Back muscles are pillars. Pain in the square muscle of the lower back: causes, symptoms, treatment

Muscle relaxants and pain relievers can help relieve pain. In more severe cases, the doctor prescribes point injections. They are injected at trigger points to reduce pain and inflammation. For this purpose, anesthetics or steroid drugs are used. However, long-term use of steroids can provoke muscle weakness and atrophy.

If the spasm negatively affects the nervous structures, vitamins of group B are used. When scoliosis is detected, the patient is advised to wear special shoes. Antispasmodic drugs will help eliminate spasms.

Yoga and stretching can help reduce pain. You can relieve muscle tension and increase blood circulation in the lumbar region using therapeutic massage... It is also helpful to take warm baths during the course of therapy. In case of severe pain, it is allowed to apply ice to the back. Modern methods of treatment such as cryotherapy and laser therapy have proven themselves well.

If a patient is diagnosed with an infectious disease, then antiviral drugs and antibiotics are included in the course of treatment.

The most in a simple way for treating discomfort in the lower back with square muscle syndrome, an intense effect on the trigger point is considered, after which the damaged area of the muscle is stretched. To do this, you should use a massage roll and balls. First, the patient must warm up the muscles with a roll, then act on the lower back massage ball... It is enough to make swinging movements in different directions and up and down for a minute. You can perform the exercises while lying on the floor or near a wall. To stretch the affected area, it is recommended to place the legs behind the head in the supine position, twisting the body while standing, sitting and lying.

The muscles of the back are divided into 2 types: superficial and deep, since they form several layers. A longitudinal groove runs along the center of the back, along which the spinous processes of the vertebrae are easily felt, starting from the VII cervical vertebra. The relief of the extensor of the spine is visually noticeable. The superficial muscles of the back are arranged in several layers, therefore 2 groups can be distinguished: the superficial muscles of the first and second layers. Deep muscles also form several layers: superficial, middle and deep.

Superficial muscles of the first layer

located in the upper back, in the back of the neck. There are two trapezius muscles, they are located symmetrically and move the shoulder blades: they bring them closer and further away from the spinal column, and also provide movement of the upper limbs. Athletes train the trapezius muscles by raising and lowering the shoulders with weights in the hands, as well as by bringing the shoulder blades together and spreading them with a load. Pain in the area of these muscles can be associated with damage to the nerves in the C3 and C4: the third and fourth cervical vertebrae. Pain in the trapezius muscle is one of the most common pain syndromes, they are caused by overstretching, trauma, static overstrain, hypothermia. Pain in the area of this muscle can also be the result of stress, sometimes it persists even after the provoking factor has been eliminated. Muscle damage of this type is accompanied by painful sensations during movements of the arms and head.

Latissimus muscle occupies the entire lower back, its upper bundles are partially overlapped by the trapezius muscle. With its help, the shoulders and torso move, at the same time it performs auxiliary functions during breathing, expanding the chest. The latissimus muscle is innervated by the thoracic spinal nerve extending from the C6 and C8: the sixth to eighth cervical vertebrae. The cause of pain in the latissimus dorsi muscle can be a block of nerve endings. Most often, it is in this muscle that athletes and children in whom the muscle corset is at the stage of formation deal with pain. If the latissimus muscle is damaged, the movements of the hands are limited: an attempt to lift them is accompanied by severe pain. Severe swelling during stretching is rare.

Superficial muscles of the second layer

goes up from the nuchal ligament and spinous processes of the sixth cervical vertebra. It is partially overlapped by the trapezius muscle. It performs the functions of head and neck movements: tilts the head back, forward, to the sides. Cervical osteochondrosis can cause muscle loss of elasticity, aching pain in the neck.

overlapped by the trapezius and superior posterior dentate muscle, with its help the neck moves. With cervical osteochondrosis and damage to the nerves of the cervical spine, it loses its elasticity, depriving the neck of normal mobility. The muscle is innervated by the cervical nerves and the greater occipital nerve.

, located under the trapezius muscle. It sets in motion not only the scapula, but also the cervical spine. This muscle can become a source of neck pain, as tension points often appear in it. It is she who begins to ache if the head is in one position for a long time, and the neck becomes numb. The pain is felt in the corner of the neck and may radiate to the shoulder.

also located under the trapezius muscle, it takes part in the movement of the shoulder blades. Myofascial interscapular pain syndrome caused by overexertion, inflammation or other type of damage to this muscle accompanies diseases such as scoliosis, osteochondrosis, arthrosis of the joints.

the muscle visually resembles a rhombic plate, it is located under the trapezius muscle. It also drives the scapula. When someone complains that he has pain “between the shoulder blades,” it is usually about the small and large rhomboid muscles, which are innervated from the cervical vertebrae.

forms not even the second, but the third layer of superficial muscles, since it is located under the rhomboid. She participates in the physiology of respiration, pushing the ribs apart during inhalation. Pain in this muscle can be felt as localized to the scapula and shoulder area. Dull, deep pain in the upper part of the scapula, in which a person cannot accurately find the epicenter of discomfort, usually indicates damage to this muscle.

in contrast to the top, it lowers the ribs during inhalation. It is located at the junction of the thoracic to the lumbar. When this muscle is affected, the pain is localized in the lower back, in the region of the ribs.

Deep back muscles

- short and weak, they occupy the deepest position. Suboccipital muscles participate in the movements of the head, its rotation, limit the suboccipital triangular space in which the vertebral artery is located. There are 6 of them in total: anterior straight, lateral straight, large posterior straight, small posterior straight, superior and inferior oblique muscles of the head.

covered by the muscle that straightens the spine, it sets the spinal column in motion. The bundles of this muscle can be divided into semispinal muscles, multifidus muscles and rotator cuff muscles.

The deepest layer of the transverse spinous muscle:

, is the most powerful and longest muscle of the back. Thanks to this muscle, we can keep our back upright. With its help, the spinal column bends and unbends, and in addition, this muscle is involved in the breathing process. With the defeat of this muscle, pain can spread to the lumbar region, give to the scapula, shoulder, abdominal wall. Weakening or overstrain of the muscles of this layer is accompanied by curvature of the spine.

Interspinous muscles unbend the spinal column, and also help maintain it in an upright position. The interspinous muscles are located along the entire spinal column with the exception of the sacrum.
Intertransverse muscles are designed to keep the spinal column in an upright position, also with their help we bend.

http://www.pozvonochnik.net/files/pic58.jpg (in the figures: Musculi intertransversarii - intertransverse, Musculi interspinales - interspinal).

Fascia

Fascia is a type of connective membrane that forms the sheaths for the muscles. They provide muscle glide and transfer movement to the bones. In addition, the fascia protects the vessels and nerve fibers passing between the muscles. When the muscles contract, the fascia changes their position, stimulating the blood flow towards the heart.

The superficial fascia covers the superficial muscles of the back.
The nuchal fascia is an extension of the cervical fascia, located in the back of the neck.
The thoracolumbar fascia forms a "sheath" that houses the muscle that straightens the spine. Consists of two sheets, its greatest thickness is in the lumbar region.

In addition.

The paravertebral muscles are located near the spinal column. They support the spine and allow movements such as bending and turning the body. Various muscles are attached to the processes of the vertebrae. Back pain is often caused by damage (stretching) of the paravertebral muscles during hard physical work, as well as reflex muscle spasm in case of damage or disease of the spine. With a muscle spasm, the muscle contracts, and it cannot relax. When many vertebral structures (discs, ligaments, joint capsules) are damaged, an involuntary contraction of the paravertebral muscles occurs, aimed at stabilizing the damaged area. With muscle spasm, lactic acid accumulates in them, which is a product of glucose oxidation in conditions of a lack of oxygen. A high concentration of lactic acid in the muscles causes pain. Lactic acid builds up in muscles due to spasmodic muscle fibers compressing blood vessels. When the muscle relaxes, the lumen of the vessels is restored, the blood is washed out of the lactic acid from the muscles and the pain disappears.

Back pain can occur for a variety of reasons, ranging from banal stretching of muscles and ligaments and ending with such serious diseases as malignant tumors. Pain in the back can indicate the pathology of the spine, intervertebral discs, spinal cord, nerves or blood vessels, as well as the skin. In some cases, pain is the result of an acquired or congenital curvature of the spine. It is worth noting that back pain, according to the World Health Organization, is the most common reason for seeking medical advice.

Back anatomy

The back is formed by the vertebral column, the posterior and lateral parts of the ribs, and the muscles of the scapular and lumbar region. The very strong muscles of the back allow you to hold, tilt and rotate the entire body, and also participate in the movements of the upper limbs.

The upper border of the back runs along the spinous process ( unpaired process of the vertebra, heading from the posterior surface of the vertebral arch along the midline) of the last seventh cervical vertebra, as well as along the acromial processes ( scapula processes). Below, the border is a line that is bounded by the crests of the iliac bones ( upper ilium) and sacrum. The posterior axillary lines serve as the lateral boundaries. In the back, a paired scapular, subscapular region and an unpaired vertebral region are distinguished, which corresponds to the contours of the spinal column and the lumbar region.

The skin of the scapular region is thick and inactive. In men, this area is usually covered with hair. In some cases, it can lead to the appearance of boils ( purulent-necrotic lesion of the hair shaft and surrounding tissues). Also, the skin contains a large number of sebaceous glands, which, when the lumen of the excretory lining is closed, can become inflamed ( atheroma). Following the skin is dense subcutaneous fat, which has a cellular structure. It is followed by the superficial fascia ( connective tissue) of the scapular region and its own fascia, which serves as a sheath for the superficial muscles. In depth, directly near the scapula, there are two separate fascial cases - the supraspinatus and the infraspinatus.

The skin of the lumbar region is thick and can easily fold into folds. Behind it is the hypodermis ( subcutaneous fatty tissue) and superficial fascia of the back. A little deeper is the fatty tissue, which also spreads to the buttocks, forming the lumbar-gluteal cushion. In this area, two sections are conventionally distinguished - internal and external. The border between these sections runs along the muscle that straightens the spine.

It is worth considering separately the following structures that make up the back:

ribs;
shoulder blades;
muscles;
nerves.

