Low back pain is one of the most common reasons forcing patients to seek help from a neurologist or therapist. Pain in the lumbosacral spine can be permanently paralyzing, making movement and self -treatment impossible. Acute lower back pain often occurs in both men and women.
With greater frequency in middle age and old age, back pain can often be seen in adolescents and young adults. This is due to rapid growth, weakness of the fragile muscles of the lower back, injuries. Therefore, pain in the lumbosacral spine is the most pressing problem that anyone can face.
Lower back pain with lumbar osteochondrosis
Lower back pain with osteochondrosis can increase with coughing and sneezing, with any movement, especially when the body is bent forward. Along with back pain, lumbar osteochondrosis can manifest itself as a violation of sensitivity in certain parts of the skin or muscles of the lower trunk and legs, weakening or loss of tendon reflexes in the legs.
- As a rule, with osteochondrosis, there is curvature of the lumbar spine. Depending on the area where the curvature occurs, scoliosis (curvature to the right or left), lordosis (forward curvature) and kyphosis (smoothing of the lumbar spine or even its curvature to the back) are distinguished. If, with osteochondrosis, the spinal cord is pinched, there is a violation of urination or defecation, as well as a violation of the sensitivity of the bladder or genitals.
- However, lumbar osteochondrosis is most often indicated by radicular pain - which develops as a result of pinching a nerve root that extends from the spinal cord at one level or another. So, one of the well -known lumbar syndromes is lumbago. It occurs during times of physical stress or in awkward bodily conditions, and sometimes for no apparent reason. Suddenly, within minutes or hours, there is a sharp shooting pain ("lumbago"), often burning and breaking ("as if the pole had been stuck in the lower back").
The patient freezes in an uncomfortable position, unable to straighten if an attack occurs while lifting weights. Attempts to wake from sleep, coughing, or bending the legs are accompanied by a sharp increase in pain in the lower back and sacrum. If the patient is asked to stand on his feet, then a state of sharp lumbar movement from the entire lumbar region will be revealed as a result of muscle tension.
Examination of lumbosacral osteochondrosis
These tests are used as a method of conducting initial diagnostics, they are named after the doctor who recommended them.
| Symptoms of Dejerine | if you tighten the abdomen and listen to the lower back, the pain will be stronger. In this case, there is a high probability that the patient has osteochondrosis. |
| Symptoms of Neri | if, when the head is tilted forward sharply before touching the chest, there is pain in the lower back, this also indicates a problem in the spine. |
| Lasegue symptoms | this can be felt after the following actions: lying on your back, you need to lift each leg in turn. If, after that, the lower back is rotated, and pain is given along the sciatic nerve to the leg, this is evidence of spinal pathology. |
| Larrey's symptoms | if pain occurs in a person along the sciatic nerve, after he rises forward without bending the knee from a lying position, we are talking about the manifestation of chondrosis. |
Herniated Disc
Herniated discs are a rare cause, the clinical manifestation of which is pain in the lumbosacral spine. The intervertebral disc (nucleus pulposus) with prolonged exposure to trauma, as well as with age, loses its elastic properties and elastic capacity.
With constant exposure (overweight, trauma, progressive osteoporosis), the fibrous annulus of the disc becomes thinner, and defects form in it. Through a weak point in the annulus fibrosus, the nucleus pulposus of the disc can shift and even protrude.
Causes of back pain
Back pain is a non -specific symptom that can be caused by a variety of reasons. From how strong back pain is in the lumbar region, whether permanent or periodic, primary or secondary, there may be a reason for it:
Chronic pain:
- Osteomyelitis;
- Ankylosing spondylitis;
- Deformans spondylosis;
- Growth disease - scoliosis;
- Infectious lesions of the intervertebral discs and vertebrae (epidural abscess, spinal tuberculosis, brucellosis);
- Metabolic bone diseases - osteomalacia, osteoporosis;
- Primary tumors and metastatic tumors of the spinal cord, vertebrae, retroperitoneal space;
- Non -communicable inflammatory diseases - rheumatoid arthritis, Reiter's syndrome, ankylosing spondylitis;
- Kidney tumors;
- Atherosclerosis of the abdominal part of the aorta and its branches.
Acute pain:
- Spondyloarthritis;
- Pathology of the hip joint;
- Spinal epiduritis;
- Protrusion of the intervertebral disc in the lumbar region;
- Osteochondritis of the spine;
- Acute intervertebral hernia;
- Intestinal obstruction, atypical acute appendicitis;
- Urolithiasis;
- Acute sprains, vertebral fractures;
- Lumbago, sciatica;
- Acute circulatory disorders of the spine - stroke;
- Acute pyelonephritis.
Radiant pain in some diseases of internal organs:
- Diseases of the pelvic organs. In women - inflammatory processes of the uterine lining, endometriosis, uterine cancer, ovarian cancer, STDs (chlamydia, ureaplasmosis, gonorrhea, trichomoniasis, etc. ). In men - prostatitis, prostate cancer;
- Diseases of the stomach, pancreas, duodenum, gallbladder;
- Intestinal diseases - inflammation of the diverticulum, ulcerative colitis, intestinal tumors;
- Kidney disease - renal colic, kidney stones;
- Surgical aortic aneurysm.
