumbosacral region.

(2) Different genders cause different types of low back pain diseases.

In daily life and work, men generally have a large amount of waist activity. When the load is too large, the posture is improper, and there is no protection, it may cause injuries to the soft tissues, bones and joints of the lumbosacral region. Therefore, male low back pain is mainly caused by injury factors.

Due to anatomical and physiological characteristics, women have some unique diseases, such as metritis, adnexitis, uterine retroversion, uterine prolapse, pelvic tumors and so on. All these diseases can cause low back pain. In addition, menstrual period can cause low back pain; Low back pain caused by increased lumbar load during pregnancy; Postpartum endocrine changes lead to joint capsule and ligament relaxation, which can also lead to low back pain.

(3) Different occupations lead to different types of low back pain diseases.

Traumatic diseases are the main causes of low back pain among manual workers, especially heavy manual workers and athletes. Workers who work in air-conditioned, humid and cold environment for a long time are prone to lower back fasciitis; Mental workers are prone to lumbar muscle strain and lumbar sprain due to lack of exercise and weak back muscle strength.