Spine

The vertebral column is one of the essential elements musculoskeletal system. The spine is divided into five segments, including cervical, thoracic, lumbar, sacral, and coccygeal. Since the back includes only the thoracic and lumbar segments, it is still more appropriate to consider the entire spinal column as a whole.

In the spine, movements can be carried out in all three planes. Flexion or extension occurs around the frontal axis, the rotation of the body is carried out around the vertical, and the body tilts to the left and right around the sagittal axis. A springy movement of the spine is also possible due to the contraction and relaxation of a specific group of back muscles.

The spine at the time of birth has only one natural bend - thoracic kyphosis ( posterior bending of the thoracic segment). Later, during the first 3 to 4 months, when the child learns to support the head, cervical lordosis is formed ( anterior curvature of the spine). When the child starts to walk lumbar bends anteriorly, which leads to the formation of lumbar lordosis. Also at the same time, sacral kyphosis is formed. Thanks to these natural bends - kyphosis and lordosis, the spine is able to withstand significant loads, being a kind of shock absorber. The spine, in addition to the supporting function, also performs a barrier function, protecting the spinal cord from all sorts of injuries. In addition, the spinal column is directly involved in the movements of the head and trunk.

In the human spine, on average, there are 32 - 34 vertebrae, which are separated from each other by intervertebral discs. In the lumbar and sacral spine there are 5 vertebrae each, in the cervical spine there are 7, and in the thoracic spine there are 12 vertebrae. In turn, the tailbone consists of 3 to 5 vertebrae. Depending on the segment of the spine, the size and shape of the vertebrae may vary slightly.

The following segments are distinguished in the spine:

Cervical is the uppermost and most mobile part of the entire spine. Good mobility allows for various movements in the cervical spine, as well as tilts and turns of the head. Because of minimum loads on the cervical segment, the bodies of the cervical vertebrae are small. The first two vertebrae, called atlas and epistrophy, are somewhat different in shape from all other vertebrae. Unlike other vertebrae, the atlas does not have a vertebral body, which performs a supporting function. Instead, the Atlanta has two arms ( back and front), which are connected by lateral bone thickenings. The first vertebra with the help of the condyles ( bony protrusions involved in bone articulation) is attached to the occipital foramen in the skull through which the spinal cord passes. The second vertebra, or epistrophy, has a bony process in the form of a tooth, which is fixed in the vertebral foramen of the atlas with the help of ligaments. It is thanks to this process that the first vertebra, together with the head, can perform a variety of high-amplitude movements. It is worth mentioning that in the transverse processes ( lateral processes extending from the arch of the vertebra) the cervical vertebrae have holes through which the vertebral vein and artery pass. The spinous processes of the cervical vertebrae, which extend back along the midline, have some difference. Most of them are bifurcated. The cervical segment is the most vulnerable part of the spine due to the fact that the size of the vertebrae is small, and the muscle corset is not as massive as in other parts.
Thoracic department consists of 12 vertebrae, which are much more massive than the vertebrae of the cervical segment. The thoracic vertebrae at the back limit the ribcage. On the lateral surface of the thoracic vertebrae there are costal fossa, to which the heads of the ribs are attached. The long spinous processes of the thoracic vertebrae, which slope downward, are superimposed on each other in the form of shingles.
Lumbar represented by 5 massive vertebrae. The bodies of the lumbar vertebrae are very large, since the maximum load falls on the lumbar spine. The lumbar vertebrae have costal processes, which, in fact, are vestigial ribs ( ribs that have lost their importance in the course of evolution and which are rudimentary). The spinous processes of the lumbar vertebrae, in contrast to the thoracic vertebrae, are directed backward. The last vertebra is inclined somewhat forward, as it articulates with the sacrum, which, going backward, forms a physiological kyphosis. It should be noted that, in contrast to the thoracic segment of the spine and sacrum, the lumbar region has increased mobility. It is the lumbar region that allows you to tilt the body to the right and to the left, to bend and unbend the body, and also to combine the tilt and rotation of the body. These high-amplitude movements are carried out thanks to strong muscles.
Sacral region at the time of birth, it consists of 5 separate vertebrae, which by the age of 18 - 25 gradually form and make up a single bone. The sacrum is a triangular bone that is part of the pelvis. On the anterior surface of the sacrum, there are four parallel horizontal lines, which, in fact, are the places where the vertebrae meet each other. On the sides of these lines are small holes through which nerves and arteries pass. On the posterior surface of the sacrum there are 5 bony ridges, which represent the fusion of the spinous and transverse processes. The lateral surfaces of the sacrum are articulated with the ilium and are strengthened with strong ligaments.
Coccygeal department represented by 3 - 5 small vestigial vertebrae fused with each other. In shape, the tailbone resembles a curved pyramid. The tailbone is more mobile in women, since during childbirth it is able to deviate somewhat posteriorly, thereby increasing the birth canal. Although the coccyx is a rudimentary segment of the spine, it still performs a number of fairly important functions. Ligaments and muscles are attached to the tailbone, which are directly involved in the functioning of the large intestine and the genitourinary apparatus. Also, the coccyx plays an important role in the distribution of physical activity. So, for example, if the body is tilted forward, then the support is the ischial tubercles, as well as the lower branches of the ischial bones. In turn, if the body is tilted slightly backward, then the load is partially transferred to the coccyx.

The structure and function of intervertebral discs requires separate consideration. The intervertebral disc is a formation that consists of fibrous ( connective tissue) and cartilage and has the shape of a ring. In the center of the disc there is a gelatinous nucleus, consisting of a gel-like substance. A dense annulus fibrosus is located along the periphery. Intervertebral discs do not have their own vessels. They are nourished by hyaline cartilage that covers the disc and is supplied with nutrients from the overlying and underlying vertebrae. The intervertebral discs act as a shock absorber when walking, running or jumping, and also increase the flexibility and mobility of the spinal column.

The spinal column is supplied with blood from the branches of the aorta, which run along the vertebral bodies or near them ( the cervical spine is supplied with blood by the branches of the subclavian artery). The main arteries are the intercostal and lumbar arteries, which supply blood not only to the anterior and posterior parts of the vertebrae, but also to some of the muscles in the back. In addition, the posterior branches of these arteries penetrate into the spinal canal ( spinal arteries), where the spinal cord is located. In turn, the spinal arteries are divided into anterior and posterior, which communicate with each other and form a network of anastomoses ( anastomosis between vessels). This network feeds the spinal cord, the vertebral bodies and the cartilaginous tissue of the intervertebral discs with arterial blood.

The outflow of blood from the spine is carried out through four venous plexuses, which anastomose to each other ( connect). At the base of the skull, these plexuses communicate with the occipital venous sinus, which is one of ten venous collectors that collect blood from the veins of the brain. It is worth noting that the veins of the spine do not have valves, and depending on the pressure, blood can move through them in both directions. This difference, however, significantly increases the likelihood of tumor metastasis ( penetration of cancer cells into other tissues) into the spine.

From the cervical spine, the outflow of lymph is carried out into the deep lymph nodes of the neck, in the upper part of the thoracic region - into the lymph nodes of the posterior mediastinum. In the lower thoracic segment, the outflow is carried out into the intercostal lymph nodes, and then into the thoracic lymphatic duct. The outflow of lymph from the lumbar and sacral segment is carried out into the lymph nodes of the same name.

Ribs

There are 12 pairs of ribs in the human chest. The number of ribs corresponds to the number of thoracic vertebrae. The rib is a paired flat bone that has an arched shape. The large curvature of the ribs provides great mobility... In turn, the curvature depends on age and gender.

Each rib consists not only of a bony part, but also of a cartilaginous one. The bony part of the rib has a body, neck and head. The rib body is the longest part and forms an angle of the rib approximately in the middle, deviating towards the sternum. At the posterior edge of the rib is the neck, as well as the head, which articulates with the corresponding thoracic vertebra. The anterior edge of the bony part of the rib has a small fossa, to which the cartilaginous part joins. It is worth noting that the top 7 pairs of ribs are directly connected to the sternum, and they are called "true". The next 3 pairs of ribs are attached with their cartilaginous part to the overlying ribs and are not attached directly to the sternum. The front ends of the lower two ribs are located in the abdominal muscles and are called "oscillating". The lower edge of the ribs carries a groove in which the intercostal nerves and blood vessels pass ( a vein is located under the lower edge of the rib, followed by an artery and a nerve). It is worth noting that this neurovascular bundle is covered with intercostal muscles in front and behind.

The first two ribs are slightly different in structure from the other ribs. The first rib is the shortest and widest of all. On the upper surface of this rib, there are grooves in which the subclavian artery and vein pass. Also next to the groove there is a tubercle of the anterior scalene muscle, to which this muscle is attached. The tuberosity of the serratus anterior muscle is located on the second rib.

shoulder blades

The scapula is a flat triangular bone that is part of the shoulder girdle ( along with the collarbone and humerus ). Three rather large formations are distinguished in the scapula - scapular spine, acromion and coracoid process. The scapular spine is a triangular bony plate that runs on the posterior surface of the scapula and divides the scapula into the infraspinatus and supraspinatus fossa. The scapular spine ends with an acromion - the humeral process. The acromion is a massive triangular process that sits above the glenoid cavity of the scapula and connects to the clavicle. Part of the muscle bundles is also attached to the acromion. deltoid muscle... It should be noted that the scapula performs an important musculoskeletal function, since more than 15 different muscles are attached to it.

In total, the following surfaces are distinguished in the scapula:

Front surface(ventral) directly adjacent to the ribs and is concave. This surface is, in fact, represented by the subscapular fossa. The inner part of this fossa is lined with ridges, which are necessary for the attachment of the tendons of the subscapularis muscle. In turn, the small outer part of the subscapular fossa serves as a bed for the subscapularis muscle. In the upper part of the subscapular fossa, the bone is slightly bent and forms the subscapularis angle. It is thanks to this shape that the blade has good strength.
Rear surface the scapula is divided into two unequal parts by a large bone formation in the form of a ridge ( spine of the scapula). In contrast to the anterior surface, the posterior surface is convex. The part that is located below is called the infraspinatus fossa, and above it is called the supraspinatus. The infraspinatus fossa is several times larger than the supraspinatus and is the place of attachment, as well as the bed for the infraspinatus muscle. The supraspinatus fossa serves as the site of attachment of the supraspinatus muscle.

