Lower back pain

There are many diseases that manifest themselves as painful sensations in the lumbar region. They may indicate problems with the spine, joints, muscles, internal organs - kidneys, intestines, liver. This is a rather dangerous symptom, and without a visit to the doctor it is impossible to determine the true cause of the pain in the lumbar region. Correct treatment is possible only after diagnosis in a medical institution.

Types of pain

During the initial examination, the doctor must ask the patient about the nature of the pain. During the period they can:

• sharp- occurs suddenly, paroxysmally, varies in intensity, lasts less than 1 month;
• subacute- the last 2-3 months, often it recurs: they become active for 2-5 days, then subside and return again after some time;
• chronic- lasting more than 1 year, the course most often repeats.

Doctors have found that most often chronic pain in this area is associated with the formation of local muscle spasms, compaction that has a specific pain point (the so-called myofascial syndrome). This process also involves the muscles that straighten the spine, back muscles, pelvic ligaments and sacroiliac joints.

The nature of the pain is sharp, aching, dull. By intensity - strong, medium, weak. Depending on the location of the pain, the following types are distinguished:

• lumbodynia- pain in the lumbar or lumbosacral region;
• sciatica- in the lower back, radiating to the legs;
• sacralgia- in the sacrum area;
• coccydynia- in the coccyx.

5 facts about back pain

• About 25% of all visits to the clinic with complaints of back pain are related to sensations in the lumbar region.
• According to research, 84% of people have experienced pain in the lumbar region at least once in their life.
• 44-78% of patients (depending on age and area of residence) experience recurrent attacks of lumbodynia.
• Up to 37% of people periodically lose their ability to work because of back pain.
• In 85% of patients who consult a doctor about pain in the lumbar region, a musculoskeletal disorder is identified, which is the cause of the pain.
• According to statistics, about 90% of patients who experience acute pain in the lumbosacral region recover within 2 weeks.

Causes of back pain

Musculoskeletal disorders

In 2006, the Federation of European Neurological Societies officially adopted the following classification of causes of pain in the lower back. They are divided into 3 main groups:

1. Spinal root compression, peripheral nerves in the lumbar spine. It occurs due to the protrusion (degenerative changes) of the intervertebral disc. Less common, due to dysplasia (disruption in the formation process) of the articular process of the sacrum.
2. Diseases of the spine caused by tumors, joint damage, infections, compression fractures, allergic reactions, autoimmune inflammatory processes.
3. Musculoskeletal disorders resulting from subluxation, spinal ligament sprain, muscle strain, intervertebral joint dysfunction.

Pathology of internal organs

1. Disorders of the genitourinary system.

   Diseases of the urinary system - urolithiasis, cystitis, pyelonephritis - often cause discomfort in the lumbar region.

   Lower back pain in women may indicate genital organ dysfunction. Often, the main sensation is concentrated in the lower abdomen and radiates to the sacrolumbar spine. They may appear during menstruation or after sexual intercourse.

   One of the possible causes of lower back pain in women is an ovarian tumor, which is located behind the uterus. Often, discomfort in the lower back is a symptom of uterine fibroids. When it grows, the pain can manifest itself strongly and acutely and indicate a serious disturbance in the blood supply, stretching of the peritoneum, and compression of the nerve plexus in the pelvic area.

   Another cause of lower back pain in women is pelvic organ prolapse. In this case, sensation is an attractive property. During walking and physical work, their intensity increases.

2. Gastrointestinal disorders.

   Often, pain is felt in the lumbar region due to gastric and duodenal ulcers and acute pancreatitis. The patient complains that there is pain of a girdle nature. Usually the lower back begins to hurt simultaneously with the right / left hypochondrium, where the most intense sensations are concentrated. In some clinical cases, lumbar pain accompanies an attack of acute appendicitis, although it is not the main symptom of the disease. Various inflammations of the intestinal mucosa (proctitis, sigmoiditis) can also cause pain.

