Why does my lower back hurt when I twist it?

Pain in the lower back when twisting may be caused by muscle strain, lumbar disc herniation, lumbar muscle strain, facet joint disorder or osteoporosis, etc. It can be relieved by rest, physical therapy, drug treatment, rehabilitation training, etc.

1. Muscle strain:

Lumbar muscles or ligaments may be strained during sudden twisting, manifesting as local pain and limited movement. Commonly seen in scenes such as carrying heavy objects and improper exercise postures. In the acute stage, you need to stop activities and apply ice. After 48 hours, you can apply heat to promote blood circulation. If the pain persists, you need to seek medical treatment to rule out other injuries.

2. Lumbar disc herniation:

Compression of the nerve roots by the intervertebral disc can cause radiating pain when twisting the waist, which may be accompanied by numbness in the lower limbs. It is related to long-term sitting and excessive waist load. Mild herniation can be relieved by traction treatment, but in severe cases, transforaminal endoscopic surgery should be considered. It is recommended to complete MRI examination to clarify the degree of protrusion.

3. Lumbar muscle strain:

Chronic muscle fatigue can cause sterile inflammation in the waist muscles and induce soreness when twisting. It is common among office workers who maintain bad posture for a long time. Core muscle training can enhance stability, and shock wave therapy can relieve local adhesions. It is necessary to avoid sitting for more than 2 hours on a daily basis.

4. Facet joint disorder:

Dislocation of the facet joints behind the lumbar spine will cause severe pain when twisting, which may be accompanied by a "clicking" sound. Mostly caused by sudden forceful turning. Manual reduction can immediately improve symptoms, and combined with ultrasound treatment can eliminate surrounding soft tissue edema. Patients with frequent recurrences need to wear waist protection.

5. Osteoporosis:

Reduced vertebral bone mass will reduce the weight-bearing capacity of the waist, and slight twisting can cause dull pain. It is more common in postmenopausal women and requires bone density testing for diagnosis. Basic treatment includes calcium and vitamin D supplementation. In severe cases, anti-bone resorptive drugs such as zoledronic acid need to be used to prevent vertebral compression fractures.

It is recommended to maintain a correct sitting posture every day, choose a hard bed for sleep, and avoid bearing weight on one side. During the acute pain period, you can try the McKenzie method to stretch the waist muscles, and swim or plank three times a week to exercise core strength. Pay attention to supplementing your diet with protein and calcium. People over 50 years old are recommended to check their bone density every year. If the pain is accompanied by fever, abnormal urination or continues to worsen, diseases such as kidney stones and ankylosing spondylitis need to be ruled out.