Muscle

The skeletal muscles of the back provide active movements not only in the thoracic and lumbar segment, but also participate in turns and tilts of the entire body and neck, participates in the act of breathing due to the attachment of muscle bundles to the ribs, penetrates the pelvis, and allows movements in shoulder girdle.

The following skeletal muscles are distinguished in the back:

Trapezius muscle is a flat and rather wide triangular muscle, which is located on the surface and occupies the back of the neck, and upper part back. This muscle is attached with its apex to the acromion of the scapula, while the base of the muscle faces the spinal column. The contraction of all bundles of the trapezius muscle brings the scapula closer to the spine. If only the upper muscle bundles contract, then the scapula rises, and if only the lower ones, it goes down. With the shoulder blades fixed, the contraction of both trapezius muscles leads to extension and deflection of the head back, and with a unilateral contraction, it tilts the head in the appropriate direction.
Latissimus dorsi is a massive muscle that occupies almost the entire lower back. The muscle takes its origin from the last five thoracic vertebrae, all lumbar and sacral vertebrae, from the upper part of the iliac crest, from the superficial leaflet of the lumbar-thoracic fascia, as well as from the lower four ribs and attaches to the humerus. The upper muscle bundles are directed laterally and form the back wall of the axillary cavity, while the lower bundles are directed laterally and upward. The latissimus dorsi muscle is involved in the rotation of the arm inward. In the event that the upper limb is fixed, then the muscle brings the body closer to it and somewhat expands the chest.
Large rhomboid muscle runs directly under the trapezius muscle and has a diamond shape. This muscle is located between the shoulder blades. The large rhomboid muscle takes its origin from the spinous processes of the first four thoracic vertebrae, moving obliquely downward, the muscle bundles are attached to the inner edge of the scapula. Muscle contraction brings the scapula to the midline. With the contraction of only the lower bundles of the muscle, the lower angle of the scapula rotates inward.
Small rhomboid muscle, as well as the large rhomboid muscle, is located under the trapezius muscle ( second layer of muscle). This muscular plate in the form of a rhombus takes its origin from the two lower cervical vertebrae. Descending obliquely downward, the muscle is attached to the inner edge of the scapula. The small rhomboid muscle brings the scapula closer to the spine.
The muscle that lifts the scapula is an elongated and thickened muscle plate that is located under the trapezius muscle in the lateral part of the back of the neck. This muscle originates from the transverse processes of the first four cervical vertebrae and, going obliquely downward, is attached to the inner edge and upper corner of the scapula. The muscle raises the upper angle of the scapula, and also slightly turns and displaces the lower angle of the scapula towards the spine. With the shoulder blade fixed, tilts the neck to the appropriate side.
The muscles that lift the ribs located only in the thoracic region. These muscles take their origin from the transverse processes of the thoracic vertebrae. These muscles are attached to the underlying ribs. It is worth noting that there are short muscles that lift the ribs, which go directly to the underlying rib, as well as long ones, which are thrown over one rib. During contraction, these muscles raise the ribs, which helps to increase the volume of the chest ( are among the main muscles involved during inhalation).
Superior posterior dentate muscle refers to the third layer of the superficial muscles of the back. This muscle begins from the two lower cervical and two upper thoracic vertebrae. Moving obliquely down, the upper posterior dentate muscle is attached to 2 - 5 ribs. Since the muscle is attached to the ribs, its main function is to participate in the act of breathing.
The lower posterior dentate muscle of the abdomen located on the border of the thoracic and lumbar spine. This muscle begins from the spinous processes of the three upper lumbar vertebrae and two lower thoracic vertebrae. The muscle bundles move obliquely upward and attach to the last four ribs. This muscle lowers the lower ribs down.
Erector spine- The longest and most powerful skeletal muscle in the entire back. The muscle lies in the groove, which is formed by the transverse and spinous processes of the vertebrae. One end of the muscle is attached to the sacrum, the spinous processes of the last two lumbar vertebrae, and the iliac crest. Heading vertically upward, this muscle is divided into three separate muscle bundles - the spinous muscle, longest muscle and the iliocostal muscle. If there is a bilateral contraction of the muscle that straightens the spine, then this leads to the extension of the entire spinal column and fixation of the entire trunk in an upright position. With a unilateral contraction, the spinal column tilts in the appropriate direction. In addition, due to the fact that several muscle bundles are attached to the ribs, this muscle can also take part in the act of breathing.
Large round muscle is a flat and elongated muscle that originates from the lower angle of the scapula, goes outward and attaches to the humerus. The large round muscle brings the shoulder to the body and also pulls it back.
Small round muscle is an oblong muscle that resembles a rounded cord in shape. The small round muscle takes its origin from the outer edge of the scapula. Moving laterally, the muscle passes into a tendon, which is woven into the posterior surface of the humeral capsule and attaches to the humerus ( to the large tubercle). The small round muscle retracts ( supination) shoulder from the body and pulls the capsule shoulder joint.
Infraspinatus muscle has a triangular shape and fills the entire infraspinatus fossa of the scapula. Heading sideways, the muscle bundles converge into a tendon, which is attached to the humerus. The infraspinatus muscle rotates the shoulder outward, and also pulls back the joint capsule of the shoulder joint.
Supraspinatus muscle is a triangular muscle that completely covers the supraspinatus fossa of the scapula. Muscle fibers passing under the brachial process ( acromion), go to the humerus. The muscle is attached to the posterior surface of the articular capsule of the shoulder joint. Contraction of the supraspinatus muscle pulls the capsule of the joint and prevents it from being pinched.
Subscapularis muscle- a flat muscle of a triangular shape, which almost completely fills the subscapular fossa. The muscle is divided into separate muscle bundles by connective tissue layers. In the subscapularis muscle, a deep and superficial layer is distinguished. In the first layer, muscle bundles originate from the costal ( ventral) the surface of the scapula, in turn, the superficial bundles start from the subscapularis fascia, which is attached to the edge of the subscapular fossa. The subscapularis muscle is attached to the humerus ( to the crest of the lesser tubercle). It should be noted that this muscle, heading towards the humerus, passes into a tendon, which fuses with the articular capsule of the shoulder joint in its front part. Thanks to this, the muscle is able to bring the shoulder to the body.
Intertransverse muscles are deep short muscle bundles that are stretched between the transverse processes of two adjacent vertebrae. Intertransverse muscles are found in the cervical, thoracic and lumbar regions. The main function of these muscles is to support the spine. Unilateral contraction leads to the inclination of the spinal column in the appropriate direction.
Interspinous muscles also located in close proximity to the spine. These short muscles are stretched between the spinous processes of adjacent vertebrae in the cervical, thoracic, and lumbar spine. The interspinous muscles take part in extending the spine and keeping it in an upright position.
Square muscle of the lower back is a flat quadrangular muscle bundle. The quadratus lumbar muscle originates from the transverse processes of all lumbar vertebrae, the iliac crest, as well as from the ilio-lumbar ligament and attaches to the last rib and the transverse processes of the first and second lumbar vertebra. Bilateral contraction of the square muscle of the lower back leads to extension of the spine, and unilateral contraction - tilts the body in the appropriate direction.
Psoas major muscle is a long and fusiform muscle. The most superficial muscle bundles attach to the lateral surfaces of the four superior lumbar vertebrae as well as to the last thoracic vertebra. Moving down, the psoas major muscle narrows somewhat. In the pelvic cavity, this muscle connects to the iliac muscle, which leads to the formation of the common iliopsoas muscle. This muscle is involved in flexion and rotation outward of the thigh. In addition, the psoas major muscle allows the lower back to bend while the lower limb is in a fixed position.
External oblique muscle of the abdomen located on the front and side surfaces of the abdomen, and also partially passes to the chest. The external oblique muscle of the abdomen originates from the outer surface of the seven lower ribs. This muscle is attached to the ilium, a connective tissue structure running along the midline of the abdomen ( white line) and to the articulation of two pubic bones ( pubic symphysis). Bilateral contraction of the external oblique muscle of the abdomen slightly flexes the spine and lowers the lower ribs. In turn, a one-sided contraction leads to a rotation of the trunk in the opposite direction.
Internal oblique muscle of the abdomen located directly under the external oblique muscle of the abdomen. This muscle is a musculo-tendinous plate that originates from the iliac crest, lumbar-thoracic fascia, and inguinal ligament. Moving forward in a fan-like manner, the internal oblique muscle of the abdomen attaches to the lower ribs and is woven into the white line of the abdomen. With bilateral contraction, the spine flexes, and with unilateral contraction, the body turns in the appropriate direction. In the event that the ribcage is fixed, the internal oblique muscle of the abdomen lifts the pelvic bones.

Nerves

The back nerves are represented by the spinal nerves. Each such nerve consists of motor and sensory nerve fibers. The first are centripetal fibers that carry impulses from the brain through the spinal cord to muscle tissues, some glands. While the sensitive fibers are centrifugal. Receiving impulses from peripheral tissues, as well as from organs, these nerve fibers ( nerve cells and their processes) conduct them to the central nervous system.

The spinal nerves are formed from the following nerve tissues:

Front roots, in fact, formed by the main processes of nerve cells ( axons), which are located in front of the spinal cord ( in the front horns). These processes, when combined, form filaments, and these, in turn, form the anterior or motor root. The anterior roots contain nerve fibers that conduct motor impulses to smooth and skeletal muscle... It is worth noting that the roots leave the spinal cord in different ways. In the cervical segment of the spinal cord, the roots move away from it almost horizontally, in the thoracic region they are directed obliquely and downward, and in the lumbar and sacral region they move downward.
Rear roots, in contrast to the anterior ones, are formed by the axons of nerve cells that conduct sensory impulses from various organs and tissues to the spinal cord, and then to the brain. It is worth noting that the posterior roots, connecting with the anterior roots, form a spinal node. This node then releases fibers to form the spinal nerve.