10 Risk Factors for Back Pain

1. Congenital pathology of the lumbosacral spine.
2. Heavy physical labor is associated with stress on the lower back, frequent bending, and vibration.
3. Acute and chronic stress that causes muscle spasms.
4. A sedentary lifestyle and prolonged stay in an improper position with a load on the lumbar region.
5. A weak muscular corset, which results in incorrect posture, stooping, scoliosis, and kyphoscoliosis.
6. Metabolic disorders and excess weight, which increase the load on the lower part of the spine.
7. Increased physical activity and sports participation increase the risk of injury.
8. Age over 50 years - due to the development of degenerative processes in the spine.
9. Frequent stress, depression.
10. Poor nutrition with vitamin B deficiency.

Back pain as a symptom of various diseases

Osteochondrosis of the lumbar spine

One of the most common diseases, the symptom is pain in the lumbar region. With osteochondrosis, the intervertebral disc, which plays the role of absorbing shocks between the vertebrae, becomes thinner. Nerve roots are compressed, muscle spasms, and severe acute pain occurs. Its intensity increases when bending over, lifting heavy objects, or when the patient tries to sit up from a lying position or stand up from a sitting position.

In advanced cases, a hernia forms between the vertebrae, which only increases the pain. Osteochondrosis most often affects the lumbar spine, because it bears the maximum load when sitting and walking.

A severe complication of osteochondrosis is spondylosis. It is characterized by the almost complete destruction of the intervertebral disc and the formation of sharp bony protrusions - osteophytes. They injure nearby tissue, causing sharp, severe pain that radiates down one or both legs.

Signs of intervertebral hernia

• The patient can get up from a sitting position only with support from a chair/table or knees.
• Any load on the lower back causes acute pain attacks.
• The patient lies on his stomach, only placing a pillow under him.
• One can only pick up objects from the floor by bending slowly.

Ankylosing spondylitis

This disease occurs as a result of the inflammatory process in the spine. It is most often diagnosed in men aged 20-35 years. The patient feels stiffness in the lower back and discomfort in the sacrum in the morning and while resting. Gradually during the day this feeling passes, the person "moves. "Many people do not pay attention to this alarming symptom; Meanwhile, ankylosing spondylitis leads to gradual fusion of the vertebrae, decreased spinal mobility and disability. Therefore, you need to see a doctor at the first signs of the disease - morning stiffness in the spine.

Spondyloarthrosis

This disease affects the cartilage tissue that covers the intervertebral disc. With age, it becomes thinner, destroyed, and bone growth forms where the cartilage breaks. Due to the fact that the intervertebral discs rub against each other, the nerve roots are irritated - this process is accompanied by severe back pain. The muscles in the back problem area are always tense and spasm.

Symptoms of spondyloarthrosis

• The pain is worse after exercise and disappears after rest.
• Pain appears after standing or walking for a long time.
• At the same time as low back pain, the patient feels discomfort in one of the hips and hip joints.

Urolithiasis disease

The pain in this pathology is paroxysmal and very intense. Usually, painful sensations arise from inflamed kidneys. It is difficult for the patient to find a position where he feels better. After an attack, the urine becomes reddish in color and the amount decreases.

Inflammation of superficial tissues and fibers

The cause of the pain may be a carbuncle or boil. This is a dense purulent formation on the skin with a diameter of more than 1 cm. It is easy to see with its purple color. The painful sensation is sharp, intense, throbbing.

Paranephritis, inflammation of the perinephric tissue caused by infection, is also painful. The sensation becomes stronger with inhalation and movement. The patient tries to lie down with his legs crossed - in this position the pain is less pronounced. The skin in the affected area swells and becomes red.

Inflammation of the spine, spinal cord

Osteomyelitis is an inflammatory process in the bone marrow that affects all bone tissue. The acute form is characterized by an increase in pulling pain, bursting nature. It is combined with signs of intoxication and fever.

Tuberculosis of the spine occurs as a result of Koch's bacillus infection. The first signs of the disease may appear years after infection. It all starts with a deep pain that appears after exercise. The infection affects the vertebrae, hinders the patient's movement, and a characteristic gait is formed.

Other diseases

Lumbar pain can be a symptom of various pathologies, including quite exotic ones. These include, for example, foot and mouth disease, Ebola fever, dengue fever and Japanese mosquito encephalitis.