Physiological causes
Back pain can occur if you:
- Overweight;
- Additional risks for women;
- You are pregnant or have just given birth;
- Spend a lot of time driving a car or computer;
- Leading lifestyles (office workers) or inactive (vendors, waiters, guides, surgeons);
- Perform dynamic physical energy with sudden changes in body position (especially if your expertise is related to strenuous physical activity);
- Load yourself up at the gym or fitness club. Be careful if you started training recently;
- Love working in summer cottages;
- Has reached postmenopause, which is conducive to the development of osteoporosis.
Low back pain and pregnancy
Pregnancy exacerbates the manifestations of the disease in the mother's body. Due to changes in hormone levels and increased load, pathology is very often shown in the second half of pregnancy. In addition to the pain that accompanies the threat of premature birth, the causes of lower back pain in pregnant women can be:
- herniated disc;
- radiculitis;
- pancreatitis;
- pyelonephritis;
- urolithiasis (kidney stones).
Why does the back hurt in the lower back
When the back hurts below the lumbar, in addition to obvious spinal diseases (sciatica, lumbago, intervertebral hernia, ankylosing spondylitis, etc. ), the likely cause is periodic pain during menstruation in women, diseases of the female genital organs, such as complementary inflammationuterus - oophoritis, salpingo -oophoritis (adnexitis), as well as diseases of the pelvic peritoneum, intestines, appendicitis (appendix of the blind intestine), in men - diseases of the prostate gland, bladder.
Pain in the upper part of the lower back
If the back hurts on the upper right side of the lower back - then liver pain can radiate, with pathological changes in the liver - hepatitis, liver failure, taking toxic drugs. The pain in this case is most often localized in the right hypochondrium.
If pain is felt on the right or left side just above the lower back, it is very likely that the cause lies in acute kidney disease. Many chronic kidney diseases such as polycystic kidney disease, malignant neoplasms of the kidneys, chronic pyelonephritis are accompanied by minor symptoms as the kidney capsule is gradually stretched.
When must you see a doctor?
- If back pain radiates to the lower back, and it itself is located slightly higher (in the chest area). The pain is accompanied by sweating, attacks of vomiting and nausea, shortness of breath.
- Pain radiates to the peritoneum, chest, neck, jaw.
- The patient is dizzy and confused.
- Tachycardia begins.
- Spinal trauma, accompanied by loss of control over bowel movements, urination.
- Weak legs, back, genitals grow numb.
Diagnostics
To determine which disease is causing lower back pain, it is necessary to undergo a comprehensive diagnostic examination.
Laboratory methods:
- General and biochemical analysis of urine and blood.
- Tests for tumor markers are found in the blood during tumor formation.
Instrumental research methods:
- X-ray of the spine.
- Endoscopy of the intestine, stomach and uterus.
- Ultrasound examination of the abdominal cavity.
- Magnetic resonance imaging.
How to treat back pain?
How to treat the lower back properly? The back treatment approach depends entirely on the symptoms of the disease, the diagnosis made by the doctor, and the stage of the disease. Typically, an integrated approach is used that includes several treatment methods.
Pain medicine. . .The ointment helps relieve inflammation, stretching, and has a warming effect if the lower back has a cold.
The following groups of ointments are distinguished:
- combination medicine (used for sprains and injuries, along with anti-inflammatory and analgesic effects, it has a healing effect due to its constituent ingredients);
- anti -inflammatory analgesics (they contain medicinal substances with a cooling effect that relieve irritation - bulbs, lavender, and painkillers);
- chondroprotectors (one of the active components of such drugs are substances used in pathological processes in cartilage tissue, which contribute to the active restoration of the cartilage surface of the joints);
- irritating medication (its effect is based on vasodilation and blood flow to the source of pain)
With the help of therapeutic exercises, patients will be able to reduce pain, create strong muscles, increase the distance between the vertebrae. They will help release compressed nerve roots, normalize blood flow in the affected area, and improve metabolic processes.
In order for the gymnastics to heal, and not be paralyzed, all the recommendations of the attending physician must be adhered to.
- The movement is done slowly and smoothly without sharp turns;
- The room must be ventilated before training;
- Patients should wear clothing that does not restrict movement;
- Exercises are performed while the patient is inhaling, and while exhaling, he or she has to return to the position again;
- The load increases gradually. First, the number of approaches was about 10, and then they increased;
- During gymnastics, you should monitor your well -being. If a sharp pain starts, then you need to stop your studies.
In addition, massage is very good for relieving pain in the lumbar spine. The positive therapeutic effects of massage include the following:
- increase blood supply to diseased parts of the body;
- kneading muscles, which makes them and ligaments more flexible and elastic;
- relieve acute pain;
- get rid of toxins accumulated in the muscles and subcutaneous tissue;
- pleasant sensation due to stimulation of the nerve endings of the skin;
- positive emotions.
It can be entrusted to a specialist at the clinic or done at home, however, the benefits from it will be invaluable.
Which doctor should I go to?
For back pain, the cause of which is unknown, the first step is to see a therapist. This will help determine the disease with a combination of symptoms.
If the reason is clear: the pain is preceded by an injury, the pain arises with a background of pregnancy, menstrual cycle or chronic illness, it makes sense to immediately contact a narrower specialist.
Self-medication is allowed only in cases where the cause of the pain is known precisely.