The spinal nerves leave the spinal cord in pairs. Each pair of spinal nerves belongs to one of the segments of the spinal cord. The cervical spinal cord consists of 8 segments ( while the cervical spine consists of only 7 vertebrae), thoracic - from 12, lumbar - from 5, sacral - from 5 and coccygeal - from 1 - 3 segments. It should be noted that the segments of the spinal cord do not correspond to the segments of the spinal column. Only the uppermost cervical segments are located opposite the corresponding cervical vertebrae, while the lower cervical as well as the upper thoracic segments are located one vertebra higher. Already in the middle of the thoracic region, the discrepancy is 2 - 3 vertebrae. In turn, the lumbar segments of the spinal cord are located at the level of the last two thoracic vertebrae, and the sacral and coccygeal segments are at the level of the last thoracic and first lumbar vertebra.

The spinal nerves of the thoracic segment are composed of four separate branches. One of these branches is represented by intercostal nerves.

The following branches are distinguished in the thoracic nerves:

Connective nerves go to the node of the sympathetic trunk ( part of the vegetative nervous system which is activated by stress) and connect to it ( anastomose).
Shell branch enters the spinal canal and goes to the dura mater ( a sheath of connective tissue that covers the top of the spinal cord and brain).
Back branch, in turn, is divided into two branches - internal and external. The inner branch sends muscle branches to some muscles of the chest ( transverse spinous muscle, semispinal and rotator cuff muscles), and the cutaneous branch innervates the skin, which is located above these muscles. The outer branch also has a muscular and cutaneous branch. The first branch innervates the iliocostal muscle, as well as some muscles of the chest and neck. The second branch penetrates the skin, which corresponds to the given muscles.
Front branch the thoracic spinal nerves are represented by intercostal nerves. Their number fully corresponds to the number of ribs. The intercostal nerves enter the neurovascular bundle, which is also represented by the artery and vein. The first six intercostal nerves reach the sternum, and the lower two go to the abdominal wall ( to the rectus abdominis muscle).

The upper six intercostal nerves extend to the outer edge of the sternum, while the lower ones travel to the rectus abdominis muscle. In the abdominal wall, these nerves are located between the internal oblique muscle and transverse muscle belly. The last intercostal nerve is located in the immediate vicinity of the pubic symphysis and ends in the lower third of the rectus abdominis muscle and pyramidal muscle.

Intercostal nerves innervate ( carry out nervous regulation) muscles that are located in the wall of the abdominal and chest cavity ( the transverse pectoralis muscle, the subclavian muscle, the levator rib muscles, the external and internal intercostal muscles, and the upper portions of certain abdominal muscles), as well as some back muscles ( upper and lower posterior serratus muscle, as well as muscles that lift the ribs). In addition, the intercostal nerves also innervate the peritoneum ( transparent and thin connective tissue membrane that covers all the organs of the abdominal cavity from above) and pleura ( a sheath of thin connective tissue that covers both lungs and lines the inner surface of the chest cavity). The first intercostal nerve is also involved in the formation of the brachial plexus. It should be noted that in addition to connective and muscle tissue, these nerves also penetrate into the skin of the lateral and anterior surfaces of the abdomen and chest. In turn, in women, these nerves are involved in the innervation of the mammary glands.

What structures can become inflamed in the back?

It should be noted that back pain can occur not only with inflammation of the structures that are located directly in the back. So, for example, in some diseases of the organs of the chest and abdominal cavity, pain occurs, which can be reflected ( irradiate) in the back.

The following tissues and structures can become inflamed in the back area:

Skin covering back can be attacked by pyogenic bacteria, such as staphylococci and streptococci, causing pyoderma ( purulent skin lesions). In addition to the skin, these microbes infect hair shafts ( follicles), sweat, as well as sebaceous glands.
Adipose tissue, located directly under the skin ( hypodermis) or in deeper layers, it can also become inflamed and lead to phlegmon ( purulent fusion of adipose tissue). Phlegmon most often occurs against the background of purulent lesions of the kidneys, pancreas or other structures that are located in the retroperitoneal space or in the abdominal cavity.
Muscles, as a rule, they become inflamed due to traumatic injury, which can occur after excessive physical exertion or with the direct effect of a traumatic factor on muscle tissue ( bruise, crush, sprain, squeeze, or rupture). Also, muscles can become inflamed ( myositis) due to a long stay in an uncomfortable position or with local hypothermia.
Ligaments and tendons as well as muscles, they tend to become inflamed after injury. Partial or complete rupture of the ligaments is accompanied by local pain of varying severity ( weak to extremely strong with complete rupture of the ligament), tissue edema, as well as limited mobility in a nearby joint.
Thoracic and lumbar spinal roots most often they become inflamed when they are squeezed by the vertebrae, pathological bone growths ( osteophytes) or a tumor, causing sciatica. A special case of radiculitis is inflammation of the intercostal nerves, which is manifested by pain along the course of these nerves of various nature and intensity ( this pathology is also called intercostal neuralgia).
Vertebrae can be involved in an infectious and non-infectious inflammatory process. In some cases, the spinal column can be affected by infections such as tuberculosis or brucellosis ( an infection transmitted from sick animals to humans that causes damage internal organs ). Also, the vertebrae can undergo purulent-necrotic inflammation. bone tissue (osteomyelitis), which is most often caused by such pyogenic bacteria as streptococci or staphylococci.
Spinal cord can become inflamed against the background of an existing infection. With myelitis ( inflammation of the white and gray matter of the spinal cord) there is a partial loss of motor and tactile sensitivity up to the development of paralysis of the limbs ( lower and / or upper). Also, myelitis can be caused by a serious injury, in which the infection is attached and one of the segments of the spinal cord is involved in the pathological process.

Causes of back pain

Back pain can occur due to a number of different pathologies. In some cases, severe pain appears against the background of a banal physical overstrain, which leads to muscle spasm... Athletes most often injure the musculo-ligamentous apparatus. In turn, in older people, in most cases, dystrophic-degenerative processes of the spine are found. These processes manifest themselves as back pain of varying intensity, limitation of mobility in the spine, muscle spasm, loss of motor and tactile sensitivity and other symptoms.