• Cardiovascular diseases - abdominal aortic aneurysm, Loeffler's endocarditis.
• Myositis is inflammation and muscle pain in the lower back, which can be caused by infectious diseases such as influenza, sore throat, and even common ARVI.
• Benign and malignant neoplasms of the spine and spinal cord.
• Renal pathology - glomerulonephritis, renal vein thrombosis, pyelonephritis, cysts.
• Low back pain in men occurs with prostate cancer.

Why does my lower back hurt when I cough?

Coughing causes muscle tension in the affected area, resulting in pain. Often, patients first learn about the developing disease when they notice pain when coughing. Often, such sensations are a sign of:

• intervertebral hernia,
• osteochondrosis,
• neuralgia,
• facet arthropathy,
• kidney disease.

Diagnostics

As mentioned above, pain in the sacrolumbar area can be a symptom of many diseases. Therefore, to identify the objective cause, you should see a doctor at the first signs. You can make an appointment with an orthopedic doctor, a neurologist or a surgeon. In the future, you may need to consult a rheumatologist, urologist or gastroenterologist.

• Preliminary examination.The doctor evaluates tissue sensitivity, muscle function, and reflexes in the affected area.
• Radiography.Examination shows changes in the structure of bones, cartilage, and joints.
• Blood and urine tests.With their help, you can determine the presence of infection and inflammatory processes.
• Functional diagnostics.It includes methods to assess nerve conduction and muscle performance - electroneurography, electromyography.
• CT and MRI.Allows detailed examination of the condition of bones, muscles, nerves, and vascular structures.
• Ultrasoundcarried out if pathology of the pelvic organs, prostate, or kidneys is suspected.

It is important to exclude (or confirm the presence of) a tumor, to differentiate between spinal root compression and musculoskeletal pain syndromes. Based on the diagnostic data, the doctor will determine the true cause of the pain and prescribe an effective treatment program.

Is bed rest necessary?

No recommendations for the treatment of lower back pain in diseases of the musculoskeletal system contain instructions on strict bed rest. Instead, patients are advised to return to normal activities as early as possible to avoid the formation of chronic pain syndrome. Strict immobilization is advised for 1-3 days in severe cases, that is, with severe pain. For acute pain in the lower back, you can use a fixation belt. However, long-term lumbar fixation is not recommended unless there is trauma or spondylolisthesis. Gradually you need to include special exercises to strengthen the spine and muscles.

Lower back pain treatment

Often, a combination of drug and non-drug agents is needed to solve the problem.

Medicine

The basis of drug therapy is non-steroidal anti-inflammatory drugs (NSAIDs). They affect the peripheral mechanism of pain formation and are prescribed to aggravate the pain syndrome. In most clinical cases, treatment is carried out in a course - no more than 12 weeks.

In most cases, patients are given B vitamins to improve nerve conduction, decongestants and sedatives. In the chronic course of this disease, it is possible to take antidepressants. For severe muscle spasms and pain - muscle relaxants, weak opioids.

Not drugs

In addition, patients may be given manual therapy, acupuncture (acupuncture). This procedure aims to activate metabolism and blood circulation in the affected area. This allows tissue nutrition to improve.

According to doctors, physical therapy, exercises to strengthen the muscles of the lumbar region, traction therapy, and transcutaneous electrical neurostimulation have little effect. Often, this procedure is prescribed if there is no obvious effect from taking the drug for 4-6 weeks. There is no scientific evidence of the effectiveness of massage, physiotherapy, or wearing various belts.

What to do for prevention

• In the morning, exercise with simple stretching exercises for the spine and muscles.
• Eat rationally, excluding fatty, fried, smoked, salty, spicy, and alcohol.
• Watch your own weight.
• Drink at least 1. 5 liters of fluid (preferably water) every day.
• Once every 6 months, take a classic massage course.
• Avoid being in one position for a long time.

Conclusion

Painful sensations in the lumbar region can be a symptom not only of pathology of the musculoskeletal system, but also of internal organs. Many patients self-diagnose and treat, for example, muscle tension, although in fact the problem may be inflammation of the kidneys. Such treatment only worsens the situation - a person focuses on a non-existent disease and provokes a serious pathology. That is why it is important to seek qualified help and identify the true cause of the pain. Self-prescription of drugs is not recommended at all.