Causes of back pain

Name of the disease	Mechanism of back pain	Other symptoms of the disease
Pain arising from inflammation of the skin and subcutaneous fat
*Furuncle* *(purulent-necrotic inflammation of the hair shaft and tissues around it)*	Painful sensations appear due to excessive irritation or destruction of painful endings, which are located near the hair shaft or follicle. It is worth noting that the most severe pain occurs 72 hours after the formation of the boil. It is on the 3rd - 4th day that the purulent melting of the boil rod occurs ( central part), in which painful endings are also destroyed.	The general condition, as a rule, is not changed. The only symptom other than local pain is fever. In this case, the body temperature can rise up to 38 ° C, and sometimes even exceed 39 ° C. During the period when the boil core has undergone melting and rejection, the pain gradually subsides. At the site of the boil, the skin heals within 2 to 5 days by scarring.
*Furunculosis* *(a pathological condition in which boils appear on the skin at various stages of development)*		Furunculosis is manifested by general malaise with the occurrence of headaches, dizziness, nausea and / or vomiting. In some cases, against the background of general weakness, loss of consciousness may occur. Also, with this purulent skin lesion, a fever occurs, in which the body temperature rises to 38.5 - 39.5 ° C.
*Carbuncle* *(acute purulent-necrotic inflammation of the skin and surrounding tissues around several hair follicles)*	The mechanism of pain is similar to that of a boil.	A carbuncle is a fusion of several affected hair shafts ( infiltrate). The size of the carbuncle can vary, in some cases it can reach 4 - 6 centimeters in diameter, and sometimes even exceed 9 - 10 centimeters. It should be mentioned that this pathological formation is extremely painful for 8 - 12 days. Subsequently, through several holes through the carbuncle, a purulent-necrotic mass is rejected ( the skin looks like a sieve). The skin at the site of the carbuncle reveals a rather deep ulcer, which is also quite painful. Over the next 15 to 20 days, the ulcer heals by scarring. The general condition with a carbuncle is similar to that with furunculosis - an increase in body temperature ( 39.5 - 40 ° C), chills, headaches, dizziness, nausea and vomiting.
*Ektim* *(skin disease in which deep damage occurs)*	The pain is a consequence of the occurrence of a deep ulcer, which forms at the site of a relatively small abscess or conflict. It is an open ulcer that serves as a source of painful sensations. It should be noted that within 3 to 5 days, this ulcer gradually begins to scar, which is manifested by a decrease in pain.	At the onset of the disease, one or several small blisters with purulent contents may appear on the skin ( sometimes pus may be mixed with blood). In the future, this abscess becomes covered with a brown crust, which, opening, exposes a painful and deep ulcer.
*Erysipelas* *(defeat of subcutaneous fat)*	The subcutaneous fat becomes inflamed and swollen. In turn, tissue edema compresses the nerves and nerve endings located in nearby vessels and the subcutaneous fat itself. In the bullous form of erysipelas, bubbles form with a colorless liquid, which are then covered with a crust. In the future, the crust falls off and often exposes painful ulcers and erosion.	During few hours ( 24 hours) after the onset of the disease, the affected skin becomes hot to the touch, swollen and painful. The resulting erythema ( reddened skin segment) has a reddish-purple color, and is also raised in comparison with healthy skin ( due to tissue edema). Also, this disease is characterized by damage to the lymphatic vessels and nodes ( lymphangitis and lymphadenitis).
Pain arising from inflammation of muscles, ligaments and deep fatty tissue
*Myositis* *(an inflammatory process that is localized in the muscles)*	The inflammatory process leads to soft tissue edema. Ultimately, the enlarged muscles compress the nerve endings in the vessels, as well as nearby nerves that are located in the deeper and / or superficial layers.	Myositis is manifested by muscle pain, which is aggravated by touching and pressing on them. Also myalgia ( muscle pain) increases during movement or when the weather changes. Sometimes this pathology can lead to redness of the skin over the inflamed muscle tissue. With untimely treatment, myositis leads to a violation functional state muscles. Also, in rare cases, other nearby muscles may be involved in the pathological process.
*Tendinitis* *(inflammation of the connective tissue of the tendon)*	Tendinitis is characterized by the presence of permanent rupture of a specific part of the tendon. Since a large number of pain receptors are located in the connective tissue of the tendon, depending on the volume of damage, the pain can be both minor and severe. As a rule, pain occurs when performing movements in a joint adjacent to the tendon.	The skin over the damaged tendon may feel red and hot to the touch. Swelling of tissues may also occur. Sometimes a crunch occurs at the site of inflammation of the connective tissue of the tendon ( crepitus). It should be noted that in some cases, the damaged tendon heals with the formation of dense nodules of calcium ( calcifications).
*Retroperitoneal phlegmon* *(purulent fusion of retroperitoneal tissue, diffuse character)*	Retroperitoneal phlegmon leads to purulent fusion of adipose tissue located in the retroperitoneal space. Ultimately, a large accumulation of pus forms, which squeezes various structures and tissues ( nerves, muscles, tendons, blood vessels), in which a large number of painful endings are located. Painful sensations with this pathology, as a rule, pulling and pulsating.	In the first period of the disease, there is general weakness, loss of appetite, dizziness, headaches, chills. Body temperature can rise to 37.5 - 38 ° C. The pain localized in the lumbar region gradually increases. In some cases, the process can spread outside the retroperitoneal tissue, causing pain in the sacrum, buttock, or abdomen.
Spinal pain
*Osteochondrosis* *(dystrophic changes arising in intervertebral discs* )**	With osteochondrosis, dystrophic changes occur in the intervertebral discs. Ultimately, they lose elasticity, which leads to a decrease in the space between two nearby vertebrae and pinching of the spinal nerves. Compression of the nerve tissue leads to cramping and sharp pains. It should be noted that pain in osteochondrosis may increase against the background of increased mental or physical activity.	Often, with osteochondrosis, there is increased sweating of the whole body or hands ( hyperhidrosis). Muscles innervated by pinched spinal nerves gradually lose their functionality and become flaccid and weak ( atrophy). Compression of the lower lumbar spinal nerves, as well as the upper sacral ( these nerves form the sciatic nerve) leads to sciatica ( sciatic nerve inflammation).
*Intervertebral hernia*	In case of damage to the peripheral part of the intervertebral disc, the nucleus of the disc protrudes outward. Ultimately, this nucleus is able to compress the spinal nerves, causing pain and inflammation of the nerve tissue. These pains can be persistent or have a cramping character ( in the form of lumbago). It should be noted that intervertebral hernia is more often formed against the background of osteochondrosis in the lumbar segment of the spine.	Since a hernia occurs precisely in the lumbar spine ( more than 75 - 80% of all cases), then this leads to compression of the sciatic nerve, which innervates back thighs and lower legs, as well as the foot. Most often in the lower limb ( as a rule, only one sciatic nerve is compressed) there may be such unpleasant sensations as "goose bumps", tingling, numbness. In addition, there is a weakening of the muscles of the legs, as well as loss of sensitivity. In rare cases, violations of the act of urination and defecation are observed. If an intervertebral hernia occurs in the cervical segment ( about 18 - 20% of all cases), then an increase in blood pressure, headaches and dizziness, as well as pains that are reflected in the shoulder and arm, are possible. In rather rare cases ( in 1 - 3%) a hernia occurs in the thoracic region. In this case, persistent pain in the thoracic segment during work in a forced position is a typical symptom. It should be noted that sudden movements, coughing and sneezing often provoke new attacks of pain.
*Displacement of the vertebrae* *(subluxation of the vertebrae)*	With displacement of the vertebrae ( spondylolisthesis), compression of the spinal nerves, as well as the spinal cord itself ( narrowing of the canal in which the spinal cord is located). As a result, pain syndrome of varying severity occurs with the emergence of various kinds of neurological symptoms.	When one of the vertebrae of the lumbar spine is displaced ( occurs most often) there is a symptomatology characteristic of inflammation of the sciatic nerve. In this case, pain occurs along the nerve fiber, loss of sensitivity in the back of the leg, the occurrence of paresthesia ( tingling sensation, numbness, "chills" in the leg), amyotrophy. If there is a displacement of the vertebra in the cervical spine, which occurs much less often, then in this case the main symptoms are headaches, dizziness, and in some cases a stable increase blood pressure.
*Fracture of the vertebrae*	The direct impact of the traumatic factor on the vertebrae can lead to compression of the nerve tissues, spinal cord, blood vessels and other tissues, causing extremely severe pain.	For a vertebral fracture, in addition to the occurrence of acute pain in the area of injury, complete limitation of active movements in the damaged segment, a sharp muscle tension, and with compression of the spinal cord, serious neurological symptoms can occur, up to a violation of cardiovascular and respiratory activity ( when it comes to fracture of the upper cervical vertebrae).
*Spinal swelling* *(benign or malignant tumor of the spine or spinal cord)*	Tumor cells, and especially cancer cells, are able to bind to pain receptors in various tissues ( nervous, connective tissue, muscle tissue, as well as the vascular wall) and cause their stimulation. The more cancer cells come into contact with painful endings, the more pronounced the pain syndrome. It is worth noting that it is pain that is the first symptom of a tumor of the spine and spinal cord. This pain is characterized by an increase in the night and / or morning period of time ( being in a horizontal position) and some subsiding when moving to a vertical position.	Pain that occurs against the background of neoplasia ( neoplasm) of the spine, often reflected in the upper or lower extremities. It is characteristic that the pain is practically not relieved by painkillers. In addition to pain, there is also a violation of the act of urination and defecation, muscle weakness and paresthesia ( the occurrence of a burning sensation, "goose bumps", numbness) in the lower, and sometimes in the upper limbs, loss of motor function ( paralysis), gait disturbance. In some cases, in lower limbs coldness is felt, the skin of the limbs becomes cold to the touch and clammy. A rather large tumor can lead to deformity of the spine, causing scoliosis.
*Ankylosing spondylitis* *(spinal inflammation of a non-infectious nature)*	The inflammatory reaction that occurs in the spinal column leads to the release of a large number of biologically active substances that are responsible for increasing pain. The inflammation is localized not in the vertebrae themselves, but in the intervertebral discs, causing dystrophic changes in them. Ultimately, the load on the muscles and ligaments of the spine increases, which leads to their pathological tension and pain.	At the onset of the disease, painful sensations may bother only a few vertebrae of the lumbar or sacral spine. In the future, the process covers the entire spine, and in some cases goes to large joints ( hip, knee, ankle and / or elbow). Stiffness in the spine gradually builds up, which disrupts normal motor function. In addition, ankylosing spondylitis ( ankylosing spondylitis) has manifestations of an extra-articular nature. These manifestations include inflammation of the iris of the eyeball ( iridocyclitis), inflammation of the heart bag ( pericarditis), acquired heart valve insufficiency.
*Scoliosis* *(lateral curvature of the spinal column)*	The pain occurs due to the compression of the spinal nerves by the vertebrae, which have undergone scoliotic curvature. Also, scoliosis is a predisposing factor for the early development of osteochondrosis.	Depending on the magnitude of the curvature of the spinal column, 4 degrees of scoliosis are distinguished. In addition to impaired posture, the normal position of the pelvic bones and organs located in the pelvic cavity sometimes changes ( bladder, rectum, uterus and its appendages).
*Kyphosis* *(curvature of the spine in the anteroposterior direction)*	With kyphosis, a wedge-shaped deformation of the vertebrae in the thoracic spine is observed along with pathological replacement of the cartilaginous tissue with the connective tissue in the intervertebral discs. Ultimately, the musculo-ligamentous apparatus cannot cope with the load, which leads to overstrain and pain.	Kyphosis leads to impaired mobility of the spinal column. The prolonged course of this pathological condition leads to stoop, and then to hunchback. It should also be noted that with kyphosis, the function of the respiratory muscles is impaired ( mostly diaphragm) due to impaired mobility of the chest.
*Scheuermann-Mau disease* *(kyphosis that occurs during puberty)*	The same as for kyphosis.	As a rule, there is increased fatigue, pain in the lumbar segment when performing moderate physical activity. Also, pain can appear with a long stay in a sitting position.
*Spinal tuberculosis* *(spinal lesion with tubercle bacillus)*	Tuberculosis is capable of completely destroying the bone tissue of the vertebrae, leading to pinching of the spinal roots. In addition, tuberculosis can lead to the formation of an abscess ( limited accumulation of pus), which, in turn, is also capable of compressing the spinal nerves.	With tuberculosis, there is general malaise, muscle weakness and myalgia ( muscle pain), low-grade fever ( 37 - 37.5 ° C). Pain sensations at the onset of the disease are usually insignificant, but as the disease progresses, they become more and more pronounced, and sometimes intolerable. In addition, tuberculous lesion of the spine causes poor posture and stiffness in movements both in the spinal column itself and in hip joints (gait disturbance occurs). Due to the fact that the load from the spinal column is transferred to the musculo-ligamentous apparatus, the muscles of the back gradually atrophy ( loss of functional status).
Spinal brucellosis(damage to the spine caused by the penetration of the pathogen of brucellosis into the body)	In brucellosis, one or two vertebrae are most often affected. In these affected vertebrae, a decrease in bone density is observed, which triggers a compensatory reaction, during which additional lateral bone growths are formed ( osteophytes). It is the osteophytes that most often squeeze the spinal roots that emerge from the spinal cord.	Brucellosis is characterized by an increase in body temperature up to 37.5 - 38 ° C. Chills and general malaise also appear, which is manifested by headache, dizziness, pain in the joints, especially in the lower extremities. If you do not detect and start treatment in time, then the defeat of the spine with brucellosis can cause purulent lesions of the spine ( osteomyelitis).
*Osteomyelitis of the spine* *(purulent inflammation of the vertebrae with involvement of the surrounding tissues in the pathological process)*	This rather rare pathology leads to purulent lesions of the vertebral bodies. As a result, an accumulation of pus is formed, which can compress the spinal cord, spinal nerves, blood vessels, soft tissue, adipose tissue, which contain a large number of pain receptors. The pain is most often severe and persistent. It is worth noting that pus can melt tissue and penetrate into more superficial layers ( through fistulas).	Osteomyelitis is rapid. The body temperature rises to 39 - 40 ° C, tachycardia occurs ( increased heart rate) and hypotension ( lowering blood pressure). Besides, general state worsens sharply, leading to fainting and seizures. Pain syndrome is most pronounced at night.
*Myelitis* *(spinal cord inflammation)*	The inflammatory process, localized in the structures of the spinal cord, leads to tissue edema. In turn, the swelling compresses nearby blood vessels and nerves, contributing to pain. It is worth noting that myelitis back pain is most often mild. It is the neurological symptoms that come to the fore. When the spinal nerves are involved in the pathological process, diffuse pain appears along the course of these nerve fibers.	Depending on the affected segment of the spinal cord ( usually affects 1 - 2 segments), as well as from the clinical form of this inflammation, the symptoms of myelitis may differ slightly. Acute focal myelitis is characterized by the occurrence of general malaise, fever ( 38.5 - 39 ° C), chills, muscle weakness, sometimes vomiting. Then there is a feeling of numbness and tingling in the legs ( paresthesia), which is quickly replaced by a complete loss of movement in the limbs. If the process is localized in the lumbar region, then in this case dysfunction of the pelvic organs occurs. With disseminated myelitis, in addition to the main focus, there are also secondary foci that are smaller in size. Uneven lesions of the spinal cord lead to varying degrees of disorder of motor, reflex and sensory disorders, both on the left and on the right. There is also a form of myelitis ( opticomyelitis), in which there is a partial loss of visual areas, as well as a decrease in visual acuity. In children, myelitis often leads to seizures.
Rib pain
*Shingles* *(a viral disease caused by herpes zoster, which is manifested by damage to the skin and nervous system)*	After the varicella-zoster virus ( herpes zoster) becomes active again ( after the first contact with him, a person becomes ill with chickenpox, and then the virus becomes inactive), it moves along the intercostal cells and causes inflammation of the overlying layers, namely the skin. There are characteristic rashes ( red bubbles with colorless liquid), severe itching and severe pain. Pain is the result of severe irritation of pain receptors located in the subcutaneous fat, as well as nerve processes ( axons) intercostal nerves.	Most often, the skin manifestations of shingles are preceded by a general malaise of the body ( headache, dizziness, fever, muscle pain), itching, tingling and neurological pain at the site of future rashes. In rare cases, the virus can infect the ophthalmic branch of the trigeminal nerve, leading to destruction of the cornea ( the transparent and most superficial membrane of the eye) or cause pathological changes in the ear canal, causing partial or complete hearing loss.
*Tietze syndrome* *(inflammation of the cartilaginous part of the ribs)*	This pathology leads to inflammation and swelling of the cartilaginous tissues of the ribs. The enlarged anterior rib segments are able to squeeze the surrounding tissues in which pain receptors are located. The pain is most often one-sided and is acute or increasing.	The cartilaginous segments of the first 5 to 6 ribs are usually affected. Sudden movements of the torso, coughing or sneezing can aggravate the pain syndrome. Tietze's syndrome is characterized by the presence of constant pain in the sternum, which in some cases can bother patients for years. Often the pain is paroxysmal. When feeling the cartilaginous part of the ribs, a painful swelling is found. Sometimes pain can be reflected along the ribs in the anteroposterior ( sagittal) direction. It is worth noting that in addition to pain in the front of the chest and sternum, there are no other symptoms in this disease.
*Intercostal neuralgia* *(pain caused by compression of intercostal nerves)*	Pinching of the spinal roots of the thoracic spinal cord inevitably leads to pain along the intercostal nerves ( thoracalgia). The pains can be either dull and aching, or sharp and piercing. It should be noted that this pain syndrome has a paroxysmal nature.	An attack of pain leads to difficulty breathing, since the person reflexively stops using the affected side, taking a forced position. In some cases, there is a twitching of the muscles innervated by the intercostal nerves, and the skin turns red or, conversely, turns pale. You may also experience severe sweating and tingling in your chest. Sometimes there may be a loss of sensitivity in some segments of the chest. An attack can be triggered or aggravated by coughing, sneezing, and sudden movements. In fact, intercostal neuralgia is not an independent pathology, but is a manifestation of osteochondrosis of the thoracic segment of the spine, scoliosis, and some infectious diseases ( herpes zoster, flu, tuberculosis), severe fatigue, injury or other reason.
*Broken ribs*	The pain is caused by the impact on various structures of the chest of a traumatic factor ( bruise, sprain, crush, crush, or rupture). In some cases, bone fragments of the ribs can damage the pleura ( a thin connective tissue membrane that covers both lungs and lining the inner surface of the chest cavity), which contains a large number of nerve receptors.	The pain is most often severe and excruciating. Any movement in the chest, deep breathing, coughing or sneezing can increase this pain. That is why patients with fractured ribs reflexively develop shallow breathing, which in turn increases the risk of pneumonia. When probing the fracture site, a crunch is often found ( crepitus), edema and deformity of the chest ( sometimes bruising). The skin becomes pale or bluish. If there is a one-sided fracture of the rib or ribs, then a lag in breathing of the affected side of the chest is found. When the trunk is tilted to the healthy side, as a rule, severe pain occurs.
*Osteosarcoma and osteochondroma of the ribs* *(malignant tumors of the ribs, in which the bone or cartilaginous tissue of the ribs is involved in the pathological process)*	Cancer cells are able to bind ( have tropism) with painful endings in different tissues ( connective tissue, muscular, nervous, as well as the vascular wall) and over-stimulate them. There is a direct relationship between the number of cancer cells and the severity of pain syndrome ( the more cells, the more pain). One of the features of osteosarcoma is that the pain is most pronounced at night and in the morning when a person is in a horizontal position.	The skin at the site of the lesion becomes swollen. In the future, a small network of dilated veins often appears on it ( phlebectasia). The progression of these cancers leads to an increase in the size of the tumor, which, in turn, compresses the surrounding tissues more and more and increases the pain. In addition, anemia occurs ( anemia), muscle weakness, lethargy, weight loss. It should be noted that the pain caused by osteosarcoma is practically not available for relief ( localization and minimization).
Pain in the area of the shoulder blades
*Pterygoid scapula syndrome* *(paralysis of the serratus anterior muscle, which leads to painful protrusion of the scapula back)*	Most often, this pathology develops against the background of trauma to the long thoracic nerve. Ultimately, this nerve is unable to transmit nerve impulses to the serratus anterior muscle, causing its paralysis. Against the background of a violation of the innervation of the serratus anterior muscle, muscle pain gradually occurs. Sometimes damage to the cervical spinal nerves or brachial plexus can also lead to this condition. The painful sensations are aching in nature.	Typically, pain occurs after muscle weakness occurs. This pain can be reflected in the shoulder or even in the forearm. Another symptom is a bulging of the lower edge of the scapula. The presence of this manifestation is detected while the patient presses on the wall with straight arms.
*Fracture of the scapula*	Squeezing by a hematoma ( accumulation of blood from damaged vessels) surrounding tissues. In some cases, the pain of a fractured scapula may be felt in the shoulder joint. This is due to the fact that with a fracture of the glenoid cavity of the scapula, all the blood flows into the cavity of the shoulder joint ( hemarthrosis).	In addition to pain in the area of the scapula, swelling also occurs, which is a consequence of tissue edema. Often, during movement or when pressing in the area of the fracture of the scapula, you can hear a crunch ( friction of bone fragments). In some cases, the scapula is displaced, which ultimately leads to the lowering of the shoulder girdle. In addition, very often there is a limitation in the mobility of the shoulder joint.
*Osteomyelitis of the scapula* *(purulent lesion of the scapula bone)*	The accumulation of pus in the subscapularis can compress the underlying blood vessels and nerves. In some cases, this pathology becomes the cause of purulent inflammation of the shoulder joint ( purulent shoulder arthritis). The pain can be moderate or severe.	In addition to pain, an increase in body temperature is observed ( up to 37 - 38 ° C), chills, general weakness, loss of appetite. Sometimes there may be an increased heart rate ( tachycardia). As a rule, the pain intensifies at night or in the morning, and gradually decreases during the day.
*Exostosis of the scapula* *(osteochondral overgrowth that can compress surrounding tissue)*	In some cases, the osteochondral neoplasm of the scapula can reach large sizes and, thereby, lead to compression of muscle tissue, blood vessels and nerves. Pain can also occur with malignant degeneration of exostosis ( cancer tumor).	If the exostosis reaches large and very large sizes, then in addition to pain, excessive pressure on the ribs may occur, which, in turn, may lead to their deformation.
*Swelling of the scapula* *(osteochondroma, chondroma, osteoblastoma, osteoma)*	Tumor cells have protein molecules on their surface that bind to pain receptors and cause them to be stimulated. Pain at the onset of the disease may not be very disturbing, but as the tumor grows, the pain sensations increase significantly and are almost impossible to stop with pain medications. This is due to the fact that there is a direct relationship between the size of the tumor and the severity of the pain syndrome ( the more cancer cells there are, the more pain is).	The skin in the area of the scapula is most often hot to the touch, thinned and swollen. If the tumor is located near the glenoid cavity of the scapula, then there is a violation of movement in the shoulder girdle. In some cases, pathological fractures may occur, which are associated with a loss of bone strength. If the tumor reaches a large size, then it is capable of squeezing the vessels and nerves of the chest, thereby causing severe pain and discomfort.

In addition to the above reasons, there are a number of pathologies associated with the cardiovascular system, gastrointestinal tract, respiratory system, which can lead to pain in various areas of the back. That is why, when back pain occurs, the consultation of an experienced doctor is required, who is able to carry out the correct differential diagnosis and accurately determine the disease.

The most common pathologies in which reflected back pain may occur

Name of the disease	The mechanism of pain	Other symptoms of the disease
Diseases gastrointestinal tract
*Stomach and duodenal ulcer*	Excessive exposure to gastric juice, bile and gastric enzymes ( pepsin) on the mucous membrane of the stomach and duodenum leads to local ulceration ( an ulcer is formed). As a rule, pains with these pathologies are localized in the upper abdomen, but sometimes they radiate ( reflected) in the lumbar and / or thoracic segment of the spine, as well as in the left side of the lower back. The intensity of pain can be different - from slightly aching, up to "dagger".	Stomach ulcers often lead to heartburn and belching. A rapidly emerging feeling of satiety with food is often replaced by nausea and even vomiting. After eating, there may be a heaviness in the abdomen. In half of the cases, a table violation occurs ( constipation). With a duodenal ulcer, "hunger pains" are observed, which appear on an empty stomach and are stopped only after eating or when using medications or substances that reduce acidity ( antacids, antisecretory drugs, soda). In addition, duodenal ulcers are characterized by symptoms such as belching, nausea and vomiting, abdominal and intestinal bloating, and nighttime pains.
*Pancreatitis* *(inflammation of the pancreas)*	Normally, pancreatic enzymes enter the duodenum and become active only there. In some cases, there is a premature activation of these enzymes in the pancreas itself, which, in turn, leads to inflammation and severe pain. Depending on the affected area, pain can occur in the left or right hypochondrium, in the epigastrium ( the upper part of the abdomen, located below the sternum), and when the entire pancreas is involved in the pathological process, it must have a shingles ( the pain gives, including to the lower back).	General malaise, fever ( up to 38 - 38.5 ° С), palpitations, shortness of breath, nausea, bloating, stool disturbance ( diarrhea or constipation). The face of a patient with pancreatitis becomes pointed and pale. The body becomes covered with sticky sweat, the mucous membranes become dry. In some cases, the skin around the navel and on the lower back becomes cyanotic, covered with dark blue spots. This is due to the fact that blood in pancreatitis can accumulate under the skin and lead to the formation of these spots ( Mondor's symptom).
*Intestinal obstruction*	Painful sensations arise due to squeezing of the mesentery by the intestines, in which the nerve trunks and blood vessels are located. The nature of the pain depends on the type of intestinal obstruction ( dynamic, mechanical or mixed). Most often, there is constant and bursting pain or cramping and severe.	The main symptom of intestinal obstruction is pain that is localized in the abdomen and can be reflected in the lumbar region. In the future, pain may subside, which indicates inhibition of motility and intestinal motility. Often, the feeling of nausea that has arisen is replaced by indomitable and repeated vomiting. Obstruction is accompanied by gas and stool retention, as well as bloating.
Diseases of cardio-vascular system
*Myocardial infarction* *(one of the manifestations of coronary heart disease)*	Death of heart tissue ( necrosis) leads to severe and persistent pain. With myocardial infarction, pain persists for more than 15 minutes ( up to 60 - 70 minutes) and are stopped either after using narcotic painkillers, or on their own within a few hours.	The pain is localized behind the sternum, but in some cases it can radiate ( give away) in the shoulder, arm, shoulder blade, abdomen, or throat. Various arrhythmias also occur quite often. In addition to pain and heart rhythm disturbances, shortness of breath and dry cough may occur. In some cases, a heart attack is asymptomatic, and sometimes the only sign of a heart attack is cardiac arrest.
*Angina pectoris* *(a disease that manifests itself in short-term pain or discomfort in the heart area)*	The pain occurs due to a violation of the blood supply to the coronary vessels that feed the heart. Unlike myocardial infarction with angina pectoris, the pain lasts no more than 15 minutes and responds well to treatment with nitrates ( nitroglycerine).	Pain and discomfort with angina pectoris are pressing or burning in nature. Very often, pain is reflected in the shoulder and left arm, neck, lower jaw, in the upper abdomen or in the interscapular region. Shortness of breath, nausea, or vomiting sometimes occurs.
Diseases respiratory system
*Pleurisy* *(inflammation of the pleural sheets that surround each lung)*	Accumulation of pathological fluid in the pleural cavity ( exudate) leads to overstretching of the pleural sheets, which contain a large number of nerve endings. Also, pain occurs due to friction against each other of the inflamed and rough sheets of the pleura. Chest pain in some cases may radiate to the area of the scapula.	Pleurisy is often accompanied by an increase in body temperature ( 38 - 39 ° C) and chills. The pain increases with coughing, during breathing, shortness of breath appears. The affected half of the chest during breathing may lag behind the healthy one. The accumulation of a large amount of abnormal fluid in the pleural cavity can lead to compression of the lung.
*Pneumonia* *(inflammation of the lung tissue)*	Pain in pneumonia indicates that not only lung tissue is involved in the pathological process ( there are no pain receptors in the lungs), but also pleura. The intensity of pain depends on the degree of involvement of the pleura in this inflammatory process. If pneumonia affects only one lung, then the pain is localized in the right or left hypochondrium. With bilateral pneumonia, not only the chest hurts, but also in the area of the shoulder blades.	As a rule, pneumonia with pleurisy begins with a chill followed by a fever ( up to 39 - 40 ° C). Then a wet cough with phlegm appears. In addition, there is general malaise, muscle pain, headache, loss of appetite, drowsiness. In some cases, the sputum may contain streaks of blood, which indicates the release of red blood cells from the bloodstream and their entry into the lungs ( occurs in the second stage of croupous pneumonia).
*Lungs' cancer*	Growing up, a cancerous tumor is able to penetrate the bronchi, pleura and nerve tissues, which causes severe pain. The faster the tumor progresses, the stronger the pain.	A dry or moist cough may appear, accompanied by the production of sputum or blood. In some cases, cancerous pneumonia occurs, which is manifested by an increase in body temperature, chills, general weakness, and shortness of breath. When a tumor grows into a heart bag, pain in the heart occurs, and if nerves are involved in this pathological process, then neurological symptoms appear ( muscle paralysis, pain along the nerve, etc.).
Kidney disease
*Pyelonephritis* *(inflammation of the kidney and pelvis)*	The penetration of pathogens into the kidney leads to its inflammation. In the future, focal damage to the kidney occurs with the involvement of the intercellular substance in the pathological process. Pyelonephritis leads to tissue destruction ( including nerve endings) and replacing them with connective tissue ( fibrosis). Against the background of a banal infection, the pain can be aching or dull, and if pyelonephritis is a consequence of blockage by calculus ( stone) pelvis or ureter, then there is a pronounced pain syndrome, which is paroxysmal in nature.	Acute pyelonephritis is manifested by an increase in body temperature up to 39 - 40 ° C, chills, general weakness, malaise, loss of appetite, headache, sleep disturbance. Nausea and vomiting are common. An increase in the frequency of the urge to urinate is combined with discomfort during this process. Urine often becomes cloudy ( the presence of protein and bacteria in the urine). An exacerbation of chronic pyelonephritis is also manifested by the aforementioned symptoms, however, this pathological condition is more dangerous. The thing is that chronic pyelonephritis leads to chronic renal failure ( violation of all functions of the renal tissue), and can also cause arterial hypertension of renal origin ( increased blood pressure).
*Renal colic*	Increased pressure in the renal pelvis ( cavity connecting the ureter to the kidney) leads to acute impairment of the renal blood supply and the occurrence of severe pain syndrome. The pain comes on suddenly. Usually the pain is felt as much as possible in the lower back ( in the place of projection of the left or right kidney). It is worth noting that an attack of renal colic lasts from a few seconds and minutes to several hours.	Pain syndrome often spreads to the lower abdomen, groin and perineum, as well as the thighs. Abrupt movements can provoke renal colic. Sometimes there is nausea and vomiting, bloating, stool disturbance ( diarrhea). If renal colic occurs against the background of blockage of the ureter with a stone, then there is an increase in the frequency of urge to urinate. The cessation of urine excretion also occurs.

Why does the back hurt in the lumbar region?

Lumbar pain can occur for a variety of reasons. Lower back pain can be caused by an injury to the lumbar region, prolonged stay in a very uncomfortable position, physical overstrain, stressful situations, sprains of muscles and ligaments, acquired or congenital curvature of the spinal column, etc. Below is a list of the most common diseases that can cause pain in the lumbar region.

Pathologies that can lead to pain in the lumbar region are as follows:

Purulent skin lesions ( pyoderma). With a local decrease in the protective properties of the skin, such pyogenic bacteria as streptococci and staphylococci can penetrate into it. In this case, a purulent-inflammatory process develops, which leads to the appearance of painful abscesses of various sizes. These diseases are most often accompanied by general malaise, fever, and weakness.
Stretching the muscles and ligaments of the lower back usually occurs in professional athletes or untrained people after excessive physical activity. In addition to pain, inflammation and local tissue edema also occur.
Osteocondritis of the spine is a degenerative disease in which the cartilaginous tissue covering the intervertebral discs gradually breaks down. Ultimately, the distance between the vertebrae gradually decreases, leading to compression ( squeezing) the roots of the spinal cord, which are located on the sides of the vertebral bodies. It is the squeezing of the spinal roots that manifests itself in severe pain ( radiculitis).
Scoliosis is a lateral curvature of the spine ( frontal curvature). This pathology leads to an uneven distribution of the load on the spinal column. Ultimately, the skeletal muscles and ligamentous apparatus of the lower back are constantly overstressed, which causes pain.

Why does my back hurt during pregnancy?

During pregnancy, women often encounter pain in the back and, in particular, in the lower back. The fact is that during pregnancy, some changes occur in the musculo-ligamentous apparatus of the back. In order to ensure the normal passage of the fetus through the birth canal ( pelvic bones), under the influence of a special hormone ( relaxin), the ligaments and muscles become looser and less elastic. And this, in turn, increases the load on the spine and intervertebral discs. In addition, during pregnancy, the center of gravity shifts, which is manifested by a strong forward displacement of the lumbar spine. In this case, the muscles of the lower back are constantly overstrained, which ultimately leads to microtrauma and pain.

Pain during pregnancy can occur at various times. Quite often, this symptom occurs at 4 to 5 months of pregnancy. As the child grows, the center of gravity of the pregnant woman shifts more and more, which increases the pain. This is why back pain is most severe in the last month of pregnancy. Increased pain also occurs due to the fact that the child begins to squeeze the lower back from the inside.

If, before pregnancy, a woman was diagnosed with osteochondrosis of the spinal column ( dystrophic changes in the intervertebral discs), then the likelihood that when carrying a child she will experience back pain increases many times over. These pains can also be observed in pregnant women with curvature of the spinal column ( scoliosis or kyphosis), in obese women or overweight and in women with poor back muscle development.

In some cases, back pain can be reflected in the back of the thigh, lower leg, or foot. This symptomatology, as a rule, indicates compression and inflammation of the sciatic nerve ( sciatica). In addition to pain, paresthesias also occur ( a burning, tingling or crawling sensation), impaired sensitivity and muscle weakness in the leg.

Every adult has experienced pain in the lumbar region at least once in his life. Let's take a look at what is the cause of the pain, what exercises for the lower back need to be done to make it healthy and strong, how to pump up the lower back.

Strengthening the lumbar muscles

In this article, I will move away from my usual style and write everything in the first person. I had a problem, once I got low back osteochondrosis while skiing. It hurt like hell, nerves pinched.

11 years have passed since then, today my deadlift weight is 140 kg. Without any pharmacology, exclusively natural. And the back does not hurt. I will tell you how to strengthen your lower back muscles so that you never have problems with it. Even if you already have problems, I will help you stop their progress and relieve pain. So, let's begin.

A person, unlike animals, experiences a large number of problems with the spine. This is due to our upright posture and, accordingly, an increased load on the spinal column. The lower back suffers for the same reason. The situation is aggravated by a sedentary lifestyle, weak muscles and the practice of lifting weights from the floor, when a person does it with a round back, bent over with the letter "G".

The lumbar muscles provide cushioning or cushioning of the compression load on the spinal column. It is logical that strengthening the muscles of the lower back will allow them to better perform their function. The roots of the spinal cord, coming out of the spine, will not be pinched (that is, there will be no lumbago in the back and pain when bending over, walking).

And we will be pumping not only visible muscles that can be felt. There is also a psoas muscle that is not visible. The psoas is considered the core muscle and flexes the hip, or the lumbar spine if the leg is fixed. When you arch your lower back, she certainly participates in this. A weak psoas muscle can cause lower back pain.

We'll start with exercises for people who already have problems. Then we will look at the exercises that can be performed after the initial strengthening of the back.

Entry level exercises

When your lower back hurts, you need special training. And you don't need it now gym.

Press, oddly enough

You say - what does the press have to do with it if your back hurts? Remembering the topic. If you only swing your back, your lower back will tilt back. And so - there will be uniform support from all sides. That is, in order for the support of the spine to be optimal, the muscles must be strengthened on all sides of the body.

Before you start exercising, you should relieve inflammation. As long as you feel acute pain, you cannot practice.

When the pain becomes dull, aching, less noticeable (inflammation is relieved), start doing exercises.

Exercise # 1:

Lie on a polymer mat, put your hands on your chest, bend your legs at the knees.
Raise your head and top of your chest, trying to bend as much as possible in the chest region. Do not lift your lower back.
Do 10 of these movements. Take your hands behind your head, repeat the same 10 times. Watch the sensations so that there is no pain.

Exercise number 2:

Now extend your arms along your torso and keep them a few inches off the floor. Right hand stretch to the right heel by flexing the lower back to the side. Then repeat the movement for the left side.
Do it 10 times on each side.

Over time, you will be able to raise the chassis more relative to the floor. Now we have pumped up the front of the abdomen and sides.

And now the back

Now let's take care of the back. Ideally, do hyperextension in a simulator. But if there is no such possibility, we will proceed from what is. We have a rug, right?

Exercise # 1:

Lie on the mat with your stomach down. Stretch your arms forward, clasp their palm to palm, as if going to dive.
Bend up slightly so that your body rises slightly above the rug. Hold the tension, then lower yourself back down. Do this 10 times.

Exercise number 2:

Get on all fours - support on your knees and palms. Bend your lower back as far down as possible, lifting your head. Now, on the contrary, round your back up and lower your head.
This movement is called. Do this 10 times.

Exercise number 3:

Stand up. Move the pelvis back, bending in the lumbar region. Lean forward as far as your lower back will allow. It should not be rounded. The number one challenge is to maintain the deflection. Hold at the end point for a second and straighten up. Repeat 10 times.
If your lower back rounds back during the bend, straighten up and start over. Most of the problems arise from this roundness.

These exercises are aimed at strengthening the lower back and psoas.

Start at 10 times, gradually work up to 30. Do this every day in the morning.

Stand with feet shoulder-width apart. Pull your buttocks back as much as possible (this will create a deflection in the lower back). If at the same time you experience pain in the tailbone area and a little higher - you squat early, train according to the previous schemes.
Stretch your arms in front of you, look at the tips of your fingers. Squat just below parallel with the floor, without rounding your back. Hold down for 1 second and stand up. Please note that while squatting, your body does not fall forward. If this happens, spread your legs just wide enough so that you do not lean more than 20-30 degrees forward.
The bend in the lower back should compensate for this tilt. As a result, your body is almost perpendicular to the floor.

So, you've been doing these exercises for a month.

Harder exercises

Let's go - hyperextension in the gym!

Hyperextension in the simulator

If you are interested in how to pump up your lower back at home, then you can arrange a place for hyperextension on the couch and ask a second person to help. If this is not possible, go to the gym or do the exercises from the previous section.

So, how to pump up the lower torso using hyperextension while working on the simulator.

Adjust the height of the treadmill so that your pelvis is half resting on the support.
Place your hands on your chest or behind your head. Keep your back so that you get a natural arch in the lower back. Tighten the shoulder blades. Keep your head slightly raised up.
Lower your torso down to the point where your stretch allows you to maintain the correct arch in the lower back. Rise to a straight line with your legs.
Keep your back straight all the time!

Do 1 set of 15 reps the first time. Then you can add up to 3 approaches.

For the abs, practice a Roman chair and bench leg raises once a week, but not vertically up to the ceiling.

Plank

Lower back exercises do not have to be dynamic. Here, for example, is the bar. You stand for 60-120 seconds on your elbows and toes, keep your body straight. The same psoas muscle in tension, core muscles in tension, all psoas muscles are involved so that the pelvis does not fall inward. And press as an antagonist. Sometimes the muscles need such a load.

Side dynamic bar

And one more exercise that is best done for physically advanced people. Both the psoas muscle and the lateral part of the press work in it. This exercise is similar to a plank, but dynamic.

Stand on your elbow, sideways to the floor. The humerus is perpendicular to the floor. Cross your legs. The primary anchor points for your body are your elbow and the side of your leg from heel to hip.
Lift your pelvis up just above a straight line with the body, lower it back. Start with 10 reps.
Gradually reach 30. It is not as easy as it seems at first glance.

These exercises can be done three times a week. They will help you build a strong lower back, and if pain bothers you, it is very, very rare.

The square muscle of the lower back is a paired postural muscle that is responsible for lateral stability and tilt of the spine and chest, lifting the hip, and can also participate in the exhalation process. It begins at the iliac crest and is attached to the XII rib and the transverse processes of the lumbar vertebrae I-IV. Roughly speaking, it connects the lower ribs and the pelvis. This muscle is often the source of lower back pain. If gluteal muscles weakened, the square muscle of the lower back partially takes over their function of stabilizing the pelvis and, accordingly, is exposed to unintended overstrain. the site will tell you how to get rid of the pain caused by overexertion of the quadratus lumborum.

Overstrain of the square muscle of the lower back: the most common causes

The causes of back pain, namely in its lower part (lower back), can be:

protrusion or hernia of the vertebral disc;
trauma;
pinched nerves;
inflammation of the nerves;
diseases of internal organs (reflected pain);
infections;
rachiocampsis;
spine diseases;
difference in leg length;
displacement of the joints;
overexertion or muscle strain.

It is possible to assume overstrain of the square muscle of the lower back only after undergoing a full examination and excluding other reasons that led to the appearance of pain.

A characteristic feature of problems with the square muscle of the lower back is painful sensation, as well as a noticeable tilt to the "painful" side. Possible causes of overstrain of the specified muscle:

the habit of sleeping on one side with a raised hip;
carrying weights on one side;
weakened muscles of the buttocks;
incorrect posture, etc.

How to relieve tension in the square muscle of the lower back

To relieve lower back pain, it is enough to perform the exercises below, aimed at relieving tension in the square muscle of the back.

Massage will also be useful, but it is better to contact a qualified specialist for it, who knows exactly the technique of performing massage movements.

We suggest you try the exercises and postures below.

1. We reach for the fruit (up to 10 repetitions)

stand upright, raising your straight arms up;
now raise one hand higher as if you intend to pick a ripe fruit from the tree;
bend the opposite leg at the knee and lift the thigh up;
inhale and feel the contraction of the square muscle of the lower back;
exhale and relax;
repeat on the other side.

2. Gentle twisting while lying down

lie on your side;
apply a roller to the left thigh;
turn the body in the direction of the roller;
hands rest on the sides of the roller (as shown above);
turn your head in any direction (whichever is more convenient for you);
You will have to look for the best position on your own, adjusting the bend of the hips and knees, pulling the thigh away from the lower ribs;
linger in the chosen position for a couple of minutes;
exhaling slowly, return to the starting position;
repeat on the other side.

3. Graceful tree pose

lie on your back;
bend the spine so that the body tilts to the right side;
keep your hips and shoulders on the floor;
grasp your right wrist with your left hand;
give your feet to the right;
so that the legs do not part, it is fashionable to cross them in the ankle area;
feel the entire left side stretch;
after a few minutes, return to the starting position and repeat the pose on the other side.

4. Side stretch while sitting

get down on all fours;
place your hands exactly under your shoulders;
the knees and inner thighs should touch and be aligned under the pelvic bone;
move your hips to left side rolling onto outer part left leg ( right leg should be located on the left);
look over your right shoulder;
inhale as you stretch the left lower back and left thigh;
exhale to return to the center position;
repeat on the other side.

5. Child's pose

kneel down;
sit with your buttocks on your heels;
bend forward with your arms outstretched;
put your chest on your hips;
move your hands to the position of the arrow, which points to 10 o'clock, so that the body bends to the left;
linger in this position for a minute;
repeat on the other side (hands at 2 o'clock).

The site hopes that the above postures will help relieve tension in the square muscle of the lower back, and with it - and pain in the